Patient # 2 would require a BVM because their RR rate is less than 12, and they were found unresponsive so there is a potential for their airway to not be patent. SpO2 is also at 86% where according to BLS standards you want to keep their SpO2 between 92-96% and above. Patient #1 would not require a BVM because their RR rate is within normal limits (12-20). SpO2 is 93% but they are complaining of SOB so I would use a NRB or nasal cannula. I have difficulties for when to use NRB or nasal cannula but in this scenario I believe I would use a NRB. Correct me please if I am wrong.
By no means am I practically trained in EMS, I just do a lot of research lol, but as for the question in the video... My bet is that pt 2 would be getting the BVM. His SpO2 and RR are both low. Pt 1, on the other hand, has a fine RR and SpO2, and doesn't need any sort of ventilation by the looks of it. I would assume Pt 1's respiratory distress would improve with high flow O2 on a non-rebreather. Edit: Just watched to when you explained, I forgot to consider the nasal cannula. Now it makes more sense. Also just now realizing that 93% SpO2 isn't optimal, lol. Awesome video, your channel is so informative!
If using a bag without oxygen is it necessary to have the reservoir bag on the back? And how do u decide which is appropriate, the oral or nasal adjunct?
I would use a BVM on Patient #2 with an airway adjunct, OPA if no gag reflex, teeth clenching, or oral trauma; NPA accessible if OPA is contraindicated. Considering Patient #2 has no Hx of COPD, her SPO2 should be at least 94%, and 1-2 word sentence speech further suggests she needs oxygen support. Since she presents with ventilations that fall within the standard range, I would use a Non-rebreather, set at 10 L/min, to supplement her oxygen intake. Upon my reassessments, I would titrate up to 15 L/min if necessary, according to her feedback, visible presentation, and subsequent SPO2 readings. Question: is it better to start at 10 L/min, then titrate up as necessary. Or go straight to 15 L/min with patient #2?
I’m late to this but currently in an NREMT class I would give patient 1 NRB at 15 if that’s to much for them then nasal cannula. Patient 2 bag em. BVM.
Does it need a qualification to use a BVM if one (without 02) is available or would a first aider be allowed to use one (without OPA or NPA, which I have no training on) during CPR or on pt. with CP depression e.g. opioid, benzo, GHB OD? I bought one for the van, just in case because MTM on some is quite nasty HPV, vomitus, BBVs. What about use of Oxygen by a first aider on Pts with vitals you state?
patient one = start with bag valve mask at 10L/minute and raise oxygen if needed but make sure to breathe for patient patient two = start with nasal cannula at 2-3L/minute and then if they need high flow oxygen switch to non-rebreather which i would start with a non-rebreather to begin with because they were having difficulty breathing
Hey Pauline, for mild breathing symptoms a nasal cannula at 2-6 LPM can be tested before a NRB Mask. Also you are in luck! I'm coming out with a video on all oxygen devices soon (this week) stay tuned my friend.
Can you setup different packages on your website. It will be a bit cheaper for us. We are students and finance is always a problem, $150 is a bit expansive. Thanks :)
What about a responsive patient with difficulty in rate or depth such as in chest pain or COPD? Would we use the NRB or BVM? Wouldn’t they try to fight us on the bvm?
@@TheParamedicCoach Thank you for the prompt reply. I have my final medical scenario tonight and I’ve been getting mixed advice on this situation. Today is for all the marbles so I don’t want to try to BVM a patient that is going to fight me on it. CPAP is outside our SOP in my area. Side note: love the channel. Been watching it since I started three months ago.
I havent been in EMS since 2013. Im getting my recert class for met soon. What I think I would do would be : Patient 1 would be NC with probably 2-4 lpm and adjust accordingly and Patient 2 would get BVm, high flow O2.
