Take my practical in 3 days, have been watching these videos on repeat for the last week, they are extremely helpful and I really appreciate what you guys are doing!
When you give those breaths you are looking for a rise and fall of the chest. The rate is 2 breaths of every 30 compressions. The depth is about to 2” and always allow the chest to recoil. Remember to reassess for pulse radial or carotid because if there pulses come back stop CPR and monitor that patients pulses. You can still give 1 breath every 2-3 seconds. If you are in public make sure to call for an AED just in case!
Just remember, with no CPR done at all, they will almost always die before the ambulance arrives or on route to hospital. So if nobody else is willing to step up, if nobody has any training on this stuff, just try it. The persons heart has stopped beating... you really can't make things any worst by doing bad CPR if the alternative is no CPR. Do what you can until the ambulance arrives, try and use the Defib if someone can bring it to you and set it up. But if nothing else at least try the chest compressions, you are giving them a fighting chance, keeping them barely alive until the professionals can turn up and take over. That's all CPR is... keep them alive until the real specialists can do their thing to actually restart their heart.
I had to wait six months after I completed my EMT-B course to apply for a job. Got an interview next week and this is a great refresher. I never really forgot but it does take me back to that rush in class when we act out scenarios with family members. Gets you going!
Very close. In NY State during the second Integration section, it also has verbalizes Insert an oral adjunct OPA/NPA , and verbalizes transport of patient.
You guys are amazing! I have skills test for my basic this weekend and I've been a little nervous. But you guys with your epic videos about the skills are helping a ton! You guys rock!
@@USMCwifey2001 I've heard of proctor's letting you keep doing compressions and not delivering your AED if you don't call for it. Err on the side of caution and always call for it! Verbalize EVERYTHING
a couple comments. The quality of the cpr being done is not deep enough, it should aproximate 1/3 of pt's chest the rythem is also too fast, it should be 100-120bpm. additionally as soon as you determine pt is vital signs absent the aed should be applied as quickly as possible, not after one full round as the pt's survival outcome decreases 7-10% each minute the aed is delayed
@@br1mst0ne54 Current AHA guidelines are: 0 - 1 year: At least one-third anterior-posterior diameter (about 1.5 in. [4cm]) 1 year - the onset of puberty: At least one-third anterior-posterior diameter (about 2 in. [5cm]) Onset of puberty and up (adult): 2 - 2.4 in. (5 - 6 cm)
must we tell the partner to do compressions after the rhythm analysis and before giving the shock? During my final for the EMT class i took, that was not expected.
+trueavaholic It's always a good idea to verbalize what you want done. Chances are you will be performing the test in front of someone you don't know. Be sure to let them know what is going on in your head.
So my NREMT skills test is coming up and I had a question about this. So when the AED was analyzing the patient and advised shock, the EMT prompted for the other EMT to begin compressions until the AED was charged then proceeded to clear the patient a second time. In my EMT course, we were told that after the AED was finished analyzing, we were to remain clear of the patient until shock was delivered, would that be an acceptable method aswell?
Great question Cedrick! Be sure to check with your proctor at your testing site. We have heard of both, as long as you can verbalize what you're thinking and why you're doing it, you will do great! If you have any other questions let us know.
Now they want you to continue CPR until the last second. Right before the shock is advised the EMT hops off of the patient with immediate instruction from the other EMT to remain clear. You do CPR as often as you can alongside the use of the AED. Each state is different though.
if you keep doing compressions while the AED is analyzing the patient then it won’t analyze the patient correctly. that’s what i was taught in my EMT class, at least.
You continue compressions alongside the AED charging. The only times you stop compressions is when the AED is analyzing and when it delivers the shock.
Someone experienced with CPR and Defibs would do it how they did. Separate for the rhythm analysis (so that the person doing CPR doesn't affect it) soon as that's done back in with compressions and keep going until you hear that the Defib has charged, at that point either stop CPR or if you KNOW the person operating the Defib will give clear instructions wait for their cue to stop just before they shock. But for the layman, the untrained person in the street, its safer for all parties to do CPR until it tells you to stop for rhythm analysis, then as long as your quick about it get it charged and give the shock as quick as the Defib will let you, then carry on CPR. But as long as you know when you need yo stop and when it's safe to keep going, it's better to even just get like 5 chest compressions in whilst it's charging than leaving them without circulation for upto 30sec
Quick question: in this scenario before I start chest compressions.. should i check for clear unobstructed airway in the mouth/throat or should i just proceed straight to chest compressions? Also would I have to put a Oropharyngeal Airway before doing compressions? ughh i think i am confusing myself. Sorry for the questions. Thank you for your videos.. this is the only way I learn, through informative videos.
