Hey y'all,
Before I start, I need to say something that might make my question easier to see in the mess that follows. I'm one of those annoying people who need to analyze simple things to the point of madness, and that's where I'm stuck right now. I just need some help getting out of it. The questions I have boil down to this:
- Can I fail for calling ALS and verbalizing rapid transport if it's not necessary?
- How should ETA for the nearest ALS unit affect a transport decision?
- What situations (for priority patients) would warrant waiting to transport? Unconscious patients with friends to question for SAMPLE? Others?
I had an issue with my practical exam (and looking at the title for this thread, you can imagine that issue was medical assessment). Embarrassing, really, because these are supposed to be cake-walks. What got me was backup/transport decisions. The check-off sheet has "Requests additional help (ALS) if necessary," and "Identifies patient priority and makes treatment/transport decision" in Scene Size-Up and Primary Survey respectively. This got me because my instructor was irritated whenever one of us mindlessly said, "Ok, I'll call for an ALS unit ... This is a load-and-go patient" in practice. As far as going down the checklist, yeah, you get your points and you dodge your critical fails that way; but I ended up trying so hard to avoid saying, "I'll call for ALS backup, load and go" for a runny nose that I missed the train for saying it in a chest pain scenario. I called for transport after SAMPLE :sad:... Live and learn.
I'm re-testing tomorrow, but I've been looking around for a couple weeks already, looking at common scenarios and when it's appropriate to say "priority status, let's initiate transport now." As far as I can see, all the scenarios I've seen/heard about for NREMT practicals are "call ALS/priority/transport immediately (i.e. after primary assessment)."
So, getting to the point (don't want to bore anyone), is it safe for me to make it a habit - like saying "scene safe/BSI" - to simply call for ALS in scene size-up and verbalize initiating transport after the primary assessment? And would it hurt me on the exam if I called for ALS/immediate transport for something that's not really critical? I'm only talking about the practical exam here, going by the form and passing the assessment. I did everything else right; it was just the one thing that tripped me.
Like I said, I'm one of those annoying people who need to analyze (and then I hit a critical fail). So if anyone could make this as simple for me to understand as it's supposed to be, I'd owe them! Again, this is just for the practical exam...
Thanks, and sorry for the essay... I'm one of those people :sad:
Before I start, I need to say something that might make my question easier to see in the mess that follows. I'm one of those annoying people who need to analyze simple things to the point of madness, and that's where I'm stuck right now. I just need some help getting out of it. The questions I have boil down to this:
- Can I fail for calling ALS and verbalizing rapid transport if it's not necessary?
- How should ETA for the nearest ALS unit affect a transport decision?
- What situations (for priority patients) would warrant waiting to transport? Unconscious patients with friends to question for SAMPLE? Others?
I had an issue with my practical exam (and looking at the title for this thread, you can imagine that issue was medical assessment). Embarrassing, really, because these are supposed to be cake-walks. What got me was backup/transport decisions. The check-off sheet has "Requests additional help (ALS) if necessary," and "Identifies patient priority and makes treatment/transport decision" in Scene Size-Up and Primary Survey respectively. This got me because my instructor was irritated whenever one of us mindlessly said, "Ok, I'll call for an ALS unit ... This is a load-and-go patient" in practice. As far as going down the checklist, yeah, you get your points and you dodge your critical fails that way; but I ended up trying so hard to avoid saying, "I'll call for ALS backup, load and go" for a runny nose that I missed the train for saying it in a chest pain scenario. I called for transport after SAMPLE :sad:... Live and learn.
I'm re-testing tomorrow, but I've been looking around for a couple weeks already, looking at common scenarios and when it's appropriate to say "priority status, let's initiate transport now." As far as I can see, all the scenarios I've seen/heard about for NREMT practicals are "call ALS/priority/transport immediately (i.e. after primary assessment)."
So, getting to the point (don't want to bore anyone), is it safe for me to make it a habit - like saying "scene safe/BSI" - to simply call for ALS in scene size-up and verbalize initiating transport after the primary assessment? And would it hurt me on the exam if I called for ALS/immediate transport for something that's not really critical? I'm only talking about the practical exam here, going by the form and passing the assessment. I did everything else right; it was just the one thing that tripped me.
Like I said, I'm one of those annoying people who need to analyze (and then I hit a critical fail). So if anyone could make this as simple for me to understand as it's supposed to be, I'd owe them! Again, this is just for the practical exam...
Thanks, and sorry for the essay... I'm one of those people :sad: