MA EMT-B Practical today..seeking opinions

[Amycus]

Hi everyone, been reading the site for a bit, took my exam today and I'm uber, uber paranoid about the results.

I didn't have to repeat any stations, which is a blessing and a curse.

Here's where my stomach is in knots though....I think I might have gotten dinged on Medical...here is why:

Upon getting to the intervention portion- I chose the correct medication (metered dose inhaler), ensured the 5 patient rights, made sure it was not contraindicated (patient able to use the inhaler, no doses taken so far), and allowed the patient to administer it to themselves, coaching them how to take it (shake bottle, exhale deeply, wrap lips around the MDI tightly, spray+inhale, hold breath, etc) and was told the patient received the medication.

I verbalized later on during the ongoing assessment/repeat vitals/repeat focused that I would be rechecking vitals every 5 minutes, and if necessary, per MA protocol, contact Medical Control about administering a second dose of the mediciation (the prescription said 2 puffs, as needed, but MA protocol says one dose, and med. control must be contacted before dose #2).

However, it didn't hit me til after the station, I never stated that the MDI is standing orders in MA...I assumed by my actions it was implied (as we only have to call in the state for Charcoal), but I noticed one of the critical fails for the station is not verbalizing standing order vs med. control....

Long story short, did I likely shoot myself in the foot at the end of this station, or is there a possibility this could be missed/overlooked because it IS in fact, standing order?

Trying to ease my nerves, just a little bit...stupid 3 week wait.

 

[nemedic]

Maybe, maybe not, depends on whether or not the examiner caught it, and whether or not it is a big enough issue (generally, it is safe to get med control input) They might just dock you a point or two on the medical portion, or if its a critical criteria, then an auto fail. good luck.

 

[feldy]

I wouldnt worry to much...while generally you do need to contact med control you did it for the second one so even though you probablly didnt think about it at the time....to an examiner, it may look like you just forgot it the first time to you mentioned it a second time. Good luck. The wait can feel like an eternity so try to keep your mind off it so you wont go crazy waiting.

 

[DarthMalachi]

Practicals are ALWAYS nerve racking. Took mine for NC the other day, and in rapid trauma assessment I went thru everything spot on perfect...DCAP-BTLS, OPA, BVM @ 15lpm, etc etc...got to the abdomen, palpated all 4 quads...checked for priapism...and wasn't til I got to the dorsalis pedis pulses in the lower extremities that I realized I forgot to assess the pelvis...SON OF A...

Anyway...hopefully the examiner didn't catch your lack of verbalization...Good luck!

 

[Amycus]

On an aside, and I ask this for a very specific reason...lol...

Hypothetically of course, if you make a mistake on the exam, and for whatever reason, the examiner corrects you- so you fix said mistake and continue...are you more than likely still going to fail, or did you possibly catch a lucky break?

...hypothetically, of course.

 

[DarthMalachi]

if you make a mistake on the exam, and for whatever reason, the examiner corrects you- so you fix said mistake and continue...are you more than likely still going to fail, or did you possibly catch a lucky break?

I think you just caught a lucky break. heh.
Same thing happened to me with long bone splinting.

 

[fast65]

On an aside, and I ask this for a very specific reason...lol...

Hypothetically of course, if you make a mistake on the exam, and for whatever reason, the examiner corrects you- so you fix said mistake and continue...are you more than likely still going to fail, or did you possibly catch a lucky break?

...hypothetically, of course.

Yeah, I think you just caught a lucky break. If I remember correctly, the proctors are only supposed to tell you what is on their sheet (i.e. "this is your seated c-spine station, you have 10 minutes to complete it..." and to tell you about the scenario), at least that's how it is in Oregon.

I really wouldn't worry too much about the results, there's not much you can do about it now, so just get the attitude that you did the very best you can and have confidence that you passed. Good luck.

 

[Jaybro713]

I think you're probably fine. Especially if you're fairly confident that you didn't fail anything else.

When I took my MA practical I was so mad at myself during the backboarding portion I had to do the KED. She happened to be big chested and while I was doing the top strap, I was unable to tighten it as far as I would have liked due to her chest starting to fall out. Needless to say, when the examiner went to check the straps I stated that I knew I failed because that top strap wasn't tight enough. He never said a word to me about it but I still passed. I think it's because he knew that I knew it wasn't tight enough and understood that I didn't want my gf's chest all hangin' out in front of him...

