# Practical rules/ guidelines



## WarDance (Jan 24, 2009)

I just took my practical today and aced everything but my trauma.  I was wondering if any of you guys knew what the policy was on letting students know why they failed.  

I had the entire sheet memorized and there was a long deliberation about whether I failed or not going on in the next room.  I could hear some of the things that were being said and I believe that there is a very grey area concerning my failure.


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## Epi-do (Jan 24, 2009)

At every practical I have been at, whether as a student or a proctor/patient, people were not told why they failed.  If you feel you have a legitimate complaint, there are rules/guidelines in place for what can be appealed and how to go about doing it.  It may just be easier to retest the one skill station though.


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## WarDance (Jan 24, 2009)

No I did retest on trauma once already.  The first time I failed I figured out why.  They guy had a sucking chest wound, I didn't see it, I didn't treat it.  I will admit that.

I would like to explain what went on during my retest.  I honestly think it will just make me feel better by explaining it here.  Please point out if you see anything wrong.

First off I was called to the scene of an altercation at a bar where a man was beaten with a baseball bat.  The police were on scene.

I took BSI, the scene was safe (cops everywhere).  I put my partner on c-spine, directed my other partner to take vitals, I put him on O2 15L/ min nonrebreather.  I called for ALS.  The pulse was rapid, breathing fast and shallow w/ paradoxical motion.  BP was fairly normal.  I exposed and found nothing.  I assumed a flail segment.  Based on the vitals I determined that this was a priority patient and we should transport.  I put him on a backboard and went.  I also said I was going to treat for the possibility of shock.  During transport I did a rapid trauma while my partner took vitals.  The rapid trauma was neg. for any other injuries.  The proctor said the respirations were becoming  "agonal and inadequate."  I said we should switch to a BVM with O2 at 15 L/min.  At that point I determined there was nothing more I could do as a basic and the treatment I was already providing would be continued until rendezvous with ALS or arrival at the hospital.

Do you guys see anything there?  I know I don't.


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## Epi-do (Jan 24, 2009)

We have had discussions on here before about flail segments, but if you were taught to splint it, did you remember to do so?  Did you do anything to "protect" the airway?  NP?  OP?  When respirations became agonal did you reasses for a pulse?  I really can't help but think that you did miss something on your assessment, and that there were other injuries.


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## Ridryder911 (Jan 24, 2009)

WarDance said:


> No I did retest on trauma once already.  The first time I failed I figured out why.  They guy had a sucking chest wound, I didn't see it, I didn't treat it.  I will admit that.
> 
> I would like to explain what went on during my retest.  I honestly think it will just make me feel better by explaining it here.  Please point out if you see anything wrong.
> 
> ...



Chances are the patient developed a tension pneumo. With the cursors of a a flail segment with paradoxical movement, immediate splinting and re-assessment of the lower airway should had been initiated. What was the lung sounds? Where they performed as part of the rapid trauma assessment? Not identifying or recognizing a tension pneumo can be grounds for failure. 

NREMT and most states do not allow one to "find out" as this is part of the rules of maintaining credibility. 

R/r 911


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## WarDance (Jan 24, 2009)

I have the 2nd set of vitals.  I forgot I wrote them on my hand!

BP 98/70
HR 120
R 26 

I just realized something.  The proctor described them as "agonal" but there's no way if they were 26.  We were taught not to splint a flail segment...just put 'em on O2 and drive fast.  I don't think it would have made a difference if I would have diagnosed it as a tension pneumo because as a basic treatment is the same....O2 and drive fast.  I have a feeling I heard "agonal" and I just said let's go to a BVM without any thought.  When I heard that word I think "about to die."  Maybe he meant gasping?  

I've just had a really hard time accepting that I failed.  I had one of the highest grades in the class and I've always done well on everything.


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## Ridryder911 (Jan 24, 2009)

WarDance said:


> I have the 2nd set of vitals.  I forgot I wrote them on my hand!
> 
> BP 98/70
> HR 120
> ...



Unfortunately, you were taught wrong. Lower airway obstruction (yes, tension is considered one) should be assessed in detail in rapid trauma assessment. As well, flail segment/paradoxical movement should have been treated as part of the airway treatment. Continuation of paradoxical movement can cause lung, vessel damage. You were not taught even manual stabilization, bulky dressings... as they are definitely in all EMT textbooks?