Ideally yes. I'll make a scenario for you. Imagine you're alone and you arrive with a trauma bag since you heard shouts for help, you have OPA's, BVM, oxygen etc. Assume you already have bsi on and you're approaching the pt. You mentally make a general impression of the patient ie. ( male mid 50's lying supine no visible breathing, skin looks pale and diaphoretic maybe even cyanotic, long sleeve cotton shirt, group of by-standers standing around making snapchats) this should take one maybe two seconds as you approach, Yell out to anyone around "hey what happened, Does anyone know this guy?!"They say we don't know he grabbed his chest and then fell down. Drop your trauma bag by his head where you can still reach it while on your knees. you're perpendicular to his chest right below his armpit. You pull his shirt up to expose his chest while simultaneously shouting loud something like "HEY WAKE UP, CAN YOU HEAR ME!!" no response... Following the AVPU scale you know he's not awake and not verbally responsive, don't wait, immediately go to painful stimuli. Do a quick and firm sternal rub or trap pinch. he's still not responsive.. Total time at this point from arriving should be about 5-10 seconds. Now clearly direct one person (point to them and loudly say call 911 to send ALS) Point to another person or say to everyone GET A AED, RUN! now you assess for airway and carotid pulse. His mouth is closed. quickly but not forcefully, use two hands to do a head tilt chin lift, (typically the head will stay in a slightly hyper-extended state without needing to hold it on an unconscious pt. (assume there is no MOI for c-spine precautions) Now doing this simultaneously use two fingers with one hand and feel for a carotid pulse while looking at the patients mouth, use your other hand with your fingers underneath the nose and your thumb on his chin to pull his mandible (lower jaw) down, opening his mouth. briefly look at the position of his tongue, if there's vomit, blood, obstructions like food or teeth. I'm writing all of this out but in reality it would take a second or two to do this. Say for instance, you don't see any foreign material but his tongue is flapped back, regardless look back at his chest and watch for any rise and fall. If you still don't have a pulse or can see or hear breathing after about 5-7 seconds begin compressions. Remember that assessing vitals cannot be longer than 10 seconds. In this situation which is really quite plausible, other people will be around and hopefully will help. hopefully you're good at CPR and can talk while counting or know the approximate timing. While doing your first 30 compression wether the air way is clear or not, look up and tell someone to get down on their knees across from you to help, tell them to watch and do exactly what you're doing, when you say start or go or whatever. you finished 30 high quality compressions, and the bystander takes over. Make sure to tell them to count each compression out loud so you know where they are at. You know his tongue is flapped back so this is your time to insert the right size opa. if there was an obstruction, or something else blocking his air way it most likely would have been forced out during your first 30 compressions. If you're good, inserting an OPA should take about 5 seconds. you should have enough time to get your rescue mask out or bvm opened, mask attached and tube hooked up to oxygen. if you don't have enough time to get oxygen flowing to the bvm, it's more important to get ambient air into him. You hear your bystander count 25,26,27,28 you should have a good seal on his face by now and ready to ventilate, 29, 30 tell the bystander. STOP, while you squeeze the bvm until you see chest rise, squeeze for approximately one second, squeezing too fast could force air into the gastric system and could make him aspirate. on the second ventilation as soon as you've squeezed the bag in tell the bystander to start compressions again. you don't have to wait for the bag to refill and wait for compressions. Air will be forced out on the first one anyway so don't waste time. At this point You're about 30 seconds into CPR and hopefully you were paying attention to how well the bystander was doing. If he wasn't doing good compressions take over again and assume the role of ventilating too. If done correctly, 1 rescuer can do high quality CPR even with a bvm, just use a good E-C grip and head tilt chin lift. Once the AED arrives its probably a good Idea for you to attach the pads and set it up since you're very likely more trained than everyone else around. Even if you're in the middle of a set say your counting 12,13,14, and a person throws you the AED have a bystander take off where you left. if you're still getting it set up and the bystander reaches 30 and doesn't know how to use a bvm thats okay, tell them to continue compressions. you get the AED on and it says "ANALYZING" tell the bystander to stop and don't let anyone touch the patient. It will then say shock advised. tell them to start compressions again, (alot of people get this wrong and don't continue compression in this period) once it says charging and the sound and light comes on then tell them to stop and "CLEAR" the pt. make sure nothing is touching him and deliver the shock. Compressions should begin immediately and the next ventilation should happen after 30 more even if you missed a ventilation set while applying the AED. If the bystanders are doing a good job let them take over compressions while you reposition right behind the head of the patient to do good ventilations and assessing for any signs of life. If they're not doing good compressions it's just gonna be harder on you and it's your decision to take over again or try to coach them to do it better. Hopefully the pt becomes responsive at some point, immediately remove the opa and asses the ABC's again you might have to insert a NPA and continue rescue breathing or do neither and put him on high flow 02 with a non rebreather mask. If the guy is still dead when ALS arrives they'll take over and hopefully congratulate you for doing an excellent job. Tell them everything you know, how long its been, how many sets of cpr were done, how many shocks from the aed etc. while its all fresh in your mind. Hopefully this never happens but it's good to run through mental scenarios just in case. Best of luck, Stay well!
@@10--50 you have no idea how much im learning from your post right now.. thank you Sir. Thank you i need to develop a routine like that which makes me more efficient and faster. You have a good system i will follow 😁😁 thanks man this really helps!!
@@user-kk8wr7bv8b I'm glad that helped! It's amazing how much you can forget if this happens in real life, so running through scenarios in your mind while you're calm or watching video's of real rescues is important. Just remember that real events are never the same, try thinking what you would do if you had another trained person with you and how you would communicate, or if there was a massive bleed or spinal injury with an arrest. Think about what you'd differently if it were a child or infant, or had no cell service, a different aed, multiple patients, if it was a drowning or you had an equipment malfunction etc. I'm glad you're looking into this and encourage you to keep it up. Wish you the best!
So I am retaking the 3 stations i failed tomorrow and i'm pretty sure I've got it all good to go. The only concern i have about this particular station is that I've heard mixed things about continuing compressions while the AED is charging. Should I or should I not have my partner continue these compressions while charging? thanks
He continued when it said shock advised, clear patient. It said it twice, would that be an automatic fail or no because it doesnt shock until you press the button?
When it says deliver shock now tell everyone CLEAR and make sure no one is touching the patient (anyones hands, knees ect.). Once you see no one is touching the patient you deliver the shock then continue CPR.
Wouldn't you reassess for a pulse after the shock was delivered? If not, why? Are you allowing the AED to assess for a pulse? Very helpful videos, thank you!
