I gave gordan a rundown on the basic EMS procedures we use irl. But using these procedures only works with those who can actually RP and want to RP. But otherwise not a bad list gordan.
SAMPLE History (gathered while taking vitals) S-Signs and Symptoms - EX: Sir what seems to be the problem today? A-Allergies to medications - EX: Are you aware of any allergies to medications sir? M-Currently taken medications - EX: Are you currently taking any medications? P-Pertinent Past Med history - EX: Have you had any recent major surgery or been admitted to the hospital recently? Have you been hospitalized for this problem before? L-Last oral intake - EX: What did you eat and or drink last? E-Events leading up to the injury/Expose the injury site - Leads into OPQRST mainly.
Acute Injury Guide O-Onset - What happened before the event, EX: Sir what were you doing before your chest started hurting. P-Provocation - Does palpation (lightly pressing on it) make it worse? Q-Quality - Patients description of pain. Ideally, this will elicit descriptions of the patient's pain: whether it is sharp, dull, crushing, burning, tearing, or some other feeling, along with the pattern, such as intermittent, constant, or throbbing. - EX: Can you describe the pain? R-Radiation - Does the pain radiate or move to other parts of the body? - EX: Does it feel like its in multiple places <insert body parts other then the one affected> not just the <chief complaint site>? S-Severity - Have the patient rate the pain on a scale from 1-10, 10 being the worst pain they've ever felt. T-Time - How long has the event been occurring.
Trauma Injury Guide - Used as a guide to remember the various types of injuries while performing a quick trauma assessment. D-Deformities C-Contusions A-Abrasions P-Punctures B-Burns T-Tenderness L-Lacerations S-Swelling
EXAMPLE RP:
PT Chief Complaint: Chest pain and shortness of breath.
Start with a general assessment of the patients condition as you walk up, does he appear to be sweating and in distress? Is he guarding his arm in addition to his chest? (possibly indicating a myocardial infarction AKA heart blockage, will need to follow up with more questions). Walk up and introduce yourself "Hello Sir, I'm Doctor Simon of the NCMD, what seems to be the problem today?". Go ahead and start doing your vitals: Pulse, Respirations and Blood Pressure and get them on high flow O2 (15lpm) on a nonrebreather mask (never withhold oxygen, always go ahead and get them on O2). Then start SAMPLE, in this case you should only get the S then move into OPQRST which will be part of the S assessment, then finish out the AMPLE, you dont need the LE as often, so if you need to load and go, do it. If you deem this a heart attack, and if the systolic pressure (BP of120/80 is normal, 120 would be the systolic) >100, you can administer Nitroglycerin which will dilate the blood vessels (make the arteries, veins and capillaries get wider) and help alleviate some of the blockage. At this point, getting an iv started on a slow drip would be good in case they code (go into cardiac arrest) and you need to push drugs quickly. Once you have made the diagnosis and begun medical care, you will want to load them on the stretcher and go. The "Golden Hour" rule applies here as the sooner they get access to definitive medical care, the greater chances that there will be minimum necrosis of the heart.
Using these guides to help guide the RP, you should be able to more fully flesh out any trauma or acute illness RPs, and actually have some fun.
_________________ "Fir Na Tine" "Ut Vivant Alii"
---------------------- Jack Johnson/Bruce Willis Age