Brady EMS 12th edition makes me question my training

BLSSam

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I recently moved states and have begun the arduous reciprocity process. I found out I have to take the NREMT cognitive portion so I've been doing a bit of review just to make sure I'm all up to date. In my review I encountered this lovely question (question 18)
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where they seem to be saying if an AED gives you a no shock advised alert you should recheck the pulse and not immediately resume CPR.

This is news to me I was always under the impression you should start pumping the chest the second you get a no shock advised, but now I am questioning everything I know. If it said you are on your third No shock advised sure then you recheck and I've seen local protocols say after the second NSA you should recheck but now I got that last minute test anxiety and have to know the right answer!

Any help for my stupid EMT-B *** would be appreciated haha
 

STXmedic

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I hope that was intended hyperbole...

As to the question, what its getting at is to verify that they're actually pulseless. Since the machine can't distinguish PEA from a perfusing rhythm, they're suggesting confirming its a pulseless rhythm. That does go against what AHA recommends, though.

One thing that you have to realize is that medicine is rarely black and white- it's all different shades of grey. There are numerous opinions and often several correct/acceptable ways to do things.
 
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BLSSam

BLSSam

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I hope that was intended hyperbole...

As to the question, what its getting at is to verify that they're actually pulseless. Since the machine can't distinguish PEA from a perfusing rhythm, they're suggesting confirming its a pulseless rhythm. That does go against what AHA recommends, though.

One thing that you have to realize is that medicine is rarely black and white- it's all different shades of grey. There are numerous opinions and often several correct/acceptable ways to do things.
So when I'm taking the NREMT exam tomorrow if I were to see this exact question you would go with check the pulse?

Also try explaining that nuance to a CAT machine, I'm not new to the field this just threw me in loop. And no hyperbole, I was trained with the AHA association guidelines for defibrillation and this made me question if I was recalling my training correctly haha don't read to much into it!
 

STXmedic

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I'd honestly have probably answered continue CPR, especially since NREMT tends to follow AHA. Whether thats right or wrong, I wouldn't stress it too much. You're not going to fail registry because of a single question.
 
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BLSSam

BLSSam

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I'd honestly have probably answered continue CPR, especially since NREMT tends to follow AHA. Whether thats right or wrong, I wouldn't stress it too much. You're not going to fail registry because of a single question.
Yeah good point I tend to over think things on tests and am pretty committed to knowing protocols 100% accurately so this just kinda threw me in a loop. Thanks for the help man!
 

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