I was just typing a facebook message to somebody that posted in a group I'm in asking for help for their EMT patient assessment practical exam. I ended up not sending it to them, but decided to post up some of the information I was going to send here.
1. Patency (open and unobstructed)
1. Respiration vital sign without rate
2. Consider administering oxygen
1. Check for uncontrolled life threatening bleeds
2. Pulse vital sign without rate
3. Check skin signs
If you can count to potato, you can be an EMT. Airway has one thing for you to consider, breathing has two things for you to consider, circulation has three things for you to consider. It's a nice checklist. Some schools like to break it by teaching students to do lung sounds at A or B though.
In addition to ABC123, I've seen some schools teach ABCD, D for disability (mentality). I find that confusing, but if it works for the student, why not also complicate it more by making it ABCD1234, four things to ask for disability (mentality): Person, Place, Time, and Event (I've seen some places teach Person, Place, Purpose, and Time).
For skin signs, check for CTCTC: color, temperature, condition (moisture), turgor, and capillary refil. A lot of schools just teach color, temperature, and moisure, but made this one up awhile ago after I saw online somebody saying CTC, and thought CTCTC was better, lol.
These are super helpful! I finished my EMT-B course in December and this is a great way of keeping everything fresh in my mind while I look for a job. Some of them I hadn't heard before. Me and one of my classmates are quizzing each other to see what we'd forgotten.
This really helped me in class on skills nights. I wrote it on my palm as a crutch instead of having to refer back to the paper.
Your ENTIRE medical assessment for the registry can be broken down into mnemonics – (BSMAC-GACCAT-OPQRST-SAMPLE-FVIT)
We’re going to go into each category and explain, but instead of trying to remember every single line of the assessment in order, this is a way to remember the whole list simply. All critical failure criteria is in red.
1. B-SMAC is the first section of the assessment, they are the first thing you do on a scene.
2. GACCAT – is your initial assessment. It stands for:
ABC’s (good Airway?, O2 and Breath sounds? Skin color, temp, condition?)
Transport Decision – Load and Go now (There are no stay and play scenarios in the registry practical!)
3. OPQRST-I : These are slightly different based upon the type of medical call. We will use Chest pain as an example.
Onset- when did this start?
Provocation – what started it?
Quality – how would you describe it?
Radiation – Does the pain travel anywhere?
Severity – Scale of 1-10, how severe?
Time – How long has this been going on?
Interventions What have you done about it?
4. SAMPLE -This should be familiar!
Signs and Symptoms – chief complaint and pertinent findings
Allergies – Are you allergic to anything?
Medications – What prescription medications do you take on a regular basis?
Past Med Hx – History of present illness (Has anything like this happened before?)
Last Oral Intake – When was the last time you had anything to eat or drink?
Events – What was going on just prior or leading up to the problem today?
5. FVIT – Once again, we’ll use EMT chest pain protocol as an example.
Focused History (Verbalized)
Interventions – Nitro Example, but similar for all meds
1 Get orders for nitro (0.4mg sublingually) or state that you have a standing order
2 Check expiration date, right patient right dosage, right drug, make sure fluid is right consistency and color (not precipitated) , check for contraindications
3 Explain to patient effects of Nitro and reason for administration; doublecheck systolic over 100 and no ED meds or hx of sensitivity
4 Administer 1 spray or tablet of 0.4mg nitro under the tongue
5 Monitor for changes every 5 minutes (if poor, repeat 1-5 to a max of 3 doses.)
Transport (Reevaluate transport decision)
Now look at the national registry skillsheet for EMT Medical or Paramedic Medical
Try to break it down in your mind so you can see the mnemonic
B-smac – Bsi, Scene safe, Mechanism, additional units, C-spine
Gaccat – General imperssion, Avpu, Chief complaint, ABCs, Transport
OPQRST - SAMPLE ( you know these!)
F-VIT – Focused, Vitals, interventions transport
I personally don't find it useful, but we were required to learn SIN in my First Responder Awareness (FRA) - Hazmat class and additionally CIA, PCP, and DDD for First Responder Operational (FRO) - Hazmat. I did find learning how to understand the NFPA 704 and how to use an emergency response guidebook (ERG) useful though. FRO will be required by Santa Clara County in California by 2013 for those of you who are interested in working there.
SIN Safety Isolate and Deny Entry Notification
CIA Command/Managment Identification and Hazard Assessment Action Planning
PCP Protective Equipment Containment and Control Protective Actions
DDD Decontamination and Cleanup Disposal Documentation
One I just mentioned in another post.... some areas consider this to be their vital signs or things necessary to reassess after every 5/15 minutes of transport ir when there is a significant event e.g. med admin or patient condition changes.
This is great! I'm terrible with searching out mnemonics, so this will definitely come in handy with my class.
One thing I'd suggest, though-- could we add measurements to it, as well? Like for instance, I remember that SpO2 is supposed to be 97-100% (95-mild hypoxia, <92=severe hypoxia) but, like seeing the mnemonics here actually makes a great study aid, I believe the numbers would be as well.
I just pooched a test (though I still got a high B on it) because I couldn't remember normal HR and respirations on the various demographics.
A couple I learned in my EMT-B class and my A&P class:
MURDERS INC (for the major body systems) Muscular Urinary Respiratory Digestive Endocrine Reproductive Skeletal Integumentary Nervous Circulatory (lymphatic and cardiovascular)
And for remembering Visceral vs Parietal (could be dirty, depending on how you look at it)
visceral starts with V, like vagina (which is on the inside)
parietal starts with P, like penis (which is on the outside)