Patient Assessment

Medical Skeleton

Forum Ride Along
9
0
0
I am currently taking the EMT course at Miramar College. In class, the patient assessment is in precise, linear steps. When I did my 8 hr ride along with a SDFD ALS unit, the assessment was all blurred together for me. I know that the field is different (taking BP in a classroom vs a ambulance on the side of a freeway in the rain). I am asking to see how long has taken people to adapt from the classroom to the field. Not in just patient assessment but in all aspects of the patient care. Thanks.
 

ffemt8978

Forum Vice-Principal
Community Leader
9,116
189
63
Classroom knowledge is great, but it's what you do in the field that counts. As you gain more experience, you'll find that your able to perform certain assessments without actually doing them. For example, you walk into a room and introduce yourself to the patient. The patient responds in a normal and sensible manner. You've now established the ABC's, AVPU, and GCS scores and made your intitial impression of sick/not sick.

The time it takes you to master these skills will decrease as your patient contact increases. The classroom is the foundation of your EMS skills, but patient contact is how you improve them.

Also, it is important to remember that education is learning the rules; experience is learning the exceptions.

And in closing, welcome to the forum. I hope you stick around and keep posting. You'll find lots of friendly people here, with almost all ranges of experience and certifications.
 
OP
M

Medical Skeleton

Forum Ride Along
9
0
0
Thanks for the input. Today in class I did a patient assessment and got all the points. It took awhile but I got it. To pose a new Q off this thread... Where is a place that a student can get more patient contact? My school only covers one ride-along and I really need more then a scenario with a friend.
 

MMiz

I put the M in EMTLife
Community Leader
5,203
236
63
Originally posted by Medical Skeleton@Oct 21 2004, 09:45 PM
Thanks for the input. Today in class I did a patient assessment and got all the points. It took awhile but I got it. To pose a new Q off this thread... Where is a place that a student can get more patient contact? My school only covers one ride-along and I really need more then a scenario with a friend.
First, welcome to the forum!

Classroom knowledge will present you with the basis from which you will form your own in-field techniques.

Here is how I do it:

When I walk up to someone, I ask a question. If they respond, I know I have the ABCs and a patent airway. I then ask why they contacted EMS. They will provide their symptoms, and usually describe the problem. I then tend to ask for the SAMPLE history (Allergies, Meds, Medical History, Last Oral Intage, Events leading up to). By just talking to people I tend to know their rating on the Glasgow Coma Scale, and pretty much everything else just falls into place.

The field is a place of innovation, and you'll come up with your own techniques. I've seen some pretty amazing patient assessments, backboarding, and splinting, each far different than I learned in class. I suggest you just go with the flow and learn, EMS is a constant learning experience.

As far as getting more time in the field, I would highly suggest calling every local EMS agency, and asking to do ride-alongs. They will immediately know what you are talking about, and you'll be able to schedule additional ****s with crews.

I hope that helps, and I hope you continue to keep us updated with your progress as an EMT, it's an exciting experience!
 

ffemt8978

Forum Vice-Principal
Community Leader
9,116
189
63
Originally posted by Medical Skeleton@Oct 21 2004, 07:45 PM
Thanks for the input. Today in class I did a patient assessment and got all the points. It took awhile but I got it. To pose a new Q off this thread... Where is a place that a student can get more patient contact? My school only covers one ride-along and I really need more then a scenario with a friend.
Check with your local ambulance service to see if you can do a "hands off" ride along. Basically, you would only be able to watch as the crew treats the patient, but you should be able to pick up some good pointers. You might also check with your local hospital to see if you can do a rotation in their ED.
 

rescuecpt

Community Leader Emeritus
2,088
1
0
Try to always do your assessments in the field the way you do in class. Once you've been doing it for a while, you should still be doing it that way! Of course, that's not always how it happens, but they're designed that way for a reason and if you can accomplish all the points in the assessment in the field, you are truly doing your best for your patients.
 

Luno

OG
Premium Member
648
30
28
I am going to differ with the Cpt on this one, as the field is much different than class. In class and in all practical exercises, work by the numbers, so when you take that information to the field you have a practical understanding on what each step concerns. Now when you're in the field, you can adapt your assessment to the situation, skipping steps because they are irrelevant, or doing steps because they are relevant, however when you have the time, do a complete (A-Z) assessment. I am a firm believer in knowing the steps, and why the steps are taken, before deciding that you can skip a step, or you need to focus on certain steps over others. But learn procedure and why, before you form your attack plan outside of the steps.

Luno
 

rescuecpt

Community Leader Emeritus
2,088
1
0
Luno, I agree things are different, but for someone who is brand new, they shouldn't skip any steps. Once they get some experience under their belts, they'll develop the professional judgement needed to understand which steps are irrelevant and why. Until then, CYA and do everything.

My crew had the fun of riding with a probie who had no clue what was going on, despite our best efforts to educate him (we had myself as ALS, a crew chief who is a NY State instructor, and a medic student). He would skip steps all the time. Luckily the rest of the crew was there to fill in the missing pieces. This guy actually had an EMT card - we don't know how, considering he had never seen a KED until we pulled it out on an MVA one day - but it's a required skill station for the NY State exam. HMMM... He's not going to last much longer, he is now one of the Chief's "special friends".

Anyways... field experience is very very important for developing your professional judgement and the best way to do that is to start out textbook and as you learn, adapt.
 

ffemt8978

Forum Vice-Principal
Community Leader
9,116
189
63
Originally posted by Luno@Oct 24 2004, 08:21 PM
I am going to differ with the Cpt on this one, as the field is much different than class. In class and in all practical exercises, work by the numbers, so when you take that information to the field you have a practical understanding on what each step concerns. Now when you're in the field, you can adapt your assessment to the situation, skipping steps because they are irrelevant, or doing steps because they are relevant, however when you have the time, do a complete (A-Z) assessment. I am a firm believer in knowing the steps, and why the steps are taken, before deciding that you can skip a step, or you need to focus on certain steps over others. But learn procedure and why, before you form your attack plan outside of the steps.

Luno
Like I said:

Also, it is important to remember that education is learning the rules; experience is learning the exceptions.
 

PArescueEMT

Forum Bartender
628
0
0
In answer to your first question... 5 years and counting. I am positive that I don't catch everything.

Your 2nd, find out if there are any Volunteer ambulance services in your area. If you join one, you might be able to start out riding as a 3rd on the truck.

That's how I started.

AND I'M SURE OTHERS DID THINGS THAT WAY TOO

Sorry. had to point that out to the ones who are usualy the ones to mention it
 

ffemt8978

Forum Vice-Principal
Community Leader
9,116
189
63
Originally posted by PArescueEMT@Nov 6 2004, 02:12 AM
AND I'M SURE OTHERS DID THINGS THAT WAY TOO

Sorry. had to point that out to the ones who are usualy the ones to mention it
We were saving it for you :D
 

GFD940

Forum Probie
25
0
0
I have to agree with rescuecpt. When you first start out do a complete, thorogh exam. As you get experience (I have been a medic for 7 yrs and still learn new things all the time) you will learn what is pertinent info to look for.

Any EMT can tell you what is happening to a pt. The good EMT can tell you what is happening and WHY. OK, he's having trouble breathing. That's obvious. To help him you have to find out why. Be thorough! Don't over look the not so obvious like a spontaneous pneumothorax.

Also, don't get distracted by the obvious. Yeah, that open tib/fib Fx looks nasty on a trauma pt. but compared to a lacerated liver that is the least of a pts. worries!
 

Top