We're told not to check for a pulse immediately following a shock because even if it is successful, it still would take several minutes for the heart to resume a perfusing rhythm. Thus, we're instructed to always immediately resume chest compressions following a shock
Often EMT's will request for ALS or Paramedics, and they can then determine once they arrive on scene, but your job is to continue CPR and follow the instructions on the AED. If it advises a shock, clear the patient and deliver it. It could be good to assess for a pulse, but often people just resume CPR. I don't have much experience, but I would assume you would get on top of the patient, straddling him of course, while he is on the stretcher/cart, continuing CPR there. Once in the ambulance, you can resume your position beside the patient. Often a physician will decide when to stop CPR and pronounce the patient as deceased. Anyway, I hope this helped.
Charles Maunder holy cow this guy would fail big time.. why cant they just show how to do the station right?? I can do cpr in my sleep and i failed it 3 times the nremt is a joke..
you would open the airway (in this case with an unconcious patient with no one around when the fell) via the jaw thrust manuver before you look listen and feel for a pulse, breath sounds, and chest rise and fall. After that and finding a pulseles patient (regardles if they were breathing or not) begin CPR. As you take a moment between CPR cycles to breath for the patient, you would quickly look to ensure the airway was still clear and in proper position. I can't spell btw.
I was taught to check for carotid pulse and breathing 5-10 seconds during the time AED is analyzing…you are not supposed to touch patient during analyzing cycle but you can place your fingers and palpate neck for pulse
Hi Bro... NREMT training really help me in preparing my training. what is your advice if in real the AED analysed "NO SHOCK ADVISED" what is the next action?
Thanks :) I only ask as I am a first responder here in the UK and we trained to attach the AED pads before starting CBR. Just wanted to know why you guys do it slightly different. I'm are only trained in basic life support and I have been watching your videos to educate myself a little more :) Many thanks. Chris
Awesome Chris! There are times when the pads should be placed on the patient first but it depends on a few factors. Glad to hear you're enjoying our videos. How far are you planning on going with your education?
Hoping to get employed with my local Ambulance Service as an EMT. Well, thats the plan :) Enjoying being a Community First Responder at the moment. But we don't get as much training as I would like... Just super keen to learn as much as I can. Just glad there's educational videos like yours on here for me to watch!
+Chris Foster Right on Chris! Best of luck on your future endeavors. If you ever have any questions feel free to email us and/or check out our site, EMTprep.com. We have a lot of great content up on the Free Training page and as of today you can link your Facebook account and add comments.
So, with the NREMT sheets that I have.. and what I learned was that you do the Scene Safe, BSI's in place, Check for responsiveness, breathing, pulse, then you are the one turning the AED on and applying, with your partner beginning the compression's. Then the AED will prompt everyone to clear, while it analyzes, then once the AED tells you to begin compression's, I would start compression's... While my partner does the BVM.... Then we switch after that and I would do the BVM... can you confirm?
Nick C I had the same question. I thought that would be the first thing you do if not your two breaths would null or void cuz patient has an obstruction
Hey Tanner, the content isn't necessarily difficult, there can just be a lot of it to comprehend and memorize at times. It is very doable if you put forth the effort. Best of luck to you!
@@Emtprep thanks so much! The fire department that I volunteer at, said that I have to take some fire classes before I take my EMT, and I take my first "fire" class in February. So I'm on the road towards the EMT classes!!
No, it is not hard. The skills are mostly common sense. Some disease pathologies can be complex though. Overall it requires a high school education for a reason...
steps of good cardiac arrest CPR, determine if patient has a central (carotid) pulse and determine if patient is responsive, if patient is not responsive with no pulse, begin compression at 100-120 BPM. if AED is available, apply pads after 2 minutes of compressions, apply pads, do CPR, until AED tells you to shock. clear patient then shock, begin 2 person CPR with one doing compressions one doing rescue breaths with either a pocket mask or a Bag valve mask attached to 15l/minute of 100% Oxygen. listen to prompts from AED. shock again if advised, if "no shock advised" check for outward signs of life and a central pulse. if both are detected check for breathing, if breathing absent begin 2 person rescue breathing with a Bag valve mask attached to 15l/min of 100% oxygen at a rate of one breath every 5-6 seconds. if breathing is present, attach patient to a nonrebreather mask at 15l/min of 100% oxygen, get them on the strecher. attach ECG and keep pads on patient in case of further cardiac arrest. then DRIVE. activate a CODE/Cath Lab alert at receiving facility. rapid transport
Great video! It seems your grading sheet is different than mine. I have my practical tomorrow, and I've watched this video countless times. Have the requirements changed at all? After the first shock is delivered, the sheet says to immediately begin two rescuer CPR (candidate must be performing ventiliations), proceeds for two minutes, and then shocks a second time. Any help is great, this is from the most recent NYS Dept. of Health sheet. Thanks!
xRaffer Great question!!! Follow what your proctor wants from you. Before the test starts it is okay for you to ask them what they would like in terms of performing certain skills. For example, during the trauma assessment, sometimes the proctor will ask you to verbalize your spinal precautions. Not all the time but sometimes. Just be sure you have a clear understanding of what they're looking for from you during your test and you will do great!
Follow those skill sheets verbatim, verbalize anything you’re unsure about, and you’ll do great. Get some sleep, eat a normal breakfast in the morning too. Be sure to let us know how it goes. We’re pulling for you!!!
uberman121 Hello, the way our student does it is correct. You can verify this at the following link. Notice the last step of the skill sheet. Let us know if you have any other questions. www.nremt.org/nremt/downloads/E215%20Cardiac%20Arrest%20AED.pdf
I just took my exam and when I was taking it the proctor told me that the 2 minutes had passed and I was just about to finish my 4th cycle of cpr. Is it a critical fail if you do not get 5 cycles in 2 minutes? Everything was perfect after though. I am concerned because the critical fail section does not mention anything about 5 cycles. When I practiced, I always completed 5 cycles in less than 2 minutes. Either I was nervous or the time was incorrect
In this video they didnt call for the aed. The aed prompts is what can fail ppl. Apparently u cant be off cpr for 10 seconds or longer so if your waiting for it to charge and no one is doing cpr they fail u
+A7Xforevaaa : Step 1 Google; NREMT. Step 2 Read the psychmotor scenario's. Step 3 Put face in Palms because these videos follow to a T the entire NREMT test.
