Do you agree with this statement?

[ironguy321]

I remember my instructor telling us...

"If you forget everything in this class, ALWAYS remember ABC and you'll be ok"

Agree or disagree?

 

[emtwacker710]

I'm gonna have to agree with that, as ABC's are the very first thing you do while assessing a pt. because if you don't have ABC's then there is really nothing you can do until you correct them, and if you really did forget everything from class except ABC's by the time you finish those someone else should be arriving

 

[MedicPrincess]

Absolutley....definantly!!! And remember, just because you have covered the ABC's when that patient that is hootin and hollerin, screamin and yellin....suddenly sits straight up, holds onto the rails of the stretcher, and in a normal volume voices says to you.... "I am about to die now!'.....remember you are about to go straight back to the A...get ready to catch her because she is probably 400lbs and going slump to the right any second!...

Oh wait...thats how my luck goes....


Yes....when you get stumped, go back to ABC's. The nice thing about that is when your testing, it buys you a little time as well. If you can't think of what to do next, you can always ask for another set of vitals, their respiratory status, ect.....

 

[skyemt]

I remember my instructor telling us...

"If you forget everything in this class, ALWAYS remember ABC and you'll be ok"

Agree or disagree?

if you do that, you will be only slightly more qualified than a layperson...

you will have no physical skills, no assessment skills, etc...

he is trying to make the point about the ABC's... if something could kill the patient in the next few minutes, FIX IT FIRST!

however, it is NOT literal...

if that's all you remember, you wouldn't deserve to even call yourself a Basic, which is saying a lot.

 

[MedicPrincess]

Where that instructor and all the other ones that use are are going with that is when all heck is breaking loose....your first on scene of that 12 car pileup with multiple ejections/entrapments and that pregnant woman giving birth while in the over turned vehicle......or your patient codes in front of you....

When you suddenly have your AH CRUD meter pegged....take a second, to take a deep breath....remember your training....and start from the beginning.....

 

[skyemt]

Where that instructor and all the other ones that use are are going with that is when all heck is breaking loose....your first on scene of that 12 car pileup with multiple ejections/entrapments and that pregnant woman giving birth while in the over turned vehicle......or your patient codes in front of you....

When you suddenly have your AH CRUD meter pegged....take a second, to take a deep breath....remember your training....and start from the beginning.....

very true...

however, i believe that this mentality is producing many EMT's who believe that if they assure the ABC's are ok, they don't really have to do anything else...

i have seen it in my own agency... there is little attention paid to skilled history taking, and other skills, and it is due to the ABC's being emphasized at the cost of all else...

yes, they are Vital... but there is more to it than that... but, this is why there are two week programs, and why Basic's are looked at in a , lets say, less than stellar light...

 

[Airwaygoddess]

Yes, the ABC's are the very first part of the patient's assessment, which is very important, but it is just as important to also carry out the rest of the assessment. This helps provides a clear picture of the patient's medical history for the EMT, and provides a good hand off report to the medic, which in turn, the transfer of care of the patient when the patient arrives at the ED. Part of the assessment is also being the patient's advocate.

 

[Jon]

Your instructor was joking, to an extent... so don't take it 100% literally.

But, he has a point... ABC's are a good start. BUT: they ARE just a start.

As Princess said... when the :censored: really hits the fan... and you have NO IDEA what to do first... worry about the ABC's... then you'll come up with a "next step" and take care of that... and so forth.

What do we do when we do triage? We check ABC's, and if we can change anything (reposition airway, control severe bleeding) we do that... and then move on.

 

[BossyCow]

Like most quotes taken out of context, its difficult to understand.

I can see, I think what he meant. When you are in a total thrash call, being able to remember ABCs is a good starting point. Allowing yourself to be distracted by other injuries and missing the thing that's going to kill them while you work on those, is an easy trap for new EMTs to fall into.

Do I think that ABCs are all we need to do? Of course I don't and I doubt that's what the instructor meant.

Do I think that the instructor was trying to dumb-down the program? Maybe, maybe not, Without hearing the whole presentation, ior knowing the instructor, t's impossible to say.

I believe that if you can get a new EMT started with ABCs on every call, it can kickstart the process they learned in school and move the booklarnin' out of their heads and into their hands. Often a brand spankin' new EMT can be overwhelmed when they have to care for their first, very own patient. I interprete this comment as an instructor, giving those new EMTs something to cling to at that moment, to silence the worry and initiate the care.

Of course, I'm sure there are those who will take it all very differently.

 

[JPINFV]

I think a better mantra than "insure ABCs if you don't know what else to do" would be to follow the 3rd law of the House of God.

"The first procedure at a cardiac arrest [or when ever all hell has broken loose], is to take your own pulse."

Take a second, calm down, and focus. The problem isn't neccessarily poor education. The simple fact is that stressful situations hamper your ability to recall information. So, especially if you're new, you are going to have problems on your first calls making sure that you do what you need to do. It's not necessarily a character fault (not neccessarily not a character fault either), but biology.

 

[ironguy321]

Often a brand spankin' new EMT can be overwhelmed when they have to care for their first, very own patient.

I'm glad you said this because I'm in that boat at the moment. I want to be an EMT to help people and gain experience to be a paramedic or a FF/EMT but at the same time I'm afraid of messing things up. It's a twisted web I've spun:wacko:

 

[Webster]

While obviously you'll be able to do more than just ABCs, those three things are the meat and potatoes of patient care, in my opinion. Other treatments can be executed after them, but the lack of any of an open Airway, Breathing, or Circulation makes it so you can't do anything else.

 

[Chimpie]

.... but at the same time I'm afraid of messing things up. ...

Oh, don't worry. You're going to mess things up. You'll put something in at the wrong angle, you'll move something to the left when you should have moved it to the right, you'll make the face of "oh :censored: I just f'd up" in front of your patient. The thing to do is admit your mistakes, correct them, learn from them, and move on.

 

[skyemt]

While obviously you'll be able to do more than just ABCs, those three things are the meat and potatoes of patient care, in my opinion. Other treatments can be executed after them, but the lack of any of an open Airway, Breathing, or Circulation makes it so you can't do anything else.

this is just the type of thinking that promotes inadequate patient care...
the ABC's are NOT the meat and potatoes of patient care...

of course, for the very small percentage who need life saving interventions, then yes... they are the meat and potatoes... what about the other 99%?

will you just do nothing, since they are not going to die in the next ten minutes?

As others have said, the ABC's are a starting place, not the end.

 

[ffemt8978]

While obviously you'll be able to do more than just ABCs, those three things are the meat and potatoes of patient care, in my opinion. Other treatments can be executed after them, but the lack of any of an open Airway, Breathing, or Circulation makes it so you can't do anything else.

this is just the type of thinking that promotes inadequate patient care...
the ABC's are NOT the meat and potatoes of patient care...

of course, for the very small percentage who need life saving interventions, then yes... they are the meat and potatoes... what about the other 99%?

will you just do nothing, since they are not going to die in the next ten minutes?

As others have said, the ABC's are a starting place, not the end.

I believe this is the same philosophy, just worded different. If you don't do the ABC's first, how do you know if you need to give your life saving interventions?

 

[LucidResq]

this is just the type of thinking that promotes inadequate patient care...
the ABC's are NOT the meat and potatoes of patient care...

of course, for the very small percentage who need life saving interventions, then yes... they are the meat and potatoes... what about the other 99%?

ABCs are not just for the "the very small percentage who need life-saving interventions", unless you think that "A" just means "do they have an airway?", "B" means "are they breathing?" and "C" means "do they have a pulse?". If you expand what you're thinking about when you think ABCs, then yes, they are definitely the meat and potatoes for 99% of patients, actually.

Airway - do they have one? If yes, are they at risk of losing it due to the MOI/NOI? FBAO? Epiglottitis? Anaphylaxis? Unconsciousness leading to obstruction by tongue? Angioedema? Do they need suction? OPA, NPA or Combitube?

