NREMT EMT-I85 Practicals

[Fire219man]

I was successful in passing the Written On-Line test for the NREMT-I curriculum. Somehow I have failed 1 of the practical stations though.

In the state of Ohio, the EMT-I practicals consist of

1. Trauma Assessment station
2. ET Tube station or Combi Tube station. "your choice on which you wish to do"
3. IV station
4. Random station " can either be Bleed/shock, seated spine, or longboard spine immobilization"

I passed every station except Trauma Assessment. Now I am pretty confident in my assessment skills, but I must be doing something in my mind and not verbalizing it.

I guess I wasn't prepared for how things needed to flow when I did this station.

I thought it would be ok just to verbalize C-spine control. Thats not enough I suspect. You must verbalize a c-collar as well.

I thought it would be ok to ensure that high flow o2 was ok to put on a patient anywhere in the assessment as long as you just verbalized putting it on a them...Not so true, they want you to verbalize it at the Initial Assessment, ABC's....

If you don't verbalize taking care of a patient that is shocky, you will fail. I didn't start an IV and give a bolis, nor did I put the patient in a shock position.

I guess the moral of the story is, just because you memorized every single step on the National Registry check sheet for that station, doesn' t mean you will pass.

You must ensure you cover the following items....

1. BSI
2. Attempt to insert OPA in an unconcious patient
3. Control any arterial bleeds during initial assessment.
4. Fix any flail segments or need for occlusive dressing in the chest on a sucking chest wound.
5. Place patient on o2 with proper administration either NRB or Bag them. This should be done in the initial assessment section.
6. After vitals are given, if patient is shocky, you should deal with that shock then. Elevate legs, start IV.
7. When placing patient on backboard, assure you verbalize securing the head last.

I now have to take the 1 skill station over again. I have to wait 2 months till the National Registry comes near my area to give the test again.

I guess I didn't realize that you need to verbalize absolutely everything you are thinking.

I mean I was thinking I already had a c-collar on. though I only said c-spine control.
I was thinking I would have had an IV in, but I never said it.
I was thinking that I would have had my partner bagging the patient, but I didn't say that
etc....

Just because you think it doesn't mean it is being done....

lesson learned for me.

What a devestating blow to my courage and spirit though. I was pretty worked up this weekend after I failed.

I graduated my class #1, and had the highest final grade on the exam. That just goes to show you that it doesn't mean jack!!!

One thing that bothers me most, is that the National Registry won't tell you what you did wrong or missed. Not at the testing station, nor anytime after. They just tell you that you failed the station.

My question is, how do you know for sure what you do wrong if someone doesn't tell you?

Learn from my mistakes!!!!

If you are thinking it in your head, you need to move your lips and say it.

 

[Ridryder911]

Sorry, but did your instructor not practice and rehearse this scenarios? I always teach my students to perform as they are teaching the evaluator the station.

As the old saying " assume" means, one should not. Verbalize everything and yes, oxygen is part of the treatment of shock.. as well, one cannot assess after placing a cervical collar on.. other tidbits. Your Intermediate level, then you have to treat accordingly...i.e IV, intubation (if trauma be sure to describe in-line traction while intubating)

Personally, they give you ten minutes take at least 9minutes and 30 seconds of them. Go into great detail of assessment, with describing in real life that you would had expedited assessment and treatment, but this is an evaluation station of your assessment skills.

Good luck,
R/r 911

 

[Fire219man]

Trauma Assessment was never stressed during our normal study. During review time last week, we did have 2 outside helpers give us a scenario and we ran with it. I did the same thing in practice that I did at the National Registry. I wasn't corrected on anything in practice, but surley paid for that by failing the registry.

I surley will take all 10 minutes to describe in detail what I am doing next time.

I hope this post is some food for thought to all those that have to take the NREMT Practicals.

 

[Ridryder911]

Sorry for your educational experience. I am finding this is becoming the "norm" which is scary for educators as myself. Trauma assessment in the Intermediate portion is very important, since many times this maybe the only education or exposure one will have in trauma during the whole entire Paramedic program.

I am just enquiring and commenting that I am seeing more and more programs not utilizing lab time effectively. Personally, I require each student to be evaluated at least on 15 separate trauma scenarios in the Intermediate portion. As well rehearsal and practicing of the NREMT practical examination, until it becomes second nature. It does no good how well a medic is if they cannot pass the boards/cert to be able to practice.

Personally, I would practice and practice and after passing the test, complain to the educational or program administrator, so it does not appear to be sour grapes. I am sure you are not the only one this occurred to and the program needs to be evaluated and possibly some changes to occur.

Good luck,
R/r 911

 

[Fire219man]

I totally agree with everything you just said. I wish you had been my instructor..

I definatley wasn't presented with what to expect during my practical session. Though I won't point fingers, as it is my responsibility to be prepared. I actually thought I was prepared for this practical. Breezing through my 3 other skill stations.

When you practice in class, and they say your good to go. Then you take your test and it's like they look at you as if your incompitent, it makes you wander what went wrong.

I now know what to expect, what to practice, and how to approach these skill stations now that I have failed it.

 

[MedicDoug]

If it doesn't kill you it makes you stronger. Don't spend any more time beating yourself up, just review, practice, and you should be fine the next time.
Didn't the examiners give you the option of retesting the one station you failed? That's standard NREMT testing procedures at most places.

 

[Ridryder911]

Actually, that is independent upon the state it is given. Technically, NREMT is not supposed to give re-test or even if you passed or failed on advanced examinations.

