Pneumonics

When your training to be an EMT, you find yourself overwhelmed at times, so the big shots decided that pneumonics would help the EMT-In-Training learn better and faster. Alot of these pneumonics are used for Nursing, for becoming a doctor, and even for becoming a first responder.

At first you think they will be easy to remember;
OPQRST (onset, provocation, quality, radiation, severtiy, time),
SAMPLE (Signs and symptoms, Allergies, Medications, Pertinent Past Medical History, Last Oral Intake, Events leading up to incident),
ETA (Estimated time of arrival),
AVPU (Alert, Verbal, Painful, Unresponsive- Stimuli),
PMS (Pulse, Motor, Sensory),
JVD (Jugular Vein Distention),
ALS (Advanced Life Support),
PERRL (Pupils are Equal Round and Reactive to Light),
A&O x3 (Alert and Oriented to Person, place and time)
LOC (Level of Consiousness)
ETOH (Ethanoyl-Drinking)
SOB (Shortness of Breath)
MVA (motor-vehicle accident)
But the easiest and most important pneumonic is this; ABCDE. Airway, Breathing Circulation, Decision to Transport and Expose (Trauma).

Last night at work I had a chance to review my EMT skills and remember my basics all over again. While sitting in a 1:1 with two patients, I was taking vitals of one patient between visits from the physicans. They spoke quietly to each other and then to the fairly alert patient, and then back to each other. They preformed small medical procedures, and then left. The patient's respirations had jumped from 20 breaths a minute (10 L on a face mask) to 44 breaths a minute (on a Bipap). Convinced that if it was an issue the doctors would have done something, because this occured while they were in the room, I pulled the call light to get the nurse in there, but only a CNA showed up. I instructed the CNA to go get the nurse and explained why, then was pulled to the other bed to tend for my other 1:1.

This was when my ill patients family member showed up. She shook my hand and kindly talked to me about his needs. I gave her as much information as I knew about her loved one, but then stopped and looked at him. She started to ask questions to which I didn't know the answer to, and then gave her the nurses' names, the doctors names and the interns names, so she could ask them. When I explained to her my title she understood and left the room briefly. I took his respirations again and realized they weren't adequate and thought to EMT class. Airway, he was sitting upright, mouth open, he had a patent airway, Breathing, he was struggling to get adequate air in, let alone talk, but he still had Circulation. ABC. The next step would be 15 L NRB, but he was on 10 L with a BiPap, I couldn't change the O2 due to the doctors orders.

I looked to the charge nurse standing in the doorway, recieving information and talking to the family member and told her, "His respirations are irratic and at 44 breaths a minute." This was when the nurse ran to the nurses station and seconds later the room filled with doctors, nurses, x-ray tech's and phelbotomists as they began immediate care that was almost the same as a code.

As I watched all of this hustle and hubub from the corner of the 1:1 I realized something. Medicine isn't as difficult as everyone makes it out to be. You just have to go back to the Basics. My patient is fine now, and is doing better, but we needed to step away from the cool fancy projects long enough to remember the basics, because without those, we wouldn't even have a pulse.
Until next time, BSI (body substance Isolation)