NREMT few questions

[thenuke1]

my test is thursday and im still a bit iffy on a few things no remembe these are for the NREMT not on the job

1. Reading my book i noticed in a few emergency care sections it says "based on Spo2 readings and if no signs of hypoxia and respiratory distress are present O2 my not be necessary, instead apply a nasal cannula at 2-4 lpm" now is this for ALL emergencies or just those where it is specified ...

2. You are transporting a non emergency patient. You stopped at a + intersection and notice that another car has also stopped at the same time in the lane next to you. Who has the right of way ?

3. what is the correct way to do the power lift ? i know its legs bent back straight but the test words it a different way and its not lateral or upright either.

 

[cmetalbend]

my test is thursday and im still a bit iffy on a few things no remembe these are for the NREMT not on the job

1. Reading my book i noticed in a few emergency care sections it says "based on Spo2 readings and if no signs of hypoxia and respiratory distress are present O2 my not be necessary, instead apply a nasal cannula at 2-4 lpm" now is this for ALL emergencies or just those where it is specified ...

2. You are transporting a non emergency patient. You stopped at a + intersection and notice that another car has also stopped at the same time in the lane next to you. Who has the right of way ?

3. what is the correct way to do the power lift ? i know its legs bent back straight but the test words it a different way and its not lateral or upright either.

1. I believe it's due to the teaching that all patients get oxygen as EMT-B's and 2-4 ltr won't aggrivate a patient with COPD. Or less chance anyway.
2. General traffic laws says the "Guy to your right has the right of way" well if you don't have a "Right" then thats you.
3. I'll get back with you after I double check tomorrow

 

[thenuke1]

1. I believe it's due to the teaching that all patients get oxygen as EMT-B's and 2-4 ltr won't aggrivate a patient with COPD. Or less chance anyway.
2. General traffic laws says the "Guy to your right has the right of way" well if you don't have a "Right" then thats you.
3. I'll get back with you after I double check tomorrow

1. so it refers to all patients ? even if the book doesnt mention a nasal cannula in certain patients

 

[cmetalbend]

1. so it refers to all patients ? even if the book doesnt mention a nasal cannula in certain patients

Again, I am refering to what the instructor drilled into our heads. "Every patient gets Oxygen" so the fall back on amount would be the minimum for a patient who's numbers don't indicate a need so to speak.. Now blow by might be less, but depending on administration. With that being variable, nasal would be the my choice for a measurable amount. And yes, I would say that applies to all patients. Remember Oxygen is the 'Miracle Drug". "Never withhold Oxygen from the patient." is stated several times in my book. Even in COPD patients. When dealing with an UNKNOWN case of COPD with very poor o2 stats you would apply a NRB. Because the benifits outweigh the risk. Personaly I would ask your instructor for his opinion. It makes sence if you think about it. To use the min. as a fall back, on a "have to issue" when there are little or no indications.

 

[TransportJockey]

Hopefully with the new AHA guidelines that old tired BS line that EMTs are given about giving O2 to every patient will change. For the moment the NREMT test says put it on every patient, but they're finding out that O2 is not as harmless as once believed. In the field treat the patient, not the monitor.

 

[cmetalbend]

Hopefully with the new AHA guidelines that old tired BS line that EMTs are given about giving O2 to every patient will change. For the moment the NREMT test says put it on every patient, but they're finding out that O2 is not as harmless as once believed. In the field treat the patient, not the monitor.

I agree to some extent anyway. I really don't know the real answer as to why "All patients get oxygen." My best understanding would lean towards the prevention of shock. On another note could you name a few scenes when it would be contradicted? other than COPD.

 

[reaper]

Hopefully with the new AHA guidelines that old tired BS line that EMTs are given about giving O2 to every patient will change. For the moment the NREMT test says put it on every patient, but they're finding out that O2 is not as harmless as once believed. In the field treat the patient, not the monitor.

I agree to some extent anyway. I really don't know the real answer as to why "All patients get oxygen." My best understanding would lean towards the prevention of shock. On another note could you name a few scenes when it would be contradicted? other than COPD.[/quote

]Oxygen does not prevent shock! It is not contraindicated in COPD. Treat your pt. If the pt needs O2, then give it as needed.

Not all pts need O2. It can be harmfull in stroke, TBI and a lot of other cases. Research the medication you are using. Don't trust some idiot instructor to tell you everyone needs it.

 

[TransportJockey]

I agree to some extent anyway. I really don't know the real answer as to why "All patients get oxygen." My best understanding would lean towards the prevention of shock. On another note could you name a few scenes when it would be contradicted? other than COPD.[/quote

]Oxygen does not prevent shock! It is not contraindicated in COPD. Treat your pt. If the pt needs O2, then give it as needed.

