You guys are my late night entertainment. These videos really help and make me feel more confident in my labs. I can only imagine the impact you will have on me as I take the nremt. You guys are great!!
taking the nremt psychomotor test tomorrow. these videos are so so so helpful for review. They are exactly like the skill sheets! Thanks for making them!
Man, that blonde girl is always up to some kind of asthma/bleeding/crash non sense. Seems kind of high maintenance, but at least she's not screaming, rocking, and pacing the scene looking for things and people that aren't there.
Danny Lee Hey Danny, we've seen a lot of your comments on our videos and we appreciate your thoroughness. You are correct, the metal strip is there to help shape the mask to the patients nose. Thanks again!
Some things I noticed, as I plan on taking this assessment tomorrow. Tank is vertical, without support. That is very bad, and if I were to do that during my exam, it'd be an instant failure, due to the volatility of oxygen under pressure. Another thing I noticed was that the bag mask's oxygen wasn't refilled after the first fill, nor were Nasal Cannula mentioned at all if a patient doesn't tolerate the mask. Other than that, this video was very helpful, and I plan on watching the rest as my assessments near. Thank you for your help, in advance.
+thepsynergist That seems to be the biggest issue I have, most educational institutions will mark a candidate for the "Inability to act as a competent EMT" critical criteria for leaving an O2 tank standing upright.
It did not look like he did anything to actually open the oxygen tank valve. He was about to spin it but never did. Are we going to have to do that on test day?
You should review MOANS (airway.jems.com/tag/moans/) and repositioning is always the first step. Bring the patient's face into the mask and not mash down on the patient, if that doesn't work immediately place in OPA if not contraindicated. The tongue is generally the most common obstruction. If you can ramp up obese patients, when not contraindicated, this can help with decreasing weight on the chest. I'm sure you have had answers in the past two years, but I feel like some basics stated here can really help folks in troubleshooting and maybe others may benefit. Finding real patients to practice on under an anesthesia group would be the ultimate, but practice practice practice is what really brings your skills to the next level. There is no skill too basic, just when you think you have it, you will not have it. Of course there are airway disease processes that could cause resistance, but stating too many to list gives you nothing. COPD, reactive airway disease, allergic reactions, and foreign body obstructions will make the patient more challenging to manage and could make bagging impossible at times. Talk to your OMD, local advanced providers, and even attempt to simulate these scenarios if possible. Good luck and never stop learning!
When assisting an apneic patient's ventilations and you feel increasing resistance without secretions or vomitus present, I would re-open the patient's airway and inspect the mouth and oropharynx for a potential airway obstruction or a foreign object that could potentially be obstructing the airway. If I happened to make the mistake of not inserting an OPA before ventilating, I would re-open the airway and insert an OPA according to the proper sizing of the patient or I would insert an NPA into the nostril if the patient has an intact gag reflex. If there is vomitus or secretions occluding the airway and oropharynx, I would measure my rigid tip catheter and insert it into the mouth and provide suction for no more than 15 seconds until the airway is clear. Then I would re-open the airway and assist the patient's ventilations via BVM connected to 15LPM high-flow oxygen.
Hey Alex, great question! Generally speaking, you'll give a NRB mask to someone who can maintain their respiratory drive. A BVM is used to assist or fully deliver ventilations the patient requires when they can't maintain their own. As always, follow your local protocols!
It's easy for you to remember if you know there are devices that give the patient more oxygen and there are devices that ventilated the patient. The nasal cannula and Non-rebreather mask are in different categories than a BVM. The goal of the BVM is to ventilate the patient because the patient cant' breathing adequately to support life.Nasal cannula and the no-rebreather mask are used to increase the oxygen level to the patient when the patient is able to breathe on their own. If your patient respiratory rate is between 8-28 you can use a non-rebreather mask if the respiratory rate is below 8 and above 28 or the patient has shallow or agonal breathing you need to ventilate this patient via BVW.
You are allowed 2 other chances after your first fail on that day before you have to come back on another day to retest. So that should not be a reason to fail the entire thing. Plus if that is only station then you only have to retest that station next go around.
Passed 1st try with the minimum 70 questions. I almost strictly used your program!! Excellent excellent program!!!!
Tom that is awesome news, congratulations!! Best of luck on all your future endeavors.
You guys are my late night entertainment. These videos really help and make me feel more confident in my labs. I can only imagine the impact you will have on me as I take the nremt. You guys are great!!
It has really helped me since so many things have changed since I did EMT 6 years ago.
Brandon Hernandez Thanks Brandon, glad you're getting so much use out of them!
72Disco1998 Glad we can help! If you have any questions please let us know.
EMTprep Yeah, really great informative videos. Keep up the great work.
taking the nremt psychomotor test tomorrow. these videos are so so so helpful for review. They are exactly like the skill sheets! Thanks for making them!
Glad you like them! Best of luck on your test, let us know how it goes!
@@Emtprep I passed each station! Thank you for the study help! I take the cognitive exam tomorrow 👍🏼
That's awesome Dominic! Congratulations!!
Man, that blonde girl is always up to some kind of asthma/bleeding/crash non sense. Seems kind of high maintenance, but at least she's not screaming, rocking, and pacing the scene looking for things and people that aren't there.