As per NREMT skill exam sheet Critical Criteria: _...."Did not find, *manage*,associated with airway, *breathing*, hemorrhage or shock, hypoperfusion"...._

Let's refrain from using the emphasis of load and run and more emphasis to examine on the way the possibility of why your patient is crashing.


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## bstone (Jan 24, 2009)

Epi-do said:


> At every practical I have been at, whether as a student or a proctor/patient, people were not told why they failed.  If you feel you have a legitimate complaint, there are rules/guidelines in place for what can be appealed and how to go about doing it.  It may just be easier to retest the one skill station though.



May have been your experience, but certainly not mine. I failed advanced trauma assessment on my first try for Intermediate. I contacted my training facility, the testing company, the state OEMS and even wrote a certified letter to the NREMT asking _why_. Simply saying "you failed" but providing no additional information is ridiculous. In the end I was able to find out from a little birdy that _everyone_ from my school failed due to our instructor and facility teaching us wrong. The school even paid for my retest and the motel stay. I retrained with a medic instructor and passed on my 2nd try.

However, the policy of not telling students why they failed is counter to proper instruction. It's wrong and absolutely must be changed.


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## WarDance (Jan 24, 2009)

I clearly remember my instructor saying, "don't bother to try splinting or anything.  ALS or a hospital is the only thing that will help."  My proctor was someone from a different EMS station.  I'm kind of losing confidence in the program that I just went through.  Did I mention that 5 of the 9 people failed today?  I think that's a good indication that we were not prepared.


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## bstone (Jan 24, 2009)

WarDance said:


> I clearly remember my instructor saying, "don't bother to try splinting or anything.  ALS or a hospital is the only thing that will help."  My proctor was someone from a different EMS station.  I'm kind of losing confidence in the program that I just went through.  Did I mention that 5 of the 9 people failed today?  I think that's a good indication that we were not prepared.



That totally could be the issue. My training facility totally trained us wrong and we all failed. Call the testing company and ask about a good instructor you can study with. I bet you're THIS close to passing. Good luck!


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## Ridryder911 (Jan 24, 2009)

bstone said:


> Simply saying "you failed" but providing no additional information is ridiculous.




It should* NEVER BE CHANGED!* This is a *Board Examination*, not a teaching event! You should have been taught* before *the event. You will never find any credible testing event as what you specifically failed at. Even such as oral boards, are never discussed on what specific you failed at. 

Testing should *NEVER *be confused with the education process and learning portion. By the time the candidate reaches the testing portion they should be well prepared. Again, they are only asking the minimum qualifications to ensure public safety. 

One should be prepared for the examination. Again, it is used for verification for the candidate to demonstrate that they have the knowledge and ability to meet the minimal standard criteria for testing. I personally wish they would no longer even allow the skills sheet to be publicized as it was before. We now have persons passing due to memorization of such and no longer are screened, to show exactly or even details upon the areas of failure is reviewing and coaching. Credibility of the test is immediately lost. 

I have taken several EMS and Nursing Board examinations,  I have yet seen or heard of any that would discuss the test, nor would I ever should expect them to. Tests are designed to screen not teach! 

R/r 911


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## bstone (Jan 24, 2009)

Rid, we will agree to disagree. But that's not really new, is it?

After I finish med school I plan to be actively involved in EMS. I will *strongly* encourage for this to be overturned.


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## Ridryder911 (Jan 25, 2009)

bstone said:


> Rid, we will agree to disagree. But that's not really new, is it?
> 
> After I finish med school I plan to be actively involved in EMS. I will *strongly* encourage for this to be overturned.



Good luck, as soon as you get the USMLE and Law Boards, NCLEX, etc to disclose what specific areas their candidates fail at, NREMT will as well. 


Encourage better education then one will not have this problem. 

R/r 911


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## bstone (Jan 25, 2009)

Ridryder911 said:


> Good luck, as soon as you get the USMLE and Law Boards, NCLEX, etc to disclose what specific areas their candidates fail at, NREMT will as well.
> 
> 
> Encourage better education then one will not have this problem.
> ...



"Better education" is not the issue. The EMS academy I went to is part of a major trauma hospital, has every accreditation (including CAAHEP), every instructor is a state certified I/C (Instructor/Coordinator) and is a paramedic or higher. You get college credit for going there and they are developing agreements to have their medic program to be part of a BS in EMS, at the same time fulfilling the pre-PA requirements for direct entry to New England's largest PA school. It can be very well argued that they have excellent education.

