shauniedarko

Emilea PA C, Happy new year to you. I just came across this and thought I'd throw my 2 cents in. I've only just graduated and passed my practical a month ago, but that might be a good thing since it's all still fresh in my head. There was one major thing that concerned me about this and it's that neither line assesses for ABC's or even really for mentation. I noticed in medical that you got the cc and then threw a nrbm at 15 lpm on, but omitted waiting to find out if the pt was even breathing. Hopefully this will help you. I managed to compress both pt assesments to managable bits: BSI General Impression S-M-D-D-C (Sometimes My Daddy Drinks Corona) S-Scene Safety M-MOI/NOI D-Determine # Pt's D-Determine if ALS needed C-Consider C-Spine CC & Obvious Life Threats AVPU-A-B-C-D-E AVPU-Mentation Test A-Airway B-Breathing (At this point you should make the decision on O2) C-Circulation D-Determine transport priority E-Expose Pt. At this point you want to do a rapid or focused. If they have chest pain, for example, focus in on examining the chest. SAMPLE S-Signs and Symptoms At this point OPQRSTI come into play You want to know When it started, what makes it better or worse, what kind of pain it is, whether it radiates anywhere, what it is on a scale of 1 to 10, the time and what they've done to treat it (if they've taken asprin or nitro ect) A-Allergies M-Medical Problems P- Past hx L-Last oral intake E-Events leading to At that point you should get a full set of V/S and perform some interventions if you can (Epi, Nitro, treat for shock, oral glucose) Then load em up, do a detailed, and reasses initial assessment (Mentation, ABC's), Reasses v/s, Reasses focused, and check your interventions. The Trauma is similar except you don't really worry about OPQRST. Some other words of advice - Don't forget breath sounds... If you're doing a focused on the chest or a rapid, get breath sounds. Also pay attention to what the instructors tell you. On the trauma scenario, I went first. The next 15 people had to retest because they put a traction splint on a pt with a midshaft femur fracture AND crepitus in the pelvis. Don't forget that Circulation isn't just pulse. It's also skin color, temp and condition. Forget that and you could miss someone in decompensated shock. Last, on traumas, if it's not life treatening, treat it during transport. Don't waste time splinting an ulnar fracture when you're on scene and the pt has a systolic bp of 60. Good luck. Just stay calm, be methodical and take your time and you'll rock it out.

I thought about doing that, but a lot of people told me to get EMT experience before going after paramedic, and some places won't even let you take paramedic classes without a couple years EMT experience. **EDIT** And thanks for the welcome. You guys are awesome.

Hey all, I'm Shaun, I'll be starting my EMT-B training in a few weeks. This is the start of a second career for me (I'm 28 now). I've done a lot of reading and I'm hoping to maybe clear some things up. After I finish my EMT-B training, I'll either stay where I am (in West Palm Beach, FL) for 6 months and then move to Seattle, or move to Seattle right away. Does anyone know what the prospects are of working in Seattle or the surrounding counties as an EMT-B? Do the FD's handle all the BLS calls? I know in King County they have Medic One which handles all the ALS calls, and that it's VERY difficult to get into their program. I know that here in West Palm the Fire Rescue handles most of the emergency calls and AMR handles mostly transport, so the best prospects for a long-term career are with Fire-Rescue. Does anyone know anything about Washington state? Basically I've heard if you don't go fire in WA/Seattle, job prospect's aren't good. Any help would be awesome. Thanks y'all Shaun