Generally yes, at least for me. When I got to that point I was stopped letting the proctor continue CPR while I got the AED ready and applied, but just in case I would keep count in your mind so you’ll know in the case that they don’t tell you to stop.
Brian Mattingly Whatever state you are getting licensed in can do it how ever they wish. This is just the national standard. It's good practice. 3/3 of the cardiac calls I worked I had to either place an airway or nasal. After awhile of doing chest compressions you will get vomit and need something to maintain the airway.
I am thinking the same thing. Although maybe he already had one with him, but that doesn't help us students who are told to follow the sheet we are given.
How do u know..did you knw that those dummies have a check light for adequate depth? The light comes off if you not compressing deep enough and comes on wen you are adequate
Take my practical in 3 days, have been watching these videos on repeat for the last week, they are extremely helpful and I really appreciate what you guys are doing!
+Alex Bailey Hey Alex, glad you're getting good use out of them! Best of luck on your test!
Did you pass?
we need to know if you passed
Well, did you pass?
Alex, for the love of God, did you pass or not?!
Just passed my practicals thanks to these videos !!!!! Thank you guys for the wonderful content. Graduation on Monday Woooooooooooooo! (:
CONGRATULATIONS!!!!
Congratulations! I take mine on Jan 5th for EMR,
Rkenny86 aah I take mine tomorrow!
How'd it go Sarah?
EMTprep I passed 😁😁 thank you! I take my cognitive on the 4th! I’ve been taking the practice tests non stop I bought from you guys !
When you give those breaths you are looking for a rise and fall of the chest. The rate is 2 breaths of every 30 compressions. The depth is about to 2” and always allow the chest to recoil. Remember to reassess for pulse radial or carotid because if there pulses come back stop CPR and monitor that patients pulses. You can still give 1 breath every 2-3 seconds. If you are in public make sure to call for an AED just in case!
Just remember, with no CPR done at all, they will almost always die before the ambulance arrives or on route to hospital. So if nobody else is willing to step up, if nobody has any training on this stuff, just try it. The persons heart has stopped beating... you really can't make things any worst by doing bad CPR if the alternative is no CPR. Do what you can until the ambulance arrives, try and use the Defib if someone can bring it to you and set it up. But if nothing else at least try the chest compressions, you are giving them a fighting chance, keeping them barely alive until the professionals can turn up and take over. That's all CPR is... keep them alive until the real specialists can do their thing to actually restart their heart.
Life over limb always, id rather be paralyzed and alive rather than dead
I had to wait six months after I completed my EMT-B course to apply for a job. Got an interview next week and this is a great refresher. I never really forgot but it does take me back to that rush in class when we act out scenarios with family members. Gets you going!
why did you have to wait so long??
Very close. In NY State during the second Integration section, it also has verbalizes Insert an oral adjunct OPA/NPA , and verbalizes transport of patient.
Taking my practical this weekend. The NREMT sheets dont say anything about adding an adjunct nor verbalizing transport.
@@audreythompson3857 NREMT is national . Some states have you do they’re own psychomotor as well in this case NY makes you do it
Taking my practical in a week I’m freaking out! Watching these videos and going over some medical and trauma stuff. Wish me luck 😊😊
Best of luck Vanessa! You got this!
Vanessa P good luck
You guys are amazing! I have skills test for my basic this weekend and I've been a little nervous. But you guys with your epic videos about the skills are helping a ton! You guys rock!
+Morgan Adams thanks Morgan, glad you're getting good use out of them.
He never called for an AED
Maybe because he already had one?
@@USMCwifey2001 I've heard of proctor's letting you keep doing compressions and not delivering your AED if you don't call for it. Err on the side of caution and always call for it! Verbalize EVERYTHING
How is he gonna call for an AED if the man is alone and no bystanders are present? He would have already brought his AED off of the truck.
@@brucesanchez2940 You're never alone on a call in most departments. And if you are, use your radio.
He called for EMS backup, would they not bring the AED?
a couple comments. The quality of the cpr being done is not deep enough, it should aproximate 1/3 of pt's chest the rythem is also too fast, it should be 100-120bpm. additionally as soon as you determine pt is vital signs absent the aed should be applied as quickly as possible, not after one full round as the pt's survival outcome decreases 7-10% each minute the aed is delayed
Should the airway be checked before beginning in case of an obstruction?
Yes
Request additional resources before cpr
drizyyyy he did
These videos are a great resource.
Andrew Bell thanks Andrew, glad you're liking them!
EMTprep I'm just a explorer but this helps me as well. i also take first responder my senior too! thanks for the videos
+rakamadafaka900 Skyarza "Medic Study star" is a scam.
I was taught slower compressions in school and cpr class, this is faster I think.
I think he is doing it a bit to fast but still good video
way fast he is doing like 150 you should be 100-120
He's also not going anywhere near deep enough.
As a 20 year emt. It’s not fast. Work on the street. Then u will see
@@br1mst0ne54 Current AHA guidelines are:
0 - 1 year: At least one-third anterior-posterior diameter (about 1.5 in. [4cm])
1 year - the onset of puberty: At least one-third anterior-posterior diameter (about 2 in. [5cm])
Onset of puberty and up (adult): 2 - 2.4 in. (5 - 6 cm)
these are helping so much. my NR skills test is in a week and i have a few practice sessions with my instructor coming up. thank you
You bet Thomas!!!!