They simply taught us wrong. And because of that everyone who took the NREMT-I failed. Period.

Had we retrained with our institute we would have been re-taught incorrectly. And failed again. And then a third time. Oops! We would have just ran out of chances to take the NREMT-I without additional ALS instruction.

The obvious answer is so very, very clear. Tell people where they are deficient. Then they can go back and do better. Simply giving a blanket "YOU FAILED!" is against all mature philosophies of education.


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## reaper (Jan 25, 2009)

bstone said:


> May have been your experience, but certainly not mine. I failed advanced trauma assessment on my first try for Intermediate. I contacted my training facility, the testing company, the state OEMS and even wrote a certified letter to the NREMT asking _why_. Simply saying "you failed" but providing no additional information is ridiculous. In the end I was able to find out from a little birdy that _everyone_ from my school failed due to our instructor and facility teaching us wrong. The school even paid for my retest and the motel stay. I retrained with a medic instructor and passed on my 2nd try.
> 
> However, the policy of not telling students why they failed is counter to proper instruction. It's wrong and absolutely must be changed.



Before you take your practicals, They will read you a statement that tells you all about this. NREMT is not a teaching or training org. Telling you what you did wrong is considered teaching. They try and stay away from that grey area.

I agree that these schools should make sure that their instructors know what they are doing. But, it does fall back on you. Every EMT text book states that a flail segment should be supported. It is up to you to know what is in the text books!


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## Shishkabob (Jan 25, 2009)

At my school, if you failed a skill you got to see the grading sheet on the day of remakes, but chances are you already knew why you failed during the skill. 

And before anyone says it's some crappy mill type school, it's considered one of the best in Texas and 1 of the only 16 accredited.


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## bstone (Jan 25, 2009)

Linuss said:


> At my school, if you failed a skill you got to see the grading sheet on the day of remakes, but chances are you already knew why you failed during the skill.
> 
> And before anyone says it's some crappy mill type school, it's considered one of the best in Texas and 1 of the only 16 accredited.



Your school is very progressive and should be complimented. Bravo!


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## reaper (Jan 25, 2009)

But was this NREMT testing?

They are not aloud to show you the sheet, when you take registry. 

If it was your school testing, then I think you should be able to know what you need help with.


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## redcrossemt (Jan 25, 2009)

WarDance said:


> I took BSI, the scene was safe (cops everywhere).  I put my partner on c-spine, directed my other partner to take vitals, I put him on O2 15L/ min nonrebreather.  I called for ALS.  The pulse was rapid, breathing fast and shallow w/ paradoxical motion.  BP was fairly normal.  I exposed and found nothing.  I assumed a flail segment.  Based on the vitals I determined that this was a priority patient and we should transport.  I put him on a backboard and went.  I also said I was going to treat for the possibility of shock.  During transport I did a rapid trauma while my partner took vitals.  The rapid trauma was neg. for any other injuries.  The proctor said the respirations were becoming  "agonal and inadequate."  I said we should switch to a BVM with O2 at 15 L/min.  At that point I determined there was nothing more I could do as a basic and the treatment I was already providing would be continued until rendezvous with ALS or arrival at the hospital.




ABC's in order... 

A. Did you ever verbalize something about airway? E.g. "Do I hear any respiratory noises? No? Okay, the patient's airway is patent because he's breathing" or just perform a jaw-thrust maneuever from the beginning...

B. Proctor says "shallow", you say "BVM". You have to be careful here because of the flail chest, but positive pressure ventilation is still indicated for patients with inadequate tidal volume.

C. Did you immediately check a pulse, skin color, and assess for major bleeding? You can't do anything else first.

You also could have lost a few points for MOI/nature of illness, number of patients, thinking about additional help, etc. if you didn't mention it. Could just be that you didn't write it here.

In any case, to fail, you probably hit one of the following critical criteria:


Failure to assess/provide adequate ventilation (No PPV despite being told "shallow" breaths)
Failure to find or appropriately manage problems associated with airway, breathing, hemorrhage or shock [hypoperfusion] (no airway maneuever or assessment, no treatment/splinting of flail chest, no assessment of circulation/hemorrhage)
Does other detailed/focused history or physical exam before assessing/treating threats to airway, breathing, and circulation (ordered partner to take vitals before checking ABC's)

The skill sheet for Basic Trauma Assessment/Management can be found on NREMT.org at http://www.nremt.org/nremt/downloads/patientassessmentmanagementtrauma.pdf.