Breathing - what's the general rate, quality, and work of breathing? Breath sounds? Pain upon breathing? Coughing? Blood or fluid being coughed up? History? Medications? Chest movement? Percussion? Trachea position? Paradoxical movement? Oxygen?

Circulation - general pulse quality and rate? Bleeding? (either related or unrelated to trauma**), Skin color, temperature and condition? Blood pressure? History? JVD? Shock?

I know that this bleeds the ABCs into the rest of your assessment, but when you think about the vast number of conditions that involve mostly one of the ABCs, it makes sense: asthma, pneumonia, stroke, MI, a broken ankle, some frequent flier with a cough... serious or not, an ABC problem, no matter how minor, is often the root of a patient's problem.

One time I provided care for a man that clearly did not have a life-threatening problem at all just by looking at the ABCs... he came up to me and calmly told me that he had accidentally cut his finger (okay... the As and Bs seem good) but I looked at this finger and it was indeed bleeding (uh oh... C problem) so I put a bandaid on it.

 

[JPINFV]

That's an extreme expansion of problems then. A very large percent of medical problems are then considered to be an ABC problem. Renal? Yep, that's a C. Left side CHF? B and C. Fever? Possible sepsis, so that's another C.

So, yes, expanding ABCs to consider every possible event or disease that can affect one of those, is yes, not using it properly. It's like saying a bruise and a arterial bleed are equals since they're both problems with C (bleeding).

Of course to muddle the waters further, cardiac problems can present as breathing problems. So, your patient is hypoxic and breathing decently. Is it because their anemic ("C" problem), V/Q mismatch (C OR B problem, and not neccessarily helped or hindered by supplemental O2), etc?

 

[skyemt]

ABCs are not just for the "the very small percentage who need life-saving interventions", unless you think that "A" just means "do they have an airway?", "B" means "are they breathing?" and "C" means "do they have a pulse?". If you expand what you're thinking about when you think ABCs, then yes, they are definitely the meat and potatoes for 99% of patients, actually.

Airway - do they have one? If yes, are they at risk of losing it due to the MOI/NOI? FBAO? Epiglottitis? Anaphylaxis? Unconsciousness leading to obstruction by tongue? Angioedema? Do they need suction? OPA, NPA or Combitube?

Breathing - what's the general rate, quality, and work of breathing? Breath sounds? Pain upon breathing? Coughing? Blood or fluid being coughed up? History? Medications? Chest movement? Percussion? Trachea position? Paradoxical movement? Oxygen?

Circulation - general pulse quality and rate? Bleeding? (either related or unrelated to trauma**), Skin color, temperature and condition? Blood pressure? History? JVD? Shock?

I know that this bleeds the ABCs into the rest of your assessment, but when you think about the vast number of conditions that involve mostly one of the ABCs, it makes sense: asthma, pneumonia, stroke, MI, a broken ankle, some frequent flier with a cough... serious or not, an ABC problem, no matter how minor, is often the root of a patient's problem.

One time I provided care for a man that clearly did not have a life-threatening problem at all just by looking at the ABCs... he came up to me and calmly told me that he had accidentally cut his finger (okay... the As and Bs seem good) but I looked at this finger and it was indeed bleeding (uh oh... C problem) so I put a bandaid on it.

sorry, i'm not sure what your point is... the ABC's are to correct IMMEDIATE LIFE THREATS, or threats that could kill the patient in the immediate future.

i'm not sure how many calls you have been on, but out of thousands, the percentage who were in immediate life danger is small, at least here.

of course, there are a million things in theory that can go wrong, etc...
but, i'm looking at what percentage of our patients have are at risk of immediate life threats and it is small.

sorry to take away some glamour, but that's just the way it is.

 

[firecoins]

If your patient is having a critical problem Airway Breathing and Circultion

If your patient is not having a critical problem, Ambulate BeforeCarry

works for me.

 

[certguy]

Once the scene is safe for you and your partner , ABC's come first and formost for ALL pts. If these aren't intact , the rest doesn't matter .