Hey everybody. I am a few weeks in to my EMT-B class (at Pima CC in Tucson, AZ). We're using the AAOS book. I recently missed a quiz question that I'd like to get some feedback on.
The question is: "After establishing that an adult patient is unresponsive, you should:
A) Open the airway
B) Assess for breathing
C) Check for a carotid pulse
D) Attach an automated external defibrillator immediately
My problem is this - the NREMT trauama/medical skills sequence seems to provide a different answer than the AHA CPR guidelines. They contradict each other. The skills sheet (2011 version, latest) indicates that airway is the correct answer (which it is, as per the instructor).
But, AHA says that checking the pulse is the first step after verifying the pt is unresponsive (source: p8 of 2011 BLS for Healthcare Providers manual). This was what I learned first, so it's how I initially answered the question.
My reconciliation is as follows - this is what I'd like your thoughts on, to make sure that I understand the big picture. Basically, I figure that the AHA guidelines would be more applicable if you were acting as a bystander - since CPR is pretty much the only option you have as a bystander, it makes sense to shortcut to it by checking the pulse ASAP. But in the capacity of an EMT, the pt assessment process would be the authoritative source. It's A-B-C rather than straight to pulse (and potentially CPR) because you have other tools at your disposal (e.g., OPAs) that should be inserted before potentially beginning CPR.
Is there anything you guys would add/remove/change to that logic? Do you understand the source of my confusion? Thanks in advance.
The question is: "After establishing that an adult patient is unresponsive, you should:
A) Open the airway
B) Assess for breathing
C) Check for a carotid pulse
D) Attach an automated external defibrillator immediately
My problem is this - the NREMT trauama/medical skills sequence seems to provide a different answer than the AHA CPR guidelines. They contradict each other. The skills sheet (2011 version, latest) indicates that airway is the correct answer (which it is, as per the instructor).
But, AHA says that checking the pulse is the first step after verifying the pt is unresponsive (source: p8 of 2011 BLS for Healthcare Providers manual). This was what I learned first, so it's how I initially answered the question.
My reconciliation is as follows - this is what I'd like your thoughts on, to make sure that I understand the big picture. Basically, I figure that the AHA guidelines would be more applicable if you were acting as a bystander - since CPR is pretty much the only option you have as a bystander, it makes sense to shortcut to it by checking the pulse ASAP. But in the capacity of an EMT, the pt assessment process would be the authoritative source. It's A-B-C rather than straight to pulse (and potentially CPR) because you have other tools at your disposal (e.g., OPAs) that should be inserted before potentially beginning CPR.
Is there anything you guys would add/remove/change to that logic? Do you understand the source of my confusion? Thanks in advance.