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## Ridryder911 (Jan 25, 2009)

So many students blame instructors for their failure. In reality, with the disclosure of NREMT skill(s) sheets, how can really fail and in point blame an instructor? Even if they were not taught each specific area, it is right there in plain written sight of what is expected. Step by step, and even more so what will automatically fail you and as long as one performs a decent performance examining all areas, and or recognizing and identifying life threatening injuries; one should be able to pass. 

As an educator I feel that it is my responsibility to know how the license and certification examinations are performed. It does not matter how well I instruct and educate an individual if they cannot ever receive their license. One maybe one of the brightest and sharpest individual, but unless they can meet the States requirement it will not matter. So again, I re-taking proctor course to become one. To test other schools and candidates and to witness the "flow" of the testing arena. Again, just part of the responsibility of teaching. 

R/r 911


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## WarDance (Jan 25, 2009)

I asked what my breath sounds were and he said "shallow and absent on the right side."  I but him on a nonrebreather @ 15L to start out with.  Then I switched to a BVM when the proctor said the respirations were "agonal."  I have a feeling I missed something on airway.

I have to come in and practice over the next couple of weeks.  I think I'm going to ask if I can run a trauma scenario where a guy got hit with a baseball bat and has a flail chest.  I'll run it exactly like I did yesterday and then see why I fail.  There's nothing wrong with that, right?

I don't know if I should look for another place to test sooner than 3 weeks or if I should just wait and retest at the same place.  I think I might be freaking out because I know everyone there.  My patient yesterday was a guy I know.  I nailed my medical and my patient was some random girl I don't know.  I might feel more detached and professional if I don't know anyone there.  

NREMT is the only testing service I have encountered that won't tell you what you did wrong.  College Board will return your SAT answers, the correct answers and the test book if you ask.  They will also do the same for Advanced Placement.  They'll even give you back your essays if you ask.  I think the fact that you can find out what went wrong on their tests makes them the most respected testing service in the country.  It is also probably what allows them to write such accurate tests.  

On another note, I believe that NREMT should let you see your sheets even if you pass.  It can be a learning opportunity since it is still possible to pass and not hit everything on the sheet.  Something a passing candidate missed may not have been critical but it would still help someone provide better patient care.  Isn't good patient care what NREMT strives for?


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## redcrossemt (Jan 25, 2009)

WarDance said:


> I asked what my breath sounds were and he said "shallow and absent on the right side."  I but him on a nonrebreather @ 15L to start out with.



No need to assess breath sounds. Do your ABC's first!! You don't auscultate breath sounds 'til further down the list, as I understand it. Think of the beginning as your CPR or airway station....

1. "Sir, sir, are you okay?" Open airway. 
2. Breathing? If not, or if inadequate (shallow/slow), start bagging. 
3. Pulse? Check pulse and for bleeding and shock. 
4. Rapid trauma exam.... Lung sounds, pupils, DCAP-BTLS, etc.

You would have needed to start bagging him immediately to pass. I called a couple NR proctors, and when they say inadequate or shallow breathing, you need to immediately provide positive pressure ventilations via BVM, and attach the BVM to oxygen. It's a critical criteria (Failure to assess/provide adequate ventilation). They also said they could fail you for listening to lung sounds before opening the airway.


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## WarDance (Jan 25, 2009)

redcrossemt said:


> No need to assess breath sounds. Do your ABC's first!! You don't auscultate breath sounds 'til further down the list, as I understand it. Think of the beginning as your CPR or airway station....
> 
> 1. "Sir, sir, are you okay?" Open airway.
> 2. Breathing? If not, or if inadequate (shallow/slow), start bagging.
> ...



I actually said "I'm assessing his breathing" and I got # of respirations, breath sounds and adequacy all at once from the proctor.  Well I guess I know why I failed now.  It really helps alot.  

Now the argument that I heard about whether I passed or failed doesn't make sense....oh well.


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## bstone (Jan 25, 2009)

What did you hear through the doors?


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## marineman (Jan 26, 2009)

bstone said:


> "Better education" is not the issue... It can be very well argued that they have excellent education.
> 
> They simply taught us wrong.