I am trying to become an emt and this showing what im going to be up against thank you
Did you make it?
@@1111111121121 NOPE lol
@@mauricerichards3257 lol what happened?
must we tell the partner to do compressions after the rhythm analysis and before giving the shock? During my final for the EMT class i took, that was not expected.
+trueavaholic It's always a good idea to verbalize what you want done. Chances are you will be performing the test in front of someone you don't know. Be sure to let them know what is going on in your head.
So my NREMT skills test is coming up and I had a question about this. So when the AED was analyzing the patient and advised shock, the EMT prompted for the other EMT to begin compressions until the AED was charged then proceeded to clear the patient a second time. In my EMT course, we were told that after the AED was finished analyzing, we were to remain clear of the patient until shock was delivered, would that be an acceptable method aswell?
Great question Cedrick! Be sure to check with your proctor at your testing site. We have heard of both, as long as you can verbalize what you're thinking and why you're doing it, you will do great! If you have any other questions let us know.
Now they want you to continue CPR until the last second. Right before the shock is advised the EMT hops off of the patient with immediate instruction from the other EMT to remain clear. You do CPR as often as you can alongside the use of the AED. Each state is different though.
if you keep doing compressions while the AED is analyzing the patient then it won’t analyze the patient correctly. that’s what i was taught in my EMT class, at least.
You continue compressions alongside the AED charging. The only times you stop compressions is when the AED is analyzing and when it delivers the shock.
Someone experienced with CPR and Defibs would do it how they did. Separate for the rhythm analysis (so that the person doing CPR doesn't affect it) soon as that's done back in with compressions and keep going until you hear that the Defib has charged, at that point either stop CPR or if you KNOW the person operating the Defib will give clear instructions wait for their cue to stop just before they shock.
But for the layman, the untrained person in the street, its safer for all parties to do CPR until it tells you to stop for rhythm analysis, then as long as your quick about it get it charged and give the shock as quick as the Defib will let you, then carry on CPR. But as long as you know when you need yo stop and when it's safe to keep going, it's better to even just get like 5 chest compressions in whilst it's charging than leaving them without circulation for upto 30sec
Quick question: in this scenario before I start chest compressions.. should i check for clear unobstructed airway in the mouth/throat or should i just proceed straight to chest compressions?
Also would I have to put a Oropharyngeal Airway before doing compressions? ughh i think i am confusing myself. Sorry for the questions. Thank you for your videos.. this is the only way I learn, through informative videos.
Ideally yes. I'll make a scenario for you. Imagine you're alone and you arrive with a trauma bag since you heard shouts for help, you have OPA's, BVM, oxygen etc. Assume you already have bsi on and you're approaching the pt. You mentally make a general impression of the patient ie. ( male mid 50's lying supine no visible breathing, skin looks pale and diaphoretic maybe even cyanotic, long sleeve cotton shirt, group of by-standers standing around making snapchats) this should take one maybe two seconds as you approach, Yell out to anyone around "hey what happened, Does anyone know this guy?!"They say we don't know he grabbed his chest and then fell down. Drop your trauma bag by his head where you can still reach it while on your knees. you're perpendicular to his chest right below his armpit. You pull his shirt up to expose his chest while simultaneously shouting loud something like "HEY WAKE UP, CAN YOU HEAR ME!!" no response... Following the AVPU scale you know he's not awake and not verbally responsive, don't wait, immediately go to painful stimuli. Do a quick and firm sternal rub or trap pinch. he's still not responsive.. Total time at this point from arriving should be about 5-10 seconds. Now clearly direct one person (point to them and loudly say call 911 to send ALS) Point to another person or say to everyone GET A AED, RUN! now you assess for airway and carotid pulse. His mouth is closed. quickly but not forcefully, use two hands to do a head tilt chin lift, (typically the head will stay in a slightly hyper-extended state without needing to hold it on an unconscious pt. (assume there is no MOI for c-spine precautions) Now doing this simultaneously use two fingers with one hand and feel for a carotid pulse while looking at the patients mouth, use your other hand with your fingers underneath the nose and your thumb on his chin to pull his mandible (lower jaw) down, opening his mouth. briefly look at the position of his tongue, if there's vomit, blood, obstructions like food or teeth. I'm writing all of this out but in reality it would take a second or two to do this. Say for instance, you don't see any foreign material but his tongue is flapped back, regardless look back at his chest and watch for any rise and fall. If you still don't have a pulse or can see or hear breathing after about 5-7 seconds begin compressions. Remember that assessing vitals cannot be longer than 10 seconds. In this situation which is really quite plausible, other people will be around and hopefully will help. hopefully you're good at CPR and can talk while counting or know the approximate timing. While doing your first 30 compression wether the air way is clear or not, look up and tell someone to get down on their knees across from you to help, tell them to watch and do exactly what you're doing, when you say start or go or whatever. you finished 30 high quality compressions, and the bystander takes over. Make sure to tell them to count each compression out loud so you know where they are at. You know his tongue is flapped back so this is your time to insert the right size opa. if there was an obstruction, or something else blocking his air way it most likely would have been forced out during your first 30 compressions. If you're good, inserting an OPA should take about 5 seconds. you should have enough time to get your rescue mask out or bvm opened, mask attached and tube hooked up to oxygen. if you don't have enough time to get oxygen flowing to the bvm, it's more important to get ambient air into him. You hear your bystander count 25,26,27,28 you should have a good seal on his face by now and ready to ventilate, 29, 30 tell the bystander. STOP, while you squeeze the bvm until you see chest rise, squeeze for approximately one second, squeezing too fast