Here's What an EMT Does When Responding to an Emergency
An EMT follows a slightly different protocol when responding to an emergency depending on whether they are called to a medical emergency or a traumatic injury. Read this if you want to know what they do in either situation. The only reason I'm doing this is to see if I remember it all, but you may find it interesting.
Medical/Trauma Emergency:
The EMT will enter the scene taking body substance isolation (BSI) precautions appropriate to call. If the patient is having chest pain, this might only consist of gloves and eye protection. If a woman is giving birth, then BSI would consists of full body covering, a mask, gloves, and eye protection. The EMT will then determine whether the emergency scene is safe for him and his team to enter and determine the number of patients needing attention. After the patients have been identified, the nature of the illness (NOI) or the mechanisms of injury (MOI) will be determined. If the situation looks serious, an advanced life-support unit would be called at this time. If necessary, the patient's cervical spine would then be immobilized.
Now the initial assement begins. The EMT will form a general impression of the patients, basically determining whether the patient is acutally sick or not sick. After that, the EMT will ask the patient why he was called to the scene. It is possible that the patient will not repsond, which leads into the next step taken by the EMT: determining the patients level of consciousness. The patient may be alert and fully cabable of answering the EMT's questions, he respond to your verbal instructions and not be fully alert, he may only respond to pain, or he may be totally unconscious and not respond to you at all. After determining the patient's level of consciousness, the EMT would make sure the patients airway is open and that there are no abnormal sounds such as wheezing or stridor. Next, breathing is assesed by listening to lung sounds and administering oxygen. Once this is completed, the EMT will determine the patients priority for transport, or, in other words, determine whether or not the patients must be immediately transported to a hospital.
If this were a medical call, the EMT would begin obtaining a SAMPLE history of the patient. They will ask for and observe the signs and symptoms of the illness, determine if the patient has any allergies, find out what medications he is taking, determine any past medical history that is pertinent to the current emergency, ask about the patient's last oral intake, and learn about the events leading up the the present illness. Then the EMT will ask what the patient was doing when the problem began, if anything provokes the problem, what exactly are they feeling, where the pain or discomfort is located, what is the severity of the discomfort, how long it has been bothering them, and whether or not they have taken any measures to alleviate their discomfort. Then the patients pulse rate would be determined, along with their blood pressure, skin condition, respiratory rate, and pupil reactivity. After that, the EMT would reexamine his decision regarding transport.
If this were a trauma call, a SAMPLE history would still be obtained. Instead of asking the patient about onset and all that, a rapid trauma exam would be conducted at which time the patient's head, neck, chest, abdomen, pelvis, and extremeties would be examined for deformities, contusions, abrasions, penetrations or puncture wounds, burns, tenderness, lacerasions, and swelling.
This is when the patient would be "packaged" if necessary and loaded onto the ambulance. Once there, a detailed physical exam would occur. The head would be checked for bleading. The EMT would pull the patient's hair to make sure the scalp is still attached to the skull. The ears would also be tugged on to make sure they are fully attached (This is for trauma patients). The ears and nose would be checked for blood and cerebrospinal fluid. The eyes would be checked for internal and external bleeding. The EMT would push on the fast listening and feeling for bones scraping against one another (crepetation). Then the neck would be palpated while checking for tenderness and crepetation. The trachea would be checked to make sure that it has not out of place, and the jugular vein would be examined for distension. Then the EMT would listen to the patient's chest with his stethescope. The chest would be pushed on, again listeing and feeling for crepetation. The EMT would also look to make sure that the chest rises and falls regulary, and that both sides rise and fall together (no paradoxical motion). The pelvis would be check for crepetation and then the genitals would be examined. The patients legs and arms would be assesed while determining the level of motorfunction, sensation, and circulation in these parts.
Now another set of vitals would be taken, necessary intervetions would be put in place, and the patient would again be asked about how they are feeling. Interventions put in place would be checked throughout transport to the hospital and vital signs taken every 5 or 15 minutes, depending on the severity of the patient's condition.