Hey Brian, thanks for the message here, if you are looking for confirmation, the course is my life's work and I truly believe that if more EMS providers/students had it in their possession, failure rates would dramatically decrease (catch what I say in my video intros) Secondly, this is why I have so many student results/testimonials on my website, to show you it's possible for anyone if they show up and put in the work. Hop off the fence my friend, and dive in, the video course will be your most helpful guide to becoming a certified and confident EMS provider. Hope to serve you at a higher level on the inside. Prep Course: www.prepareforems.com Evan, The Paramedic Coach
I'm going to say that #2 is getting a BVM because if they cannot speak on their own, then they cannot manage their own airway. They are going to need that ventilatory support.
Patient 2 requires a BVM because he is unresponsive, has very low RR and SP02, and cannot manage his own airway. Patient 1 is awake and alert, with an average RR and slightly low SP02, so I would give him 6L of Oxygen via Nasal Cannula.
![Airway Management with an iGel [NREMT skill]](http://i.ytimg.com/vi/LOG5EEuDTMM/mqdefault.jpg)
Your passion for teaching and EMS makes me want to excel and become the best of the best. Thanks for your videos!
Thank you for watching!
I guess I am quite randomly asking but do anybody know of a good place to watch new tv shows online?
Your videos are ridiculously helpful. Thanks for taking the time to put out so much invaluable content.
My pleasure!
A really good teacher you never ever pull dislikes!
Thank you for the kind words my friend! Thanks for your support and welcome back to the channel!
First class content for my emergency ambulance training in London.
I love the way you teach because is so simple thank you and i pick number two because the RR is below 12. Thanks
Thanks Evan! Great Video I will be taking my NREMT in December. Your Website has helped me a ton!!
Thanks Russell for watching the channel and being a member of the course! Happy to hear you are loving it!
Can’t wait for this to come out!
Thanks for watching, let's do this!
The breakdown on your videos helps me understand way more
Pt 1: NRB at 10L
Pt2: BVM W/ 15L support O2
Im going to have sooo much knowledge and notes on every chapter thanks to you and my passion for this. Class starts in august its a year long.
Open, Clear, Keep, Vent. Thank you!
Thank you so much for your videos! They have helped me so much during school!
You are so welcome!
This came just in time. Thank you so much!
Kaya, thanks for the comment and watching the channel, more to come so stay tuned!
Patient # 2 would require a BVM because their RR rate is less than 12, and they were found unresponsive so there is a potential for their airway to not be patent. SpO2 is also at 86% where according to BLS standards you want to keep their SpO2 between 92-96% and above.
Patient #1 would not require a BVM because their RR rate is within normal limits (12-20). SpO2 is 93% but they are complaining of SOB so I would use a NRB or nasal cannula. I have difficulties for when to use NRB or nasal cannula but in this scenario I believe I would use a NRB. Correct me please if I am wrong.
With an sp02 at 93 it’s not too low I would start with a nasal cannula for patient comfort and move up to a non rebreather if needed
If the SpO2 is
Great job on how /when to use A BVM. This is to help prepare for the NEMT Exam.
This is Avery excellent video and very knowledgeable for your EMT exam.
Good job Evan
Glad you liked it!
Thanks, doing my exam today. This cleared things up for me.
Thank you Coach, it really did clear up some confusion I had.
By no means am I practically trained in EMS, I just do a lot of research lol, but as for the question in the video...
My bet is that pt 2 would be getting the BVM. His SpO2 and RR are both low. Pt 1, on the other hand, has a fine RR and SpO2, and doesn't need any sort of ventilation by the looks of it. I would assume Pt 1's respiratory distress would improve with high flow O2 on a non-rebreather.
Edit: Just watched to when you explained, I forgot to consider the nasal cannula. Now it makes more sense. Also just now realizing that 93% SpO2 isn't optimal, lol. Awesome video, your channel is so informative!
wow - thank you - the way you explained it was brilliant!
Glad it was helpful!
Pt 1 : Nasal canula with oxygen administered between 4-6/lpm.
Pt 2: BVM with oxygen administered at 15/lpm and ventilations ( 1 every 6 seconds)
Great video I go for my nremt tomorrow your videos have helped me a lot hopefully I pass and keep up the good work and stay safe out there brother 🚑
Thanks for watching the channel and being a member, best of luck, keep at it, you got this!
You are a great teacher
Open, clear, keep, ventilate 👍🏼🤙🏼
If using a bag without oxygen is it necessary to have the reservoir bag on the back? And how do u decide which is appropriate, the oral or nasal adjunct?
I would use a BVM on Patient #2 with an airway adjunct, OPA if no gag reflex, teeth clenching, or oral trauma; NPA accessible if OPA is contraindicated.
Considering Patient #2 has no Hx of COPD, her SPO2 should be at least 94%, and 1-2 word sentence speech further suggests she needs oxygen support. Since she presents with ventilations that fall within the standard range, I would use a Non-rebreather, set at 10 L/min, to supplement her oxygen intake. Upon my reassessments, I would titrate up to 15 L/min if necessary, according to her feedback, visible presentation, and subsequent SPO2 readings.
Question: is it better to start at 10 L/min, then titrate up as necessary. Or go straight to 15 L/min with patient #2?
This is the best coach vids 🙃🙂😃😁
Welcome back to the channel, Colton!
Finishing up emt school here in the next 8 weeks, do you have any video's on taking the NR-EMT Test and possibly breakdown a few questions? Thanks!
Yes, that is exactly why I created my "prep course" it has helped thousands of students pass National Registry Exams. www.prepareforems.com
I’m late to this but currently in an NREMT class I would give patient 1 NRB at 15 if that’s to much for them then nasal cannula. Patient 2 bag em. BVM.
Amazing break down... thanks amigo.
Glad you liked it!
2 getting bvm , other could receive nrb
Do you have one for blood pressure? I struggle with taking vitals.
Hey Iesha, I cover topics like this and more inside my Video Study Course: www.prepareforems.com
got my fisdap today, wish me luck
Keep it up!
@@TheParamedicCoach passed!
Well explained. Thanks!
Glad it was helpful!
Does it need a qualification to use a BVM if one (without 02) is available or would a first aider be allowed to use one (without OPA or NPA, which I have no training on) during CPR or on pt. with CP depression e.g. opioid, benzo, GHB OD? I bought one for the van, just in case because MTM on some is quite nasty HPV, vomitus, BBVs.
What about use of Oxygen by a first aider on Pts with vitals you state?
great content, so helpful!!!!!
Glad it was helpful!
Can you use a BVM if high flow oxygen is unavailable?
patient one = start with bag valve mask at 10L/minute and raise oxygen if needed but make sure to breathe for patient
patient two = start with nasal cannula at 2-3L/minute and then if they need high flow oxygen switch to non-rebreather which i would start with a non-rebreather to begin with because they were having difficulty breathing
Open, clear, keep, ventilate! 15 lmp on bvm
That's the plan!
I thought that you only use a nasal cannula 4-6 liters if they patient refuse to use a NRB or can't tolerate it ?
Hey Pauline, for mild breathing symptoms a nasal cannula at 2-6 LPM can be tested before a NRB Mask. Also you are in luck! I'm coming out with a video on all oxygen devices soon (this week) stay tuned my friend.
@@TheParamedicCoach sorry just a quick question is this all in the protocols in PA?
@@paulinereinhard6918 Yes everything I do is according to National Standards.
Can you setup different packages on your website. It will be a bit cheaper for us. We are students and finance is always a problem, $150 is a bit expansive. Thanks :)
Taking my exam for working 911 Wednesday really helpful
Thanks for watching, Sami!
@@TheParamedicCoach update : got hired! Next step is practicing my skills with the help of your videos 👍🏼
a nursing student here, i wanna become an emergency nurse 3 yrs down the line
😍
patient 2 is getting a bvm with an opa (suspect trauma). Patient 1 is getting a nasal cannula at 4l
This was great...but didn't see the "mnemonic" but still a good vid no less!!
pt2 BVM, opa.
pt 1 nrb 15 ltr
Thanks for watching!
Now I understand, thank you!
That's the goal! Great job taking action here
Pt. 2 needs the BVM because his RR and SP02 are very low and he is unresponsive (he also needs an oropharyngeal airway if he has no gag reflex).
What about a responsive patient with difficulty in rate or depth such as in chest pain or COPD? Would we use the NRB or BVM? Wouldn’t they try to fight us on the bvm?
Depending on the full case, CPAP or NRB mask would be the best bet in the case you are talking about.
@@TheParamedicCoach Thank you for the prompt reply. I have my final medical scenario tonight and I’ve been getting mixed advice on this situation. Today is for all the marbles so I don’t want to try to BVM a patient that is going to fight me on it. CPAP is outside our SOP in my area.
Side note: love the channel. Been watching it since I started three months ago.
you simply kick ass
Thank you
Bvm for respiratory arrest and failure and Cpap for respitory distress?
CPAP for severe repository distress
Thank you.
You're welcome!
Im sorry, but when you say "Open the Airway" what exactly are you opening and why. Could you explain. Im trying to better understand that.
1. OPEN
2. CLEAR
3. KEEP
4. VENT
That's how you do it!
1 I would give a nasal cannula w/ 2LPM and 2 BVM w/ 15LPM assist with each breath and interpose 1 between each
Thanks for watching!
Open
Clear
Keep
Vent
Starting school shortly emt.
Awesome! Thanks for watching the channel, check the prep course here to get ahead and ready for class. www.prepareforems.com
❤️❤️❤️❤️
Open clear keep ventilate
I let another student insert an NPA into my nose for our EMT class. It was certainly an experience. 😆
OPEN, CLEAR, KEEP, VENT
Open, clear, keep , ventilate
OCKV. Open. Clear. Keep. Ventilate.
I havent been in EMS since 2013. Im getting my recert class for met soon. What I think I would do would be : Patient 1 would be NC with probably 2-4 lpm and adjust accordingly and Patient 2 would get BVm, high flow O2.
Number 2 is getting an airway adjunct and getting bagged.
Patient 2 gets BVM RR is 6 and found unresponsive
1. Nasal cannula NRB
2. BVM
Thanks for watching Tiffany!
I gotta hear it from you chief. Is your course legit?
Hey Brian, thanks for the message here, if you are looking for confirmation, the course is my life's work and I truly believe that if more EMS providers/students had it in their possession, failure rates would dramatically decrease (catch what I say in my video intros)
Secondly, this is why I have so many student results/testimonials on my website, to show you it's possible for anyone if they show up and put in the work.
Hop off the fence my friend, and dive in, the video course will be your most helpful guide to becoming a certified and confident EMS provider. Hope to serve you at a higher level on the inside.
Prep Course: www.prepareforems.com
Evan, The Paramedic Coach
1. O2
2. Bvm
Thanks for watching, Daniela!
I'm going to say that #2 is getting a BVM because if they cannot speak on their own, then they cannot manage their own airway. They are going to need that ventilatory support.
1-nasal cannula 2- BVM
patient 1 non-rebreather? patient 2 BVM?
Thanks for watching!
2. BVM
Pt 2
Patient 2 requires a BVM because he is unresponsive, has very low RR and SP02, and cannot manage his own airway. Patient 1 is awake and alert, with an average RR and slightly low SP02, so I would give him 6L of Oxygen via Nasal Cannula.
Number 2
8/28 ventilate
#replay
Open,clear, open, ventilate
Nremt test
Number 2 or 1
for patient 1 I would give a non rebreather mask and for patient 2 I would give BVM
Patient #2 needs BVM.
patient 2
open* clear*keep*ventilate
1. Non re-breather
2. BVM.
I hope Im right
i think it would be #2 because he cant is unresponsive
Pt 2 = BVM
Pt 1 = CPAP
I was wrong on CPAP. Why wouldn’t we use CPAP?
2
patient #2 is getting BVM would probably put patient #1 on a nasal cannula at 15LPM
Patient 2
Thanks for tuning in!
1 - Give him a nasal cannula with 2LPM / 2- OPA and BVM
2 gets blm 1 gets oxygen via nasal cannula
Peep.... lol
Open clear keep ventilate
Yes!
Number 2
Open, clear, keep, ventilate
That's the plan!
2
Welcome to the channel!
Open clear keep ventilate