Skills Final

That's a tall order to ask for. These patients that o2 can be harmful too generally have so many comorbidities and other variables attached to them that it's hard to isolate hyperoxygenation as the cause of their poor outcome.

Just like its tough to do a study on transport times in HEMS affecting outcomes because the crew brings so much more to the table how do you decide if their clinical knowledge and skills or the transport time is what made the difference?
 
Sandog said:
Are you a medic, or basic? I just retook my skills testing for my 2 year recert, and we use NREMT skills guidelines for testing. Nowhere was titration even mentioned.

I may only be a basic but I have a good deal of molecular biology background to understand what O2 titration entails, sounds neat and is a good idea, but the advantages are just not justified in comparison to the rare, very rare occasion that someone is harmed by O2.

I would love to see some real data showing all this harm that O2 has done, and I mean over a large sample, not a few out of a million. Can you show that?
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How many links would make you happy? 10? 20? 500? I don't think anything will. So why waste my time? I linked above where the NREMT does test and has added o2 titration for cardiac emergencies as of 2012. . Even though you haven't heard anything about it and this was for all levels in 2012. Medics were earlier.
It is now coming down to all problems especially cardiac and stroke . Don't want too much o2 on anyone.

Now someone in shock, has cyanosis, inadequate breathing etc. You bet I'll throw a nr on them, but most I have had great success with just a few LPM and a nasal cannula even tho that book in basic wanted 15 LPM nr on everyone
 
Mariemt said:
Here's the nremt page about it.
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Can you show me where in that link that it is a BLS task? From what I have read it is a ALS function.
That is why I asked if your a medic.
 
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Well this thread has gotten a big off topic. If it is NREMT skills all you have to do to pass the skills is just remember the NREMT sheets. If the SpO2 reading is low then the patient gets O2. For NREMT it's as simple as that.
 
DesertEMT66 said:
Well this thread has gotten a big off topic. If it is NREMT skills all you have to do to pass the skills is just remember the NREMT sheets. If the SpO2 reading is low then the patient gets O2. For NREMT it's as simple as that.
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We always got the thread on military time to fall back on...^_^
 
Well thanks everyone for the help. And extra info! I passed my skills final and graduated and now I have national registry tomorrow. yikes!
 
Everyone keeps talking about studies showing the "negative effects of o2" but what exactly are those. The COPD hypoxic drive argument I have heard debunked by several people who say it won't affect them unless you are going on hours long transfers. But what other side effects are other?
 
CPRinProgress said:
Everyone keeps talking about studies showing the "negative effects of o2" but what exactly are those. The COPD hypoxic drive argument I have heard debunked by several people who say it won't affect them unless you are going on hours long transfers. But what other side effects are other?
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Nothing to do with the hypoxic drive. Reperfusion injury due to hyperoxemia, free radical damage, oxidative stress, exacerbation of the inflammatory response. The list goes on and on...
 
chaz90 said:
Nothing to do with the hypoxic drive. Reperfusion injury due to hyperoxemia, free radical damage, oxidative stress, exacerbation of the inflammatory response. The list goes on and on...
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Have they been shown to be caused by o2 for the 30 mins to the emergency room.
 
It would be really hard to set up a prospective study for that kind of information. As far as I know, one has not yet been completed on outcomes during ambulance transport. Data has come out of in hospital studies for mortality and outcome, so we're trying to apply that information to our practices.
 
my best advice is to practice practice practice.

i practiced with my classmates and focused a lot on assessments.

you can run through everything verbally over a cup of coffee, etc.


as long as you don't miss any critical criteria you'll be good!
 
Mariemt said:
the systems don't trust EMTs to take blood sugar? Or they find it unnecessary?
Our system we take blood sugars, a lot! On diabetics, stroke like symptoms, all altered status... you wouldn't believe how many people presenting as strokes are hypoglycemic.
I do know it is taught that if they altered but alert enough for glucose to go ahead and give oral glucose in systems that don't check bgl
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Mariemt in CA our protocols do not allow to check BGL. If the patient has their own BGL monitor we can ask them to use it on themselves but that's it. I think it probably has something to do with being exposed to blood but I am not sure.
 
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