R/r 911

 

[i5adam8]

I was successful in passing the Written On-Line test for the NREMT-I curriculum. Somehow I have failed 1 of the practical stations though.

In the state of Ohio, the EMT-I practicals consist of

1. Trauma Assessment station
2. ET Tube station or Combi Tube station. "your choice on which you wish to do"
3. IV station
4. Random station " can either be Bleed/shock, seated spine, or longboard spine immobilization"

I passed every station except Trauma Assessment. Now I am pretty confident in my assessment skills, but I must be doing something in my mind and not verbalizing it.

I guess I wasn't prepared for how things needed to flow when I did this station.

I thought it would be ok just to verbalize C-spine control. Thats not enough I suspect. You must verbalize a c-collar as well.

I thought it would be ok to ensure that high flow o2 was ok to put on a patient anywhere in the assessment as long as you just verbalized putting it on a them...Not so true, they want you to verbalize it at the Initial Assessment, ABC's....

If you don't verbalize taking care of a patient that is shocky, you will fail. I didn't start an IV and give a bolis, nor did I put the patient in a shock position.

I guess the moral of the story is, just because you memorized every single step on the National Registry check sheet for that station, doesn' t mean you will pass.

You must ensure you cover the following items....

1. BSI
2. Attempt to insert OPA in an unconcious patient
3. Control any arterial bleeds during initial assessment.
4. Fix any flail segments or need for occlusive dressing in the chest on a sucking chest wound.
5. Place patient on o2 with proper administration either NRB or Bag them. This should be done in the initial assessment section.
6. After vitals are given, if patient is shocky, you should deal with that shock then. Elevate legs, start IV.
7. When placing patient on backboard, assure you verbalize securing the head last.

I now have to take the 1 skill station over again. I have to wait 2 months till the National Registry comes near my area to give the test again.

I guess I didn't realize that you need to verbalize absolutely everything you are thinking.

I mean I was thinking I already had a c-collar on. though I only said c-spine control.
I was thinking I would have had an IV in, but I never said it.
I was thinking that I would have had my partner bagging the patient, but I didn't say that
etc....

Just because you think it doesn't mean it is being done....

lesson learned for me.

What a devestating blow to my courage and spirit though. I was pretty worked up this weekend after I failed.

I graduated my class #1, and had the highest final grade on the exam. That just goes to show you that it doesn't mean jack!!!

One thing that bothers me most, is that the National Registry won't tell you what you did wrong or missed. Not at the testing station, nor anytime after. They just tell you that you failed the station.

My question is, how do you know for sure what you do wrong if someone doesn't tell you?

Learn from my mistakes!!!!

If you are thinking it in your head, you need to move your lips and say it.

Did you check for medic alert tags? I am currently taking an EMT-I85 class,and one of the big things that I notice alot of our class is missing are checking for medic alert tags during our Trauma assesment.It is somthing that our instructor is trying to drill into us,as apperently it is one of the most missed steps of this skill station.

 

[Tincanfireman]

I've heard many references to -I's as Trauma Techs; as such, you need to look for those reasons to apply your skils in a -I scenario. If they are bleeding, they get a line. Airway problems? Tube 'em. Shock gets appropriate treatment (blankets, IV, O2) Sugar issues? Drop a little D50 in that IV. You get the idea. Our instructor reminded us that -B's have a limited set of tools to use, -I's have more and we weren't testing as Basics. Her words were well heeded and worked for all of us. Hope the second go works out better for you!! Best of luck...

 

[Fire219man]

I will definatley be more prepared the next time through. Thanks for the tips.

 

[jones4ms]

just a thought

I totally agree with everything you just said. I wish you had been my instructor..

I definatley wasn't presented with what to expect during my practical session. Though I won't point fingers, as it is my responsibility to be prepared. I actually thought I was prepared for this practical. Breezing through my 3 other skill stations.

When you practice in class, and they say your good to go. Then you take your test and it's like they look at you as if your incompitent, it makes you wander what went wrong.

I now know what to expect, what to practice, and how to approach these skill stations now that I have failed it.

I think what helped me was instead of trying to figure out what they wanted to hear i just gave it all and let them decide what they wanted.. i.e i verbalized everything from scene sizup to transport. the addage think before you speak doesnt apply in this case, it is speak what you think. plus it helps you to not miss anything or catch it before it is to late.

only catch is: make sure you don't run yourself out of time, so think fast and talk fast lol

just my thoughts.
mike

 

[ErinCooley]

We were taught to learn the failing criteria first.. if you know what WILL make you fail, you wont do it!

 

[Fire219man]

I took my NREMT Practical again on Saturday. I was only required to re-test on the failed station of Trauma Assessment. I am happy to report I passed!!!

I made sure that I was prepared this time. I thought I was prepared last time, yet I truly put everything I had into it the second time around.

 

[i5adam8]

Congrats! I will be taking my practicals later this month,so I am kind of nervous.I heard from some of the people who have taken the I-85 written,and they say it is the most difficult out of the 3 EMT levels.I don't know why this would be true.Has anyone else on here felt this way about the I-85 written?

 

[ErinCooley]

I've only taken the I-85 written and practical... the practical was a breeze to me (and I struggled in class more than any of my peers) but the written was TOUGH. I passed first try, I left feeling very defeated however. I was truly shocked to see PASSED on the nremt.org site.

My instructor did lots and lots of NREMT prep. Almost all of our class tests were platinum which I believe are "old" registry questions. They arent exact but from all of the online study preps, books, study guides, text book tests I took, platinum were definately the best for studying.