Ok let me get this straight now, you went to major trauma blah blah blah with wonderful certified educators who taught you something that was wrong and you feel it's the national registries fault because your educators were certified?

There is no reason to inform people as to why they failed, in fact it is counter productive. If you fail the first time there are two reasons, either you forgot it or you don't know it. If you forgot it there is no reason you shouldn't be able to pass the second time after having some time to think about it and run through it in your head. If you just plain old don't know it there's no reason you should be allowed to pass the test. Are you hoping that if you fail the written they will send you a list of all the questions you got wrong along with the correct answers? I'm sorry you were taught wrong and I really hope that you brought it to your schools attention after you found out where you went wrong but expecting the NREMT to change it's practice in case bad educators still exist is just a ridiculous idea. All the sheets are posted online and you can print them off and memorize them word for word, I have a hard time putting all of the blame on the school as it seems far fetched that they would teach you something that goes against a critical criteria.


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## marineman (Jan 26, 2009)

redcrossemt said:


> No need to assess breath sounds. Do your ABC's first!! You don't auscultate breath sounds 'til further down the list, as I understand it. Think of the beginning as your CPR or airway station....



I'm much too lazy to look right now but not long ago we had a discussion about this very subject and a very good case was made for listening to lung sounds immediately when assessing the breathing.


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## bstone (Jan 26, 2009)

marineman said:


> Ok let me get this straight now, you went to major trauma blah blah blah with wonderful certified educators who taught you something that was wrong and you feel it's the national registries fault because your educators were certified?



This couldn't possibly be further from the truth. But I did get a good laugh at this. 



> There is no reason to inform people as to why they failed, in fact it is counter productive. If you fail the first time there are two reasons, either you forgot it or you don't know it. If you forgot it there is no reason you shouldn't be able to pass the second time after having some time to think about it and run through it in your head. If you just plain old don't know it there's no reason you should be allowed to pass the test. Are you hoping that if you fail the written they will send you a list of all the questions you got wrong along with the correct answers? I'm sorry you were taught wrong and I really hope that you brought it to your schools attention after you found out where you went wrong but expecting the NREMT to change it's practice in case bad educators still exist is just a ridiculous idea. All the sheets are posted online and you can print them off and memorize them word for word, I have a hard time putting all of the blame on the school as it seems far fetched that they would teach you something that goes against a critical criteria.



Or a third reason- you were taught wrong. If you're taught wrong then you can be caught up in an endless cycle of continuing to be taught wrong, failing, going back and being taught wrong again, failing, etc. Logically, if you are being taught wrong by a certified instructor in a certified training facility then you must be told this by an outside entity- in this case the testing organization- in order to get the correct training. It behooves the training organization to ensure that it identifies patterns of failure and report it to the training facilities in order to ensure that a full loop of communication and reporting it made. Otherwise things go into a nebulous void and never get resolved.

The institute I went to felt so bad they paid for my re-test and even the motel stay. The instructor was canned, as well, but not until the following class also had a 100% failure rate on the same test. In fact, just today I was this institute for my refresher course and I was speaking to another instructor there who said she was aware of the then-Intermediate instructor in teaching the class wrong. It seems the state OEMS was alerted to this and other issues about him and he was removed from instructing at all.


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## marineman (Jan 26, 2009)

So now what you're saying is your instructor really wasn't that great? I would agree that he wasn't that great because he taught you something wrong. At the end of the day the national registry has one job and that is to test us on the information not teach us just in case we had a bad instructor that taught us the wrong thing. Like I said it's unfortunate that you wasted so much time and ran in so many circles due to a poor instructor but that's no reason the national registry should change it's guidelines. 

Out of curiosity what part was it that you were taught wrong that caused you to fail? I understand instructors having different methods but between a text book, a state SOP book and various other assistant instructors in the room helping with practice I can't figure out what part would have gone unnoticed.

P.S. your third reason of being taught wrong fits into my second reason category, unfortunate but that's life.


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## bstone (Jan 26, 2009)

marineman said:


> So now what you're saying is your instructor really wasn't that great? I would agree that he wasn't that great because he taught you something wrong. At the end of the day the national registry has one job and that is to test us on the information not teach us just in case we had a bad instructor that taught us the wrong thing. Like I said it's unfortunate that you wasted so much time and ran in so many circles due to a poor instructor but that's no reason the national registry should change it's guidelines.
> 
> Out of curiosity what part was it that you were taught wrong that caused you to fail? I understand instructors having different methods but between a text book, a state SOP book and various other assistant instructors in the room helping with practice I can't figure out what part would have gone unnoticed.