could force air into the gastric system and could make him aspirate. on the second ventilation as soon as you've squeezed the bag in tell the bystander to start compressions again. you don't have to wait for the bag to refill and wait for compressions. Air will be forced out on the first one anyway so don't waste time. At this point You're about 30 seconds into CPR and hopefully you were paying attention to how well the bystander was doing. If he wasn't doing good compressions take over again and assume the role of ventilating too. If done correctly, 1 rescuer can do high quality CPR even with a bvm, just use a good E-C grip and head tilt chin lift. Once the AED arrives its probably a good Idea for you to attach the pads and set it up since you're very likely more trained than everyone else around. Even if you're in the middle of a set say your counting 12,13,14, and a person throws you the AED have a bystander take off where you left. if you're still getting it set up and the bystander reaches 30 and doesn't know how to use a bvm thats okay, tell them to continue compressions. you get the AED on and it says "ANALYZING" tell the bystander to stop and don't let anyone touch the patient. It will then say shock advised. tell them to start compressions again, (alot of people get this wrong and don't continue compression in this period) once it says charging and the sound and light comes on then tell them to stop and "CLEAR" the pt. make sure nothing is touching him and deliver the shock. Compressions should begin immediately and the next ventilation should happen after 30 more even if you missed a ventilation set while applying the AED. If the bystanders are doing a good job let them take over compressions while you reposition right behind the head of the patient to do good ventilations and assessing for any signs of life. If they're not doing good compressions it's just gonna be harder on you and it's your decision to take over again or try to coach them to do it better. Hopefully the pt becomes responsive at some point, immediately remove the opa and asses the ABC's again you might have to insert a NPA and continue rescue breathing or do neither and put him on high flow 02 with a non rebreather mask. If the guy is still dead when ALS arrives they'll take over and hopefully congratulate you for doing an excellent job. Tell them everything you know, how long its been, how many sets of cpr were done, how many shocks from the aed etc. while its all fresh in your mind. Hopefully this never happens but it's good to run through mental scenarios just in case. Best of luck, Stay well!
@@10--50 you have no idea how much im learning from your post right now.. thank you Sir. Thank you i need to develop a routine like that which makes me more efficient and faster. You have a good system i will follow 😁😁 thanks man this really helps!!
@@user-kk8wr7bv8b I'm glad that helped! It's amazing how much you can forget if this happens in real life, so running through scenarios in your mind while you're calm or watching video's of real rescues is important. Just remember that real events are never the same, try thinking what you would do if you had another trained person with you and how you would communicate, or if there was a massive bleed or spinal injury with an arrest. Think about what you'd differently if it were a child or infant, or had no cell service, a different aed, multiple patients, if it was a drowning or you had an equipment malfunction etc. I'm glad you're looking into this and encourage you to keep it up. Wish you the best!
@@10--50 Thank you! You're a legend
So I am retaking the 3 stations i failed tomorrow and i'm pretty sure I've got it all good to go. The only concern i have about this particular station is that I've heard mixed things about continuing compressions while the AED is charging. Should I or should I not have my partner continue these compressions while charging? thanks
+0wn3dforlife Great question! While charging, it is completely okay to continue compressions. Best of luck on your test!
AHA also mandates continuing compressions while unit is charging
He continued when it said shock advised, clear patient. It said it twice, would that be an automatic fail or no because it doesnt shock until you press the button?
The only time you or someone else stops CPR is when it says analyzing HR or when you are delivering shock.
When it says deliver shock now tell everyone CLEAR and make sure no one is touching the patient (anyones hands, knees ect.). Once you see no one is touching the patient you deliver the shock then continue CPR.
Wouldn't you reassess for a pulse after the shock was delivered? If not, why? Are you allowing the AED to assess for a pulse? Very helpful videos, thank you!
We're told not to check for a pulse immediately following a shock because even if it is successful, it still would take several minutes for the heart to resume a perfusing rhythm. Thus, we're instructed to always immediately resume chest compressions following a shock
There may be a pulse, but the blood pressure may be too low to feel it. That's why it's not reliable to feel for a pulse.
If you get no response from the patient at what point do you transport and how do you continue cpr while getting them to the ambulance?
Often EMT's will request for ALS or Paramedics, and they can then determine once they arrive on scene, but your job is to continue CPR and follow the instructions on the AED. If it advises a shock, clear the patient and deliver it. It could be good to assess for a pulse, but often people just resume CPR. I don't have much experience, but I would assume you would get on top of the patient, straddling him of course, while he is on the stretcher/cart, continuing CPR there. Once in the ambulance, you can resume your position beside the patient. Often a physician will decide when to stop CPR and pronounce the patient as deceased. Anyway, I hope this helped.
I counted 62 compressions on his first round. It looked like he was pushing on the right pectoral.
Charles Maunder holy cow this guy would fail big time.. why cant they just show how to do the station right?? I can do cpr in my sleep and i failed it 3 times the nremt is a joke..
Its always a know it all fuck like you
@@richied539 wat?
dakid dear god man, exactly 🤦🏻♀️🤦🏻♀️🤦🏻♀️
@Josh Stokes Peter griffin Style LOLOLOLOLOOL
Retaking this skill tomorrow. The only one i failed and just because of nerves. I got this!
Best of luck Andy! You'll knock it out of the park.
Thank you. I passed!
CONGRATULATIONS ANDY!!!!
His compressions are very fast aren't they?
what if the airway wasn't clear? After the first 30 compressions would the EMT clear the airway?
If the airway wasn't clear then they would definitely want to clear it before moving on.
Can you verbalize while your the second rescure is doing CPR
Are these videos up to date from what the NREMT is now in 2020?
