National Registry EMT Medical Patient Assessment/Management

[Music] [Applause] [Music] this is the patient assessment management medical skill and the skill you will have 15 minutes to perform an assessment patient interview and voice treat all conditions discovery you should conduct your assessment as you would in the field including communicating with your simulated patient you may remove the simulated patient's closing down to his or her Schwartz or Schwimmer if you feel it is necessary as you progressed in this skill you should state everything you are assessing specific clinical information not obtainable by visual or physical inspection for example blood pressure should be obtained from the simulated patient just as you would in the out of hospital setting you may assume you have two partners working with you or train to your level of care they can only perform the interventions you indicate necessary and will acknowledge all interventions you water I may also supply additional information and ask question for clarification purposes do you have any questions I do know right you were dispatched to a 55 year old female having chest pain okay the asanas the same safe yes the nature of all this is going to be a chest pain I was a certain number of patients because my only patient Mrs S IV nearly bought her a house back up unless s for any c-spine immobilization joisting inside to trauma no trauma okay consider these five visitors no sign of trauma I don't think it's necessary I'm going to form a gel refreshment of Asia I have of its 500 female sitting upright in the chair assess their level of consciousness as I walk up to the patient does she look at me those great patients alert assess orientation hi my name is Sean I'm gonna take care of you hi what's your name Mary Mary we're going right now you're all okay what do you do it's Saturday okay and why are we here havin a bad chest pain okay it's the patient's daily notes hence for for with the GCS of 15 and she stated her cheating point is chest pain at this time also spurning life threats you have no no life threats okay with assessing with the chief complaint of chest pain patient Airways and open so she's talking to being talking with fullest emphasis I'm SS her breathing break room log 22 normal 22 in normal with that information I'll give her honors in watchin 15 leaders be an operator mask is when I was in therapy I thought this was assess the patient's pulse Mary's okay if I check her pulse once again checking for regular than the body for her is 72 free her for this scenario big 110 regular 110 regular pulse has the skin color temperature ammunition for her it's pink normal dry you're as pale Cooley clinical claim he signs his job sorority for shock with the oxygen will also cover up with a white treat for shock and enjoy see any signs of bleeding no okay I'm gonna give her a high priority because she doesn't is having active chest mate I'm gonna get down into my secretary assessments of this so my side the symptoms is going to be the chest pain subscript s make squares pointing it Barry how long has this been going on for about 10 minutes 10 minutes does anything make it better or worse it just keeps getting worse it just keeps getting worse okay can you just grab that just be for me it's like a pressure something sitting on like a pressure okay with that chest being in your chest does it go anywhere else in your body it kind of goes down your arms okay any other thing besides that okay a scale up from 0 10 0 being no pain and 10 being the worst pain or cell in their life that's his pain 707 okay and over this ten minutes is he getting progressively worse is it getting better it's getting worse okay and then prior to us getting here did you do anything you take anything to make your fist be any better no no didn't do anything no I came in here and rest it but it didn't okay Jeremy how would you say anything nothing at all that's not on the food mitigation stuff like that okay are you on any medications aspirin nitro aspirin I tracked you haven't taken any easier today yeah okay Jimmy pass the pan of medical history two years yeah a heart attack two years ago okay much less I need something practiced you know yeah okay and before this just being started what were you doing your ammo belong here well that just came in to just say okay next I get seven right okay this time I'll start any secondary assessments I'm going to do a cardiovascular assessment on her so I'm assess her blood pressure pulse yes your Shane a little psycho cage will keep her a nice relaxed we'll be 112 our ad was all buried okay accessory pulses that's 72 for your scenario there would be 110 once that little pulmonary assessment where I'm sure listen to your lungs okay tasty breath he better yeah and over time that lungs are clear lungs are clear up to a muscle cell it's all assessment to see if the Chesapeake most with skeletal a major thing a few points where that just because it's right there is okay if I tell you they're quite yes is that cause you're you know let's take the same doesn't make it any worse no okay different segments rate assessment else that's the skin for color temperature in addition again for her seeing normal i still cal como planning also do a gi/gu assessment Jimmy noise your vomiting right now did you feel a little okay no actual vomiting yeah okay any problems going on the bathroom urination or bowel movements all that's normal okay at this point I'm going to take a full set of vital signs so I'll repeat the blood pressure I surprised - or 6112 alright so paper take your pulse ASME - still 110 so on time respirator 8:22 still 22 skin color sanitary condition clearly I'll put the spo2 probe on take a spo2 co2 set ID thank you okay I'm also going to see you assess her blood sugar 140 to 114 so I feel the pressure anticipation it's gonna be a she's possibly suffering another heart attack okay from there I'm going to call main control but before I do that I'm going to check the five flights of the medication so here I have nitro and aspirin the dosages for the nitro carbs your 24 milligrams and II wonder tablets of each aspirin they are sublingual tablets of the Nitro and these are chewable aspirin these are prescribed to you yes okay they are not expired well the expiration dates are still within deep and it is the right time to give this because she is having active chest pain I'll also check if there's any contraindications for the medications so for the Nitro or a systolic blood pressure is above 100 so we're not making any contributions there have you taken any media medications erectile dysfunction medications that's 24 to 48 hours none of those okay again you haven't taken any cuz you have now okay with the aspirin you're not allergic to aspirin no okay have you any any GI bleeds upper lower GI bleeds no there's no contraindications of any of the interventions so I'll call back control say my unit number what's the doctor answer as I'll say that I have a 55 year old female coming from home with a chief complaint of substernal chest pain the chest pains been going on for about ten minutes now she describes it as a more of a pressure to be getting worse over this past ten minutes it does radiate to her left arm she hasn't anything past ten minutes to me to make it any better she has no allergies she's upon Ashley and Nitro they're bolting date five rights are intact she does have a past medical history of an m9 three years ago she last be breakfast vote meal before doing this she was mowing her lawn her vital signs were blood pressure is 110 over 80 our closest about 110 respiratory 22 she's done 15 liters of the high flow oxygen her scans payable and diaphoretic her estate to a 90% with a blood sugar of 114 I'm calling for benefit medical control of giving up to three doses of 0.4 milligrams of something those habits of nitro and also 324 milligrams of aspirin again there's no contraindications salt but pressures above 100 she has taken a big pain medications she's not allergic either these medications and with Yasmin she has no history of any GI bleeds making those medications okay so I'm going to first start with the 324 milligrams of aspirin seeing out there are two of those tablets so I'll put out four of these tablets there's okay just put these are not too many normally down sure okay we can consider these administrators once those are cheesy to do is up to me who knows I'm gonna take these you're single 0.4 milligram tablet of nitro and Mary I'm gonna have you to put this under your tongue and let it dissolve right don't chew it don't swallow okay that after I do that I'll mark the time that I gave these medications other reassess this patient every five minutes especially I have to give the medications and then after a reassessment and either when the paramedic it's there or when I arrive at the hospital for the nursery doctor I'll give a full report of what I have and what I thought I mean I've completed the station [Music] [Applause] [Music] you [Music]

Channel: Yale New Haven Health Center for EMS

Views: 302,525

Keywords: medical station, medical, ems, emt, nremt, national registry, emt test, nationalregistryemt, yale, yalenewhavencenterforems

Id: j_vOcMMH6x4

Length: 12min 17sec (737 seconds)

Published: Mon Apr 29 2019