So now that you see and understand that having a poor (albeit certified) instructor can lead to test failure, I do not see how you can stand by your assessment that there can be only two causes of test failure- lapse of memory or missing something.

Our instructor repeatedly taught and told us to BLS the "advanced trauma patient assessment" station. He told us not to start IVs, not to intubate, not to apply a monitor. He tested us in depth and hammered this point home. All of us who went in and BLSed this station all failed it. Failure to start an IV it is immediate failure for this ALS station. However we simply did that our instructor and training facility repeatedly taught us to do. Remember, the instructor is a medic and certified. The facility is also CAAHEP certified. Months and months later a kind little birdy told me why we failed, but it took a lot of pleading and appealing to intellect to get this info. Once I realized 
this I found a medic instructor who went over the test with me and I passed on my next attempt.

However, some of my fellow students were not so lucky. They took the station three times in one year, failing each time. They had to do remedial ALS training before they were allowed to take ALL the practicals again.

Thus, feedback on specific points of failure is essential to a student. They may not have forgotten anything or messed anything up. They simply were taught wrong and suffered the consequences for it.


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## marineman (Jan 26, 2009)

I will stand by my assessment that because you were taught wrong, you simply didn't know aka reason #2 for failing it. Not saying it's your fault but in the simplest form you didn't know so you failed. That said I will also stand by the point that all of the NR check sheets are available online and yes IV is stated on the ALS version of the rapid trauma assessment so again while it stinks that you got stuck with an instructor that told you something wrong I don't feel bad for any of the students that failed because if they failed 3 times without looking at the check sheet and seeing that IV therapy is stated on there you cannot blame an instructor. Use all resources available to you in order to understand what you will be tested on and you will do just fine. Take short cuts and expect everything to be spoon fed to you and you can see the results.


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## redcrossemt (Jan 26, 2009)

marineman said:


> I'm much too lazy to look right now but not long ago we had a discussion about this very subject and a very good case was made for listening to lung sounds immediately when assessing the breathing.



I agree that a good case can be made for listening to lung sounds immediately, especially at the ALS level (you can fix a pneumo, and should right away). At the BLS level, I think it's okay... although it wouldn't really change treatment much.

In any case, this poster got respiratory rate, depth, and lung sounds at the same time but failed to act on inadequate respirations; probably hitting a critical criteria.


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## BossyCow (Jan 26, 2009)

redcrossemt said:


> I agree that a good case can be made for listening to lung sounds immediately, especially at the ALS level (you can fix a pneumo, and should right away). At the BLS level, I think it's okay... although it wouldn't really change treatment much.
> 
> In any case, this poster got respiratory rate, depth, and lung sounds at the same time but failed to act on inadequate respirations; probably hitting a critical criteria.



Not everything we do is to determine our treatment. Being able to tell that during my 30 minute transport the missing lung sounds in the lower lobe cleared up with the neb tx enroute or that the original lung sounds equal bilaterally changed en route is information that is important. 

This is similar to the BLS discussion on another thread. There is value in getting information about the patient, even if its something BLS can't treat. Being able to show glucose readings that are getting better or worse or remaining stable is good. So what if I can't give glugagen, the ER has a better idea of what's going on with the pt than if they arrived by taxi. 

If the pulse ox (combined with a proper visual assessment of perfusion) shows a steadily declining O2 sat or one that gets slowly better, this is good information. Or with the pt I had with pulmonary embolisms (yes plural) her sat would plummet suddenly then rise again. 

BLS is to stabilize and transport. Determining if a pt is stable or not is done by monitoring their vitals. Even if it doesn't 'affect their treatment much'


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## TechWho (Jan 30, 2009)

Only tangentially relevant, but shortly after reading this thread, I ended up with at least one question regarding flail chest on my written exam and recalled a lot of the discussion here. Thanks folks! :blush:


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## WarDance (Jan 30, 2009)

So I did fail because I didn't splint it.  I asked a hypothetical question last night and found out.  I also did very well on every trauma scenario I ran through last night.  I think our medic instructor just made me so afraid of the fact that basics can't do much I got way too into the priority patient thing.

Now I just have to worry about forgetting all of those other stations I had memorized before I retest.


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