For the most part yes. I have been watching these videos and following along with the sheets.
When does airway management come into play?
you would open the airway (in this case with an unconcious patient with no one around when the fell) via the jaw thrust manuver before you look listen and feel for a pulse, breath sounds, and chest rise and fall. After that and finding a pulseles patient (regardles if they were breathing or not) begin CPR. As you take a moment between CPR cycles to breath for the patient, you would quickly look to ensure the airway was still clear and in proper position. I can't spell btw.
I was taught to check for carotid pulse and breathing 5-10 seconds during the time AED is analyzing…you are not supposed to touch patient during analyzing cycle but you can place your fingers and palpate neck for pulse
Chest compressions seem too fast to allow for the heart to refill adequately?
The goal is 100-120 with proper chest recoil. What rate are you seeing the student provide?
That’s definitely the narrator of Forensic Files on the AED😂
Shh, don’t let anyone know.
Not Peter Thomas, lol!
Great demonstration
Hi Bro... NREMT training really help me in preparing my training. what is your advice if in real the AED analysed "NO SHOCK ADVISED" what is the next action?
continue cpr
you check pulse first
This must have been filmed when Dr. Green was still a Resident at County.
thank you guys for your videos and time! this is very helpful, as I'm taking my NR Practice tests in 4 days.
You bet! We're glad you're putting them to good use. Be sure to let us know how your test goes!!!
Isnt it a critical if the shock is not delivered in 90 seconds after arrival?
Zac Oakes Hey Zac, take a look at the skill sheets and let us know! That would be a great reminder for students if you find it.
Zac Oakes Not on the national registry. It's a critical fail if you stop CPR any longer than 10 seconds.
Isn't more effective to apply the AED pads straight away, before starting the compressions? Unless you are in a team of course. :)
Hey Chris, compressions take the priority but I can see where you're going with that.
Thanks :) I only ask as I am a first responder here in the UK and we trained to attach the AED pads before starting CBR. Just wanted to know why you guys do it slightly different.
I'm are only trained in basic life support and I have been watching your videos to educate myself a little more :) Many thanks. Chris
Awesome Chris! There are times when the pads should be placed on the patient first but it depends on a few factors. Glad to hear you're enjoying our videos. How far are you planning on going with your education?
Hoping to get employed with my local Ambulance Service as an EMT. Well, thats the plan :) Enjoying being a Community First Responder at the moment. But we don't get as much training as I would like... Just super keen to learn as much as I can. Just glad there's educational videos like yours on here for me to watch!
+Chris Foster Right on Chris! Best of luck on your future endeavors. If you ever have any questions feel free to email us and/or check out our site, EMTprep.com. We have a lot of great content up on the Free Training page and as of today you can link your Facebook account and add comments.
So, with the NREMT sheets that I have.. and what I learned was that you do the Scene Safe, BSI's in place, Check for responsiveness, breathing, pulse, then you are the one turning the AED on and applying, with your partner beginning the compression's. Then the AED will prompt everyone to clear, while it analyzes, then once the AED tells you to begin compression's, I would start compression's... While my partner does the BVM.... Then we switch after that and I would do the BVM... can you confirm?
www.nh.gov/safety/divisions/fstems/ems/training/documents/emtskill.pdf
Jordyn Bagalio Hey Jordyn, as long as you follow the NREMT approved skill sheets for your NREMT practical exam, you'll do great.
I passed with flying colors! Thank you.
You rock Jordyn, nice work!!!!
When does the EMT insert an airway adjunct (NPA/OPA)?
Nick C I had the same question. I thought that would be the first thing you do if not your two breaths would null or void cuz patient has an obstruction
@@Mrjacques91 this is just basic workplace related CPR. They wont be trained or OPA or NPA
Are EMT classes hard? I am considering taking them, but I'm still in highschool, and I want to be able to pass. Lol
Hey Tanner, the content isn't necessarily difficult, there can just be a lot of it to comprehend and memorize at times. It is very doable if you put forth the effort. Best of luck to you!
@@Emtprep thanks so much! The fire department that I volunteer at, said that I have to take some fire classes before I take my EMT, and I take my first "fire" class in February. So I'm on the road towards the EMT classes!!
In my experience, as long as you have a good work ethic, you should be fine (I am also in high school)
@@gabbyellis7844 thanks!
No, it is not hard. The skills are mostly common sense. Some disease pathologies can be complex though. Overall it requires a high school education for a reason...
If the patient is unresponsive, should it be compressions first? CAB?
steps of good cardiac arrest CPR, determine if patient has a central (carotid) pulse and determine if patient is responsive, if patient is not responsive with no pulse, begin compression at 100-120 BPM. if AED is available, apply pads after 2 minutes of compressions, apply pads, do CPR, until AED tells you to shock. clear patient then shock, begin 2 person CPR with one doing compressions one doing rescue breaths with either a pocket mask or a Bag valve mask attached to 15l/minute of 100% Oxygen. listen to prompts from AED. shock again if advised, if "no shock advised" check for outward signs of life and a central pulse. if both are detected check for breathing, if breathing absent begin 2 person rescue breathing with a Bag valve mask attached to 15l/min of 100% oxygen at a rate of one breath every 5-6 seconds. if breathing is present, attach patient to a nonrebreather mask at 15l/min of 100% oxygen, get them on the strecher. attach ECG and keep pads on patient in case of further cardiac arrest. then DRIVE. activate a CODE/Cath Lab alert at receiving facility. rapid transport
Great video! It seems your grading sheet is different than mine. I have my practical tomorrow, and I've watched this video countless times. Have the requirements changed at all? After the first shock is delivered, the sheet says to immediately begin two rescuer CPR (candidate must be performing ventiliations), proceeds for two minutes, and then shocks a second time. Any help is great, this is from the most recent NYS Dept. of Health sheet. Thanks!
xRaffer Great question!!! Follow what your proctor wants from you. Before the test starts it is okay for you to ask them what they would like in terms of performing certain skills. For example, during the trauma assessment, sometimes the proctor will ask you to verbalize your spinal precautions. Not all the time but sometimes. Just be sure you have a clear understanding of what they're looking for from you during your test and you will do great!
right pectoral? The heart is more to the left, so why not the left pectoral.
i have skills testing tomorrow, i’m so nervous any tips ?