 

[DarthMalachi]

Thankfully, NC got rid of the KED portion of practicals. I despise that silly green jacket. lol.

 

[Amycus]

I ended up pulling KED, but I'm pretty happy how it went. My patient held great posture and I only had to throw in a little bit of padding behind the head. Upper and lower went well, trauma went well also...except for me mixing up "occlusive" and "universal" dressings...duh...but I'm 99% sure that's only a 1 point dock for "managing secondary injuries"

Only concerns I have were that I didn't verbalize standing order properly, and the CPR station (hence the hypothetical above). My initial ventilations were successful, but somewhere during the 30/2 ratio, the examiner said that my ventilations weren't getting into the manikin's chest and to hyperextend the neck as far back as it'll go, so I did, and the new ventilations were successful. I had proper technique (proper seal, head-tilt chin lift, etc), I just didn't have the dummy's head far enough back (on these dummies you had to pull the head the ENTIRE way back or the breaths wouldn't go in...I don't think on a normal person you'd yank the head that far back. I simulated the hyperextension on myself later and it hurt =X

 

[DarthMalachi]

trauma went well also...except for me mixing up "occlusive" and "universal" dressings

Dang, heck of a secondary injury...sucking chest wound?

the examiner said that my ventilations weren't getting into the manikin's chest and to hyperextend the neck as far back as it'll go

Yeah, you got that one. That was just the examiner being nice. =)

 

[Amycus]

Oh god no, I wish it was a sucking chest wound, that woulda made sense...lol.

The patient had a deformity on their lower leg, blood from the ear, and a laceration on the scalp.

The examiner asked what I would do for each of those. I said I would splint the lower leg, I said for the blood from the ear I really couldn't do much short of catching the blood because if I try to put pressure on it, the blood could back up into the brain. The laceration on the head I MEANT to say "use a universal bandage and dress it" instead for some reason I said "use an occlusive dressing and attempt to put pressure on it. haha...a pretty bad mixup. Didn't realize it til I was walking away from the station...

The CPR examiner seemed very nice. Our station had lots of defective equipment, so she gave us a heads up before we even began. When I went to test the BVM after turning the oxygen on, she immediately said "you're forgetting something" and I realized I plugged in one end of the tube to the tank and forgot to plug it in to the BVM. Although I'm convinced I would have noticed it because all I had done up to that point was just squeeze the bag and make sure it, well, squeezed. I didn't even hold it up to my face yet to see if oxygen was flowing. I kind of laughed when that happened despite being nerveshot. The first two ventilations were fine, as were I think the next 4. Then it was the next set she said something like "the ventilations aren't getting into the manikin's chest, you're going to have to hyperextend the manikin's neck and pull the head as far back as it'll go". I pulled the head back even further, reventilated, and she told me the new vents were successful. I took that to be friendly advice, but I'm still a bit nervous. A friend (a paramedic) put the fear of god in me that if she pointed that out, she likely already had me down as failing. I'd like to believe in the idea of human goodness and compassion =X

 

[DarthMalachi]

Still, I have to be positve and hope you did fine. =)

I nearly failed the long bone injury splinting station. I almost forgot to check PMS before applying the splint LOL.

 

[Brandon O]

Sounds like you're going to make a great EMT, Amycus.

 

[Amycus]

Dang, heck of a secondary injury...sucking chest wound?

Actually I was just thinking about this comment, I could be wrong as obviously I'm not in the field yet, but if I found a sucking chest wound, I'd treat it during the ABCs on Breathing- Injury Management rather than as a secondary wound. Considering a sucking chest wound can lead to a pneumothorax and collapse a lung, I'd consider it important enough to address before it became an issue.

 

[DarthMalachi]

Actually I was just thinking about this comment, I could be wrong as obviously I'm not in the field yet, but if I found a sucking chest wound, I'd treat it during the ABCs on Breathing- Injury Management rather than as a secondary wound. Considering a sucking chest wound can lead to a pneumothorax and collapse a lung, I'd consider it important enough to address before it became an issue.

That would fall under "obvious life threatening injury" and would take precedence over anything else...eh?

 

[feldy]

Amycus, let me know if u got my PM.

 

[Amycus]

Yeah, I just got it. Thanks for your input man. Still nerveshot, but no sense getting myself sick over it. If I fail, I'll just schedule a retest and do it again

 

[Jaybro713]

Conveniently if you ever have to have said hyperextention you won't feel it...