Not all pts need O2. It can be harmfull in stroke, TBI and a lot of other cases. Research the medication you are using. Don't trust some idiot instructor to tell you everyone needs it.

Thank you. I've been trying to find links to research papers to post here that DONT require paying large sums of money to read (I have previously read them when I worked at a hospital that provided me with credentials to view the material), but am coming up short. I'll keep looking for something to post... But also there's a study of O2 free radicals that I've been reading about which some of the research tends to point towards increaded amount of 02 free radicals in the blood stream from unneeded supplemental O2 is detrimental.

 

[JPINFV]

I agree to some extent anyway. I really don't know the real answer as to why "All patients get oxygen." My best understanding would lean towards the prevention of shock. On another note could you name a few scenes when it would be contradicted? other than COPD.

Shock?
[YOUTUBE]http://www.youtube.com/watch?v=G2y8Sx4B2Sk[/YOUTUBE]


In a patient who has an appropriate oxygen saturation and eupneic, what are you hoping to achieve with supplemental oxygen?

 

[cmetalbend]

Shock?
[YOUTUBE]http://www.youtube.com/watch?v=G2y8Sx4B2Sk[/YOUTUBE]


In a patient who has an appropriate oxygen saturation and eupneic, what are you hoping to achieve with supplemental oxygen?

What part about I DON'T Know, don't you understand? As an experienced professional(I use that loosely) you can argue it to death, but till YOU change the material they teach and print, AND fail you on during your state practicals if you forget, please stop trying. And no 02 is not contraindicated with a COPD patient, only the amount, to prevent other issues.

 

[JPINFV]

Where did I say anything about COPD?

 

[cmetalbend]

Where did I say anything about COPD?

That was aimed toward Reaper. Sorry I was using a shotgun approach.

 

[ffemt8978]

That was aimed toward Reaper. Sorry I was using a shotgun approach.

You'd be better off taking that approach via PM.

 

[reaper]

That was aimed toward Reaper. Sorry I was using a shotgun approach.

You are the one that mentioned COPD as a contraindication for O2. I told you it is not. No, amounts are not contraindicated either. If you want to treat your pts off what you were taught for a test, that your choice. Or, you could research and further your education to learn the correct information. I gave you examples you asked for, as what events O2 can be harmful. Now do some searching and read up on the subject, to help educate yourself better. That is the best thing you can do.

 

[cmetalbend]

You are the one that mentioned COPD as a contraindication for O2. I told you it is not. No, amounts are not contraindicated either. If you want to treat your pts off what you were taught for a test, that your choice. Or, you could research and further your education to learn the correct information. I gave you examples you asked for, as what events O2 can be harmful. Now do some searching and read up on the subject, to help educate yourself better. That is the best thing you can do.

I will look at TBI and CVA, and thanks. But in the END it doesn't change what's in black and white on the paper. And I really don't want to answer for why I deviated from that.

 

[JPINFV]

EMT text books aren't the end all, be all of medicine.

 

[thenuke1]

EMT text books aren't the end all, be all of medicine.

as far as testing goes ... they are ....

on the field its a whole new ball game

 

[cmetalbend]

After some review and discussion with my mentors, I re-affirm the o2 for help in the prevention of Shock. Here's my rational. If the patient has injurys that are not found (such as internal bleeding), or other issues that may seem minor upon arrival (possibly not fully developed) O2 will help prevent shock. It says "If you wait for signs of Hypoperfusion or shock to develop, before beginning treatment for such, you have waited to long". So considering I can't (nor can you) DX everything in the feild. That is why every patient gets oxygen.

 

[JPINFV]

Under what mechanism are they expecting supplemental oxygen to increase oxygenation in a patient who is anemic due to blood loss? The amount of oxygen diffused in the plasma goes from negligable to... well... negligable. Dissolved oxygen is like turning a garden hose on against a fully involved 2 story house fire. Sure, I guess it's water, but... well... it's not going to do much in an anemic patient.

 

[cmetalbend]

Under what mechanism are they expecting supplemental oxygen to increase oxygenation in a patient who is anemic due to blood loss? The amount of oxygen diffused in the plasma goes from negligable to... well... negligable. Dissolved oxygen is like turning a garden hose on against a fully involved 2 story house fire. Sure, I guess it's water, but... well... it's not going to do much in an anemic patient.

Would you say that if the blood loss was slow? But even still a garden hose will buy SOME time, wouldn't you agree? I mean we can't fix internal injurys in the feild so anything to me Is better than nothing.