I'm stuck!

EMSSam

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We've just started doing on-road shifts with the ambulance as pert of our course.

I really want to start to get into some of the patient assessment and I've been practising my assessment skills and learning as many conditions as I can.

The problem is, as soon as I enter a scenario or try out an assessment on a classmate, I go blank. I'm normally on top of things but this is difficult!

Any good tips?

Also, when is the best time to use SAMPLE and OPQRST? As in, when are they 'specifically' designed for?

Thanks :)
 
Get a small notebook and right one assesment question on each page. Then use the notebook to make notes while assessing the patient. Use the questions as a prop if need be during assessment. No oe expects u to be letter perfect right off the bat. After you've got it down pretty well wean yourself off the notebook because obviously you won't be able to use it on the test.
 
Get a manikin and a buddy, or just a willing buddy. Make a study date, each make a couple "victim cards" (3X5 with chief complaint, vitals, presenting appearance).

Initially, you each do an actual set of vitals on each other. Do ths maybe three or four time Then, you practice pt asssessment as you were taught.s to bubild confidence and speed and work out any kinks (get past any "beginners luck"). Then, you use the cards to direct your assessments more (or to make you resist constricting your assessments too soon). Start simple and no hurry, then speed it up a little. Accuracy and development of "muscle memory" doing things in the right order will be your goal, and PROPER repetition is your watch-phrase.

Remember at first, (or when things are going very badly) it will seem you are moving too slowly. Use a watch or such to get an objective timing of your actions. But make sure you are doing it according to your instruction every time.
 
Try using a simple chest pain pt for practice until you get the hang of things. I used the pyramid method. Start by assessing only LOC with person, place, time, and event. After you get comfortable, add on to assessing ABCs, then OPQRST, etc.... One step at a time is the best way I found.
 
scene safety/bsi/number of patients/MOI/NOI/resources assistance is often a silent process, i introduce myself and always ask right off the bat "why did you call EMS today?" just to start a dialogue. if they answer, they're alert, and you'll be able to tell if their airway is patent if they aren't gasping to tell you their name.

i get at least their name and why they called and the rest of AO in the truck unless the nature of call is altered mental status, lethargy or something that would suggest getting their alertness level is of more importance.

rapid scans are reserved (at least in my experience and company) for unconscious patients and traumas (even small falls) and detailed assessment is then obtaining OPQRST/SAMPLE or focusing assessment on one area of trauma. branch off of OPQRST/SAMPLE (i suggest writing down on the paper "OPQRST/SAMPLE" with a space under each letter. at this point we transport and get vitals if my partner hasn't already gotten them while i was asking questions. then you reassess.
 
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scene safety/bsi/number of patients/MOI/NOI/resources assistance is often a silent process, i introduce myself and always ask right off the bat "why did you call EMS today?" just to start a dialogue. if they answer, they're alert, and you'll be able to tell if their airway is patent if they aren't gasping to tell you their name.

i get at least their name and why they called and the rest of AO in the truck unless the nature of call is altered mental status, lethargy or something that would suggest getting their alertness level is of more importance.

rapid scans are reserved (at least in my experience and company) for unconscious patients and traumas (even small falls) and detailed assessment is then obtaining OPQRST/SAMPLE or focusing assessment on one area of trauma. branch off of OPQRST/SAMPLE (i suggest writing down on the paper "OPQRST/SAMPLE" with a space under each letter. at this point we transport and get vitals if my partner hasn't already gotten them while i was asking questions. then you reassess.

this is of course, the most basic of structures, for which order can change due to condition (i.e. transporting before obtaining OPQRST etc. and applying all other mneumonics) you'll maintain fluidity after experience, get your foot in the door with a rough outline and you'll quickly learn how to hone how to obtain information and pinpoint problem areas.
 
these are hard. I freaked the first time I took the PT assesment test, and had to re take it. Practice, practice, practice. Have a partner come up with the scenarios, add total curveballs. and NEVER correct in the middle of an assessment, rather do a de breif after each practice.
 
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