Follow those skill sheets verbatim, verbalize anything you’re unsure about, and you’ll do great. Get some sleep, eat a normal breakfast in the morning too. Be sure to let us know how it goes. We’re pulling for you!!!
I’m doing mine today. I’m sooooooooo nervous
Let us know how it goes!
EMTprep thank you ! i passed all of them with a 100% !
sharon sanchez how’d it go ?
I thought you reassessed him after the first shock? Before continuing CPR
uberman121 Hello, the way our student does it is correct. You can verify this at the following link. Notice the last step of the skill sheet. Let us know if you have any other questions. www.nremt.org/nremt/downloads/E215%20Cardiac%20Arrest%20AED.pdf
@@Emtprep Broken link. Just saying.
I don't think he opened the airway? Also he didn't insert an OPA
You don’t put a OPA in on the CPR/AED skill test . But you are right about how he had no chest rise in the dummy so he did not open the airway
These are great! Is there a lecture/ book work section or UA-cam page to watch also?
I'd like to thank the guy from Minor Threat and Fugazi for showing me how to do CPR.
I have enjoy this. It's great and I will view it again.
Great Patrina!
Thank you, helps keep refreshed on this.
compressions are too shallow.
Kd Meconi as long as there is a click from the dummy, it is adequate depth.
and too fast
compressions are way too fast. Also did not verbally command partner to Call for ALS and bring AED.
I just took my exam and when I was taking it the proctor told me that the 2 minutes had passed and I was just about to finish my 4th cycle of cpr. Is it a critical fail if you do not get 5 cycles in 2 minutes? Everything was perfect after though. I am concerned because the critical fail section does not mention anything about 5 cycles. When I practiced, I always completed 5 cycles in less than 2 minutes. Either I was nervous or the time was incorrect
Hey Chris, without being there it is really hard to tell what happened. Stick to the sheets, know them inside and out and you'll do great.
But in general, is 2 minutes of CPR acceptable even if you do not complete 5 cycles?
We're getting into semantics but if you do 5 cycles of CPR you should be at 2 minutes.
I did everything they did and still failed, idk if my instructor was high but yeah.
In this video they didnt call for the aed. The aed prompts is what can fail ppl. Apparently u cant be off cpr for 10 seconds or longer so if your waiting for it to charge and no one is doing cpr they fail u
Same. Failed too even tho I legit did eveysingle thing right. The "partner" refused to do cpr for me
Either they got this station all wrong or it's just inconveniently outdated. wheres the oxygen tank or the BVM?
+A7Xforevaaa Hey A7x, our student got this one correct. Our videos follow the NREMT skill sheets to show students how to pass their practical exams.
+A7Xforevaaa : Step 1 Google; NREMT. Step 2 Read the psychmotor scenario's. Step 3 Put face in Palms because these videos follow to a T the entire NREMT test.
Aimee Pearson well now (2017), you have a bvm, but no Oxygen
I Watched the video it was very helpful
has tilt chin lift
Are they going to inform you when you are 5 cycles
Generally yes, at least for me. When I got to that point I was stopped letting the proctor continue CPR while I got the AED ready and applied, but just in case I would keep count in your mind so you’ll know in the case that they don’t tell you to stop.
@@guysthisismiranda2043 i passed i am a EMTB
thank you guys for these videos they help alot
They failed me on this because I did not put an adjunct in the dummy. It was on the skill sheet but it wasn't labeled as a critical.
Brian Mattingly Whatever state you are getting licensed in can do it how ever they wish. This is just the national standard. It's good practice. 3/3 of the cardiac calls I worked I had to either place an airway or nasal. After awhile of doing chest compressions you will get vomit and need something to maintain the airway.
+Karly O'Hare or in worst case scenarios, blood. Lol
Before starting CPR, he never checked the airway for any obstruction such as liquids or foods
Shouldn't he have called for an AED with ALS backup? I was told if we didnt call for an aed it's not gonna show up in our exam lmao
big help!thanks much!!
Are they breathing in the same mask?😳
Covid
Those compressions 😬😬
Where is the Lucas at? 😆
very accurate performance
thank u
His rate is too fast, tap timing on my metronome estimates the rate between 130-150CPM
thank youu
-bo
lets get to states bo we can make it fighting!
YEYEEEEE@@roxyfitzgerald8916
At the beginning he should of did a head tilt and chin lift after he knew there was no pulse or breathing!
agreed!
he did a jaw thrust, jaw thrust is a safer maneuver in case there is an unknown or unseen spinal injury or trauma
Ahhh after first shock maybe check pulse to see if there's is one before compressing the chest again.
If you listen closely, you can hear the Bee Gees during compressions.
Any NYFD ppl
Never asked for an AED.
Exactly what I was thinking.
I am thinking the same thing. Although maybe he already had one with him, but that doesn't help us students who are told to follow the sheet we are given.
Watch the mask! 😁
bro did not give quality depth
😂
How do u know..did you knw that those dummies have a check light for adequate depth? The light comes off if you not compressing deep enough and comes on wen you are adequate
dude was on left side of chest
Watch the mask
They put they lips on the same mask 🤢
I promise you they were cleaned!