So, I've condensed a bunch of stuff here, but overall, this is what an EMT-B does. I still suck at it.
Medical/Trauma Emergency:
The EMT will enter the scene taking body substance isolation (BSI) precautions appropriate to call. If the patient is having chest pain, this might only consist of gloves and eye protection. If a woman is giving birth, then BSI would consists of full body covering, a mask, gloves, and eye protection. The EMT will then determine whether the emergency scene is safe for him and his team to enter and determine the number of patients needing attention. After the patients have been identified, the nature of the illness (NOI) or the mechanisms of injury (MOI) will be determined. If the situation looks serious, an advanced life-support unit would be called at this time. If necessary, the patient's cervical spine would then be immobilized.
Now the initial assement begins. The EMT will form a general impression of the patients, basically determining whether the patient is acutally sick or not sick. After that, the EMT will ask the patient why he was called to the scene. It is possible that the patient will not repsond, which leads into the next step taken by the EMT: determining the patients level of consciousness. The patient may be alert and fully cabable of answering the EMT's questions, he respond to your verbal instructions and not be fully alert, he may only respond to pain, or he may be totally unconscious and not respond to you at all. After determining the patient's level of consciousness, the EMT would make sure the patients airway is open and that there are no abnormal sounds such as wheezing or stridor. Next, breathing is assesed by listening to lung sounds and administering oxygen. Once this is completed, the EMT will determine the patients priority for transport, or, in other words, determine whether or not the patients must be immediately transported to a hospital.
If this were a medical call, the EMT would begin obtaining a SAMPLE history of the patient. They will ask for and observe the signs and symptoms of the illness, determine if the patient has any allergies, find out what medications he is taking, determine any past medical history that is pertinent to the current emergency, ask about the patient's last oral intake, and learn about the events leading up the the present illness. Then the EMT will ask what the patient was doing when the problem began, if anything provokes the problem, what exactly are they feeling, where the pain or discomfort is located, what is the severity of the discomfort, how long it has been bothering them, and whether or not they have taken any measures to alleviate their discomfort. Then the patients pulse rate would be determined, along with their blood pressure, skin condition, respiratory rate, and pupil reactivity. After that, the EMT would reexamine his decision regarding transport.
If this were a trauma call, a SAMPLE history would still be obtained. Instead of asking the patient about onset and all that, a rapid trauma exam would be conducted at which time the patient's head, neck, chest, abdomen, pelvis, and extremeties would be examined for deformities, contusions, abrasions, penetrations or puncture wounds, burns, tenderness, lacerasions, and swelling.
This is when the patient would be "packaged" if necessary and loaded onto the ambulance. Once there, a detailed physical exam would occur. The head would be checked for bleading. The EMT would pull the patient's hair to make sure the scalp is still attached to the skull. The ears would also be tugged on to make sure they are fully attached (This is for trauma patients). The ears and nose would be checked for blood and cerebrospinal fluid. The eyes would be checked for internal and external bleeding. The EMT would push on the fast listening and feeling for bones scraping against one another (crepetation). Then the neck would be palpated while checking for tenderness and crepetation. The trachea would be checked to make sure that it has not out of place, and the jugular vein would be examined for distension. Then the EMT would listen to the patient's chest with his stethescope. The chest would be pushed on, again listeing and feeling for crepetation. The EMT would also look to make sure that the chest rises and falls regulary, and that both sides rise and fall together (no paradoxical motion). The pelvis would be check for crepetation and then the genitals would be examined. The patients legs and arms would be assesed while determining the level of motorfunction, sensation, and circulation in these parts.
Now another set of vitals would be taken, necessary intervetions would be put in place, and the patient would again be asked about how they are feeling. Interventions put in place would be checked throughout transport to the hospital and vital signs taken every 5 or 15 minutes, depending on the severity of the patient's condition.
So, I've condensed a bunch of stuff here, but overall, this is what an EMT-B does. I still suck at it.
posted by Ben U'Ren at 11:39 PM
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