Right? talk about frequent flyers lol
Tryna get that insurance fraud money
Shes a champ
🤣
Or pissing in the back of the bus.
In my NR test, if the O2 tank isn't laying on its side, it is a critical fail
Same!
Nothing on the critical fail criteria on the skills sheet states that. So they made that up themselves.
The metal strip across the nose on the mask is there so you can fit the mask better to the shape of the patients nose.
Danny Lee Hey Danny, we've seen a lot of your comments on our videos and we appreciate your thoroughness. You are correct, the metal strip is there to help shape the mask to the patients nose. Thanks again!
Some things I noticed, as I plan on taking this assessment tomorrow.
Tank is vertical, without support. That is very bad, and if I were to do that during my exam, it'd be an instant failure, due to the volatility of oxygen under pressure.
Another thing I noticed was that the bag mask's oxygen wasn't refilled after the first fill, nor were Nasal Cannula mentioned at all if a patient doesn't tolerate the mask.
Other than that, this video was very helpful, and I plan on watching the rest as my assessments near. Thank you for your help, in advance.
+thepsynergist That seems to be the biggest issue I have, most educational institutions will mark a candidate for the "Inability to act as a competent EMT" critical criteria for leaving an O2 tank standing upright.
id be the person who, when they ask if there is anything else i'd like to do, would say, "Did i forget something?" im gonna fail this
It did not look like he did anything to actually open the oxygen tank valve. He was about to spin it but never did. Are we going to have to do that on test day?
Many times you’ll verbalize the procedure, but ensure you check with the proctor prior to beginning the assessment and you’ll be good to go!
Is there a video somewhere for the traction splint?
What happens when you get resistance when bagging and it is not due to vomiting. What is the other reason we would feel resistance?
LittleDrummerBoy Too many lung diseases to list sir! Great question though.
You should review MOANS (airway.jems.com/tag/moans/) and repositioning is always the first step. Bring the patient's face into the mask and not mash down on the patient, if that doesn't work immediately place in OPA if not contraindicated. The tongue is generally the most common obstruction. If you can ramp up obese patients, when not contraindicated, this can help with decreasing weight on the chest. I'm sure you have had answers in the past two years, but I feel like some basics stated here can really help folks in troubleshooting and maybe others may benefit. Finding real patients to practice on under an anesthesia group would be the ultimate, but practice practice practice is what really brings your skills to the next level. There is no skill too basic, just when you think you have it, you will not have it. Of course there are airway disease processes that could cause resistance, but stating too many to list gives you nothing. COPD, reactive airway disease, allergic reactions, and foreign body obstructions will make the patient more challenging to manage and could make bagging impossible at times. Talk to your OMD, local advanced providers, and even attempt to simulate these scenarios if possible. Good luck and never stop learning!
When assisting an apneic patient's ventilations and you feel increasing resistance without secretions or vomitus present, I would re-open the patient's airway and inspect the mouth and oropharynx for a potential airway obstruction or a foreign object that could potentially be obstructing the airway. If I happened to make the mistake of not inserting an OPA before ventilating, I would re-open the airway and insert an OPA according to the proper sizing of the patient or I would insert an NPA into the nostril if the patient has an intact gag reflex. If there is vomitus or secretions occluding the airway and oropharynx, I would measure my rigid tip catheter and insert it into the mouth and provide suction for no more than 15 seconds until the airway is clear. Then I would re-open the airway and assist the patient's ventilations via BVM connected to 15LPM high-flow oxygen.
What is it a minimum of 10L per minute and nit any lower. Can't find the answer to this
The flow rate should be between 10-15Lpm. You shouldn't go any lower with a NRB.
how do you know whether to give oxygen via non breather mask or BVM?
Hey Alex, great question! Generally speaking, you'll give a NRB mask to someone who can maintain their respiratory drive. A BVM is used to assist or fully deliver ventilations the patient requires when they can't maintain their own. As always, follow your local protocols!
It's easy for you to remember if you know there are devices that give the patient more oxygen and there are devices that ventilated the patient. The nasal cannula and Non-rebreather mask are in different categories than a BVM. The goal of the BVM is to ventilate the patient because the patient cant' breathing adequately to support life.Nasal cannula and the no-rebreather mask are used to increase the oxygen level to the patient when the patient is able to breathe on their own. If your patient respiratory rate is between 8-28 you can use a non-rebreather mask if the respiratory rate is below 8 and above 28 or the patient has shallow or agonal breathing you need to ventilate this patient via BVW.
I was told generally speaking to use a BVM when respirations are below 8 or above 24.
@@Emtprep.people is for a man who has a heart failure
Can you give a patient more than 10 liters of oxygen a minute. Great video and channel
Yes 2-6 nasal cannula and 10-15 for the non rebreather
@@tonyrodriguez4686 thankyou
Hey Danny I love that picture
She looking at him like she doesn’t trust him!
Probably cause he isn't at least 6' 2"
They said I put the mask on wrong and failed me lol. Which is crap I know how to put a mask on they are just trying to get me.
You are allowed 2 other chances after your first fail on that day before you have to come back on another day to retest. So that should not be a reason to fail the entire thing. Plus if that is only station then you only have to retest that station next go around.