# NREMT-P Random Basic Skills



## bosox (Jun 10, 2010)

So..took my practical today..and failed supine spinal twice.  The biggest issue is I cannot, for the life of me, figure out what I did wrong.  
1. Scene Safe/BSI
2. Instructed partner for manual in-line immobilization 
3. Checked csmx4
4. Sized collar/Applied collar
5. Had person at head count while I log rolled and had tester slide board in (maybe both of us should have log rolled??)
6. Placed pt. on board, had person at head count while we moved pt. up and to their left (had to make two adjustments)
7. Void Space Padding (none present so none were applied)
8. Pelvis/Chest/Legs (ensure pt. took a deep breath, ensure pt. could breathe after)
9. Secured Head
10. csmx4 and transport

So I have no idea what I did wrong, I have played it out in my mind over and over again.  I cannot go through this all over again and I only have one shot to pass random basic...any thoughts or words of wisdom?


----------



## TransportJockey (Jun 10, 2010)

Only thing I'm seeing might be the log rolling thing, but other than that it looks ok


----------



## Stephanie. (Jun 10, 2010)

Hmmm... Was it the same 'judge' both times?


----------



## red_head (Jun 10, 2010)

I'm kind of digging here, but was it the straps? You said pelvis/chest/legs. Were there 2 straps on the legs (I'm assuming yes) If you completely spaced it (doubtful) and used 3, then perhaps there's your answer.

Maybe they were picky about placement? I remember our instructor used to always tell us nipple,navel,nuts,knees. (They are not exactly where you should put the straps but in the general vicinity. I always strap a little above the fullest part of the boob(for women, but gives a better picture as just to where), hips, upper thighs, and right below the knees.

I remember our instructor stressing how important the placement of the top strap was (or 2 if you do the criss-cross thing). You have to make sure it wouldn't in anyway get in the way or prevent you from performing CPR if necessary.


If you did all these things, maybe you failed for the good old reason of excessive movement?


----------



## EMT1 (Jun 10, 2010)

Did you assess airway and breathing after taking C-spine?


----------



## rescue99 (Jun 10, 2010)

bosox said:


> So..took my practical today..and failed supine spinal twice.  The biggest issue is I cannot, for the life of me, figure out what I did wrong.
> 1. Scene Safe/BSI
> 2. Instructed partner for manual in-line immobilization
> 3. Checked csmx4
> ...



You secured the head before the legs? It isn't an auto fail though.


----------



## TransportJockey (Jun 11, 2010)

rescue99 said:


> You secured the head before the legs? It isn't an auto fail though.



I'm curiouse where you see that? She said pelvis/chest/legs then head...


----------



## akflightmedic (Jun 11, 2010)

Please review this link.

On page 2 are the instructions to the candidate which state you are to use the evaluator to assist in rolling the patient. It also states you have 10 minutes to perform this skill.

http://www.emetropolis.com/flash/study/SKILL.PDF

However, none of those are critical fails according tot he checkoff sheet but there are a few critical fails which are subjective in nature.

Did you have the same evaluator both times? I did not think that was allowed if you did.

Further down on page 9 is the check off sheet, so if the patient had excess movement during this process or head was not inline or you had your partner release cspine prior to being completely secured...those could have failed you.


----------



## ExpatMedic0 (Jun 11, 2010)

I got MAST pants on my first random, failed the **** out of that lol


----------



## Shishkabob (Jun 11, 2010)

Something I'm seeing;

You checked CMS, applied the collar, then didn't check CMS again until the end.  I've been taught to always check CMS after doing something that can manipulate the spine... which putting the collar on does.


When I did my supine, I did CMS, collar, CMS, board, CMS.


----------



## TransportJockey (Jun 11, 2010)

schulz said:


> I got MAST pants on my first random, failed the **** out of that lol



Heh, I'd be one of the few I know here in CO that would get that right. NM still pushes MAST in the basic curriculum... Hell, I'm one of the only EMTs my age I know that's actually used them for more than pelvis stabilization


----------



## bosox (Jun 15, 2010)

First off, thanks for all of the replies.  I have replayed the situation dozens of times in my head (and looked at that skill sheet/examiner instructions until my eyes started to bleed) and the only conclusion I have come to is that it was the log roll.  I am just going to be sure that I do everything PERFECTLY when I re-test. I definitely don't want to take the whole exam again!  I was pretty bummed at first, but now I am able to laugh about it!  Aced all the hard stuff, and failed something I have been doing for years! Written is coming up so I need to focus on that instead.


----------



## bosox (Jun 16, 2010)

Well..took the written today...and passed!  So all that is left is the random basic station.  So I just had a few quick questions for you guys. If you have one trained EMT-B assistance and the tester with you, how would you go about log rolling the patient and slide the board in?  My thought is have the assistant holding C-Spine (with collar applied) and then place board at patient's side.  Then have tester grab slightly above pelvis (crossing arms with mine) and the mid thigh, with my hands being on the shoulder, and slightly below the pelvis.  Then have the person at the head call the roll, roll the patient towards us, sweep the back, then lean over the patient and insert the board at an angle, with now tester and I both holding patient and board, then slowly lowering patient to board.  What do you think (beyond the obvious run on sentence).  Second question...if you need to move the patient to one side on the board, would you like to move the pt. up and to the side or down then up?  Any help would be greatly appreciated.  Thanks.


----------



## bosox (Jul 18, 2010)

Thanks to everyone who replied. Re-took the exam and passed.  Finally done ^_^  Thanks again for all your help!


----------

