NREMT Medical Assessment Chest Pain

NREMT Patient Assessment of the Medical Patient experiencing Chest Pain

This demonstration has been performed systematically at a medium pace to aid you in this skill. This assessment was conducted with accuracy and detail. The actual time I spent on this skill start to finish was 14 minutes and 33 seconds. This assessment was in some ways more detailed than you will need to be while testing.

[herbiesnerd]

My son is in EMT school right now so I was curious to watch this. Well done drill.

I’m a retired firefighter paramedic of 36 years.

A couple points of constructive criticism:

1) Blood pressure was missed initially. With a real patient presenting this severely, sudden onset-crushing chest pain-pale cool clammy, instant alarm bells of probable acute MI are going off in your head immediately. If you don’t grab a BP immediately, you may never get a chance to obtain one. This patient is at severe risk of sudden cardiac arrest.
2) For an EMT, if there is an AED available, hook it up. AEDs are capable of recording EKG data although it may not have a monitor screen. In the event of any dysthymia or shock given, it will record all of it. The flash card can be removed and the data retrieved.
2) Lung sounds- always expose the skin. With experience this practice is only reinforced. Taking lung sounds over clothing or fabric is only out of laziness. It’s not a short cut. I learned this in paramedic school in 1982 from a highly respected ER doctor in Los Angeles. He had a list of different fabrics and the sounds they can mimic. Unfortunately the only one I remember is silk pajamas will mimic Rales. I always applied the stethoscope directly to the skin.
3) This patient needs rapid transport so direction needs to be given to your partner or crew about preparing to package up the patient. Gurney in the room, etc. Also, have your resuscitation equipment near the patient and be ready to use it.
4) Obviously follow your local protocols/standing orders for drug therapy but nitro is crucial to get onboard rapidly. NTG is instant acting, while Aspirin is not.
5) Heart sounds? I’m open for someone to educate me here, but out of my 20, 000+ patient contacts in my career, I never listened to Heart sounds.
EMS does not listen to Heart sounds, except on a newborn infant possibly for an audible pulse. There is no information in the prehospital setting that heart sounds will give you that you can identify or treat. Leave heart sounds to the Cardiologist. That being said, I encourage anyone to practice listening for heart sounds for personal knowledge, but there is no EMS use for it. Pulse and BP (and EKG when you become a medic) are all you need for cardiac info.

I’ll send your channel link to my kid so he can see you guys practicing. Good stuff.

Also, ALWAYS be open and accepting of constructive criticism and learning moments. The learning never ends. It’s a career endeavor. Experience teaches you recognition of what you were taught, until one day…….you’re the teacher.

[lorilam]

Thank you so much for your videos! I start EMT school in September with my 26 year old son and my husband. I have been sending these videos their way, and taking notes!

[fixedgearandunfixedgearbikes]

I hope I too have a big white board behind the patient with all the steps and reminders when i take my test!

[schmay]

The quote at the end was chilling but very true. Thanks for the video and good luck to all the future EMT's out there.

[skaterz]

In the EMT class I took, I was told that nitro has to be prescribed to the patient in order to assist with it.

[alexthomas]

Good job on the video would love to see more medical assessments! Also while it’s not NREMT required I notice a lot of people overlook it, I think a video on proper radio and bedside reports would be a benefit to a lot of people watching.

[ddahstan]

Just an immense appreciation for all these helpful resources. So thorough and detailed!!

[RallypointEMSNREMTDemos]

Thanks for commenting. I’m so glad this video was helpful! Good luck in your endeavors! Please tell others about this page!!!! RallypointEMS/Jeremiah

[Lt_SGR]

This is a great video for a Patient Assesment. Good Job

[besmirzhaku]

Jeremiah is an awesome paramedic. I had the opportunity to be his in his class recently, and let me say he's very easy to understand, I'm getting ready to take my practicals soon, and this video definitely helps a lot.

[HaloAubreeMariee]

Great video! I'm taking a fast paced EMT course (8weeks), and YouTube videos are really helpful! Thank you!

[curlyfriezz]

Wow best video I have found, helped me on my assessment. Thanks!

[fatimatomax]

You can’t forget the 15L on non rebreather when treating for shock

[angele]

You have to ask specific questions. Instead of saying “do you know where you are” say “where are you”. Or else they can just say “yeah” 😉

[porkyman]

Excellent demonstration. The details that you add in all your videos are incredibly helpful.

[PRINCEBONAVENTURE-whet]

Thanks a lot for this video I was so confused with the steps, but am now okay... Would like to watch more videos, this man is a professor like for real.

[veronicavera]

Thank you so much for this video . It describes everything with detail, very helpful. As an EMT student l really appreciate it, l cant wait to see more .God bless you all.

[alexatriolo]

Remember to verbalize the 5 rights when administering medications

[doncoleman]

We were taught to rate pain on a scale of 0 to 10 (zero being no pain). You'll always get patients who just don't understand a quantative pain scale question. "On a zero to ten, I'd say pretty bad"...…..

[dylanfitch]

Since when was steve carrel a paramedic