# Retesting NREMT-B Practical



## ConureDelSol (Dec 1, 2011)

So I'm retesting today.  I have to redo Trauma, Medical and longbone splint.  I know what I did wrong on the splint (I got stupid and forgot to splint above and below the joint >.<) but there a few quick things I wanted to get straight about the Trauma and Medical Assessments.

My trauma assessment last time was a woman who had been attacked by a dog.  She had an avulsion wound on her arm.  I know for a fact that I treated the wound correctly, so I don't think that's what made me fail.  I started getting tripped up when she kept on complaining and just going on about how she wanted to get to the hospital.  I'm not sure how I'm supposed to handle a patient like that.  I also felt that doing OPQRST on her was awkward.  Should I only do OPQRST on a medical patient or how should I know when to use it and when not to?

My medical assessment was a man who was awake, but unresponsive.  Obviously I can't get SAMPLE or OPQRST then, right?  So I checked vitals (and I think I did some really bad math when I was nervous) and did oxygen (yes, I did that before vitals).  I did a focused assessment and then was just kind of stumped.  How should I deal with an unresponsive medical patient?  Should I just repeat vitals and assessments and declare him a load and go?  I'm confused.


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## RESQGUY (Dec 1, 2011)

Well, it sucks that you have to re-take it, but here is my take on everything. 

 As far as the trauma pt, if she is asking to go to the hospital and is just making a lot of noise during the AX, I think your instructor may have been waiting for you to quiet her down. He may have wanted you to take control of your scene. The PQRST is a pain assessment technique, but not for trauma. It's usually for(chest pain, Abd pain, etc). 
 For the med ax, if he's unresponsive, you use BRIM. Breathing, responsiveness, eyes, motor. I don't know your scenario, but did you ask if "anyone" @ scene knew the pt? Also, check his body out, almost like a rapid trauma AX, make sure you are checking arms ( OD, eyes, ) Just use your AEIOUTIPS. 

Good luck man...


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## ConureDelSol (Dec 1, 2011)

Apparently there was no one else at the scene as far as I know.  I'll ask this time though.  What is AEIOUTIPS?  I don't believe we learned that acronym.


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## MICP (Dec 1, 2011)

*Aeioutips*

This is an acronym to help remember causes of ALOC.
A = Alcohol
E = Epilepsy, endocrine, exocrine, electrolytes, encephalitis
I = Infection, insulin, ingestion (toxins)
O = Overdose, opiates, oxygen deprived (hypoxia, hypercarbia)
U = Uremia (renal failure), underdose
T = Trauma, temperature
I = Insulin, infection
P = Psychosis, porphyria
S = Stroke, shock, space occupying lesions, syncope, sepsis

You can add causes to the list all day.  This will help get you started.


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## Handsome Robb (Dec 1, 2011)

ConureDelSol said:


> So I'm retesting today.  I have to redo Trauma, Medical and longbone splint.  I know what I did wrong on the splint (I got stupid and forgot to splint above and below the joint >.<) but there a few quick things I wanted to get straight about the Trauma and Medical Assessments.
> 
> My trauma assessment last time was a woman who had been attacked by a dog.  She had an avulsion wound on her arm.  I know for a fact that I treated the wound correctly, so I don't think that's what made me fail.  I started getting tripped up when she kept on complaining and just going on about how she wanted to get to the hospital.  I'm not sure how I'm supposed to handle a patient like that.  I also felt that doing OPQRST on her was awkward.  Should I only do OPQRST on a medical patient or how should I know when to use it and when not to?
> 
> My medical assessment was a man who was awake, but unresponsive.  Obviously I can't get SAMPLE or OPQRST then, right?  So I checked vitals (and I think I did some really bad math when I was nervous) and did oxygen (yes, I did that before vitals).  I did a focused assessment and then was just kind of stumped.  How should I deal with an unresponsive medical patient?  Should I just repeat vitals and assessments and declare him a load and go?  I'm confused.



"Ma'am we are headed to the hospital but I need to get some information from you so I can relay it to the doctors to help them expedite the process when we get there."

Did she fall down when the dog attacked her? If she did, did she hit her head? If she hit her head is she A&O? If not a closed head injury could explain her agitation/repetitiveness and warrant spinal motion restriction for the NREMT practical (although being attacked by a dog is a pretty good reason to be agitated haha).


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