# Taking my NREMT PM Skills exam Saturday..



## rockyfortune (Apr 3, 2014)

wish me some luck..any advice on not losing my head at the wrong time would help too!


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## Mainspring (Apr 3, 2014)

relax and take a breath? 

good luck!


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## rockyfortune (Apr 5, 2014)

thanks man...BTW...I passed the skills today.  It was challenging..not as hard as I expected...I actually credit that to my program.


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## Angel (Apr 20, 2014)

Can you explain how you did the oral scenario?? did you basically just follow the 'medical' scenario sheet adding questions as needed? 

did you treat as you go, or as on the sheet treat toward the end/simultaneously.


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## UnkiEMT (Apr 20, 2014)

Congrats.

For what it's worth, when I did mine, I asked for obvious life threats, treated them, then ran through my assessment, ready to interrupt for any life threats that turned up, then treated at the end. After treatment, ask again for any untreated injuries.

True story: On my oral trauma, the scenario was for an 8 year old hit by a car while riding her bike. One of the injuries that turned up was a femur fx. I misheard and splinted her finger. When I got to the end and asked about the untreated injuries, my examiner mentioned the femur...


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## rockyfortune (Apr 20, 2014)

Angel said:


> Can you explain how you did the oral scenario?? did you basically just follow the 'medical' scenario sheet adding questions as needed?
> 
> did you treat as you go, or as on the sheet treat toward the end/simultaneously.



followed the medical scenario sheet..orally treated everything that was introduced by my evaluator.  I did perform my vitals of bp but I was given pulse, respiration and skin ctc...i had an angina pt who was indicating signs of shock..and who had chewed about ten nitro pills from an expired bottled..i was surprised about how much all was voice treated..especially with my trauma pt.  

taking the written on wednesday of this week..hope it goes as smoothly as my skills did.


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## Angel (Apr 20, 2014)

were you able to write stuff down? I have a hard time remembering vitals. Im gonna do it how both of you said, making sure to ask about life threats. 

besides fluids did you also have to treat with dopamine? right now my mind is completely stuck on county protocols and Im trying to get away from that because national scope is (way) different. 

if either of you doesn't mind, can I PM how I would treat one of your scenarios and you just give me some feedback? Im curious how up to par I am right now vs how much studying I need (ive done tons of oral scenarios but not necessarily following that sheet)

Thanks!!


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## rockyfortune (Apr 20, 2014)

Angel said:


> were you able to write stuff down? I have a hard time remembering vitals. Im gonna do it how both of you said, making sure to ask about life threats.
> 
> besides fluids did you also have to treat with dopamine? right now my mind is completely stuck on county protocols and Im trying to get away from that because national scope is (way) different.
> 
> ...




fire away man...i'm willing to give you any help i can lend you.  

where i am...Pennsylvania..our protocols differ from NREMT..so I stuck with my local protocols...you can write it down on your glove..or on a notepad..when i took my bp..the pt was normal..i gave the normal reading an my evaluator would tell me something else..for example..bp was 120/70..evaluator would say..bp is 170/90...pulse is 90...resp is 25...skin is pale,cool and clammy..etc....

i basically proceeded as i would any medical...abc..transport decision..als yes or no...etc..then proceeded with my sample..opqrst..how i would treat conditions..etc..give me a shout if you need anything else..


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## Angel (Apr 20, 2014)

ok so rocky ill do your angina patient

first is scene safe/bsi
# of pts
need for cspine?
additional resources? (stairs, obese pt ect)
nature of illness

level of consciousness
apparent life threats/chief complaint
general impression

id do ABC's simulataneously
if hes talking to me airway patent
get a quick resp rate based off words in between breaths
check skin signs (color temp condition)
vital signs

o2 based on all of the above, im leaning toward NRB @15 based on what the above reveals.

pt states he had angina so ill ask OPQRST
SAMPLE as well

ask about ED meds

ask why he took 10 pills? (my guess is pain wouldn't go away) so id also run a 12 lead.

if chest pain still active ill give ASA 324mg hold nitro based on BP (Nationally I think its <100mmHg, here is <90mmHg)

check lung sounds if lungs clear give him a bolus of fluids 500mL titrating to adequate systolic BP, trendelenberg position

whats the 12 lead say?
That'll determine if we got to a STEMI center or not

monitor BP (vitals q5) and LOC, dopamine would be my next med if hes still hypotensive and ALOC 10mcg/kg/min

I didn't specifically say it but IV when we gave the bolus...not sure how nitpicky the proctor will be.

Am I close? obviously your feedback may change some of my treatments


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## rockyfortune (Apr 24, 2014)

Angel said:


> ok so rocky ill do your angina patient
> 
> first is scene safe/bsi
> # of pts
> ...




well..im not a medic so the meds part is beyond my knowledge...but all the bls looks good...


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