EMT-B Practice Scenarios

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Gina Orsi

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Hey everyone, I am currently an EMT-B student and we have our midterm written and practical coming up. I could use all the practice I can get, so I was wondering if anyone wanted to throw some scenarios at me. Thus far, we have covered- Documentation, legal issues, communication, lifting and moving, Anatomy, physiology, pathophysiology, airway management, and advanced airway management, Baseline vitals, patient assessment, OB, pediatrics, Shock, stroke, altered mental status, seizures, anaphylactic emergencies, and diabetic emergencies. Thanks in advanced!!!!!
 
You come across a 17 yo Male laying supine in a park with noticeable urticaria and pale skin- along with audible Wheezes.

Go.
 
Okay, scene saftey bsi and all that good stuff. I would determine his level of consciousness & asses his ABC's and take care of all of those. Determine if I need ALS assistance or not. I would administer oxygen 15lpm nonrebreather. If he is alert I would obtain the sample and opqrst from the patient, if he were unresponsive I would try to gather as much history as possible from any bystanders or witnesses. If in fact he does have an allergy and carries an epipen I would then ask him for it, ensure that it is his prescription, the adequate dosage, expiration date, and coloration of it. Obtain permission from medical direction to assist in administration of the epipen. I would then determine if the best method is to transport based on our eta or transfer to ALS care.
I believe I hit most of the points haha, Im ready for constructive criticism , dont hold back.
 
Sounds pretty good. I used to assist with teaching EMT classes and help do scenarios. So if it's ok I'll "nit pick" even though your assessment was decently solid. When i was a student I always liked the teachers who were a little bit more strict.

Usually someone who is experiencing an anaphylactic reaction will be sitting (typically tripod) or standing and bending over in an attempt to breathe easier. Typically if they are laying flat, they have lost consciousness ( not always, but typically). While I'm checking LOC I would also check for a pulse and to check to see if he's breathing. I would most definitely call ALS and get them enroute incase IV Epi, Benadryl, duo NRB, etc etc needs admin by ALS. Your spot on with 02 admin, however, if he was unconscious and having difficulty breathing ( shallow, slow, absent, etc) and had no gag reflex I would begin bagging him with the use of an OPA. If he had some level of gag reflex I would bag him with an NPA. Since the patient was found in a field I would look for a possible bee stinger, and remove if found.
 
I am trying to go to medic school after this and trying to do my best so I do not mind nitpicking or constructive criticism at all. The positioning is actually a very good point I failed to pick up on. Supine I shouldve figured unconscious. Question, At which point in your assessment would you call for ALS? After checking abc's? or once youve determined its an anaphylactic reaction?
 
Also, do you have any advice for making the transition from emt-b school to medic school? All I hear is that it is terribly hard, specially the program I plan on enrolling in. I am doing fairly well in my program now, which is conducted through the same school.
 
Your scene size up includes considering additional resources. with an appernetly unresponsive patient who looks scrappy (supine, pale) I think calling ALS on arrival/scene size up would be appropriate. If not then, when you assess LOC. Basically, as soon as you realize you need it and you won't be wrong. Wait till you have him NPAed, bagged, and epied and you might have a problem.
 
Gina Orsi said:
Question, At which point in your assessment would you call for ALS?
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Once I saw they were ALOC/unconscious, especially with the respiratory distress. If I saw someone laying in a field not responding to my approach I would call. If dispatch came in as unconcious party, I would of called for ALS then. If you get there and it's all gravy, you can cancel them. Once you realize they will need any ALS intervention, CALL.
 
Gina Orsi said:
Also, do you have any advice for making the transition from emt-b school to medic school? All I hear is that it is terribly hard, specially the program I plan on enrolling in. I am doing fairly well in my program now, which is conducted through the same school.
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There's debate wether to work as an EMT prior to medic school, or going straight to medic school is the best approach.

I think it depends on the individual ( this is just my opinion). Some people need the field experience to really get comfortable with the EMT skills. Some don't. But just remember EVERYTHING you learn in medic school is built off of the basics that you learn as an EMT.

So if you feel you could run a BLS call right now - with confidence- I'm sure you would do fine in medic school. If your still nervous talking to patients and recognizing what's going on in the field, then maybe work as an EMT for a bit prior to moving on to medic school.


You can't be a good medic without first being a great EMT.
 
For the sake of testing/school I always called for ALS on every call no matter what it was. You never know when they're going to make your patient nosedive, and if you just verbalize "I'd like to call for ALS just in case" then you know you've said it and you can focus on your assessments.
 
I don’t think I’d say “just in case.” I’d give a specific reason why you want ALS for that “patient".
 
There are usually several scenarios in EMT class that you are not supposed to call for ALS on.

While we like to think it does, ALS doesn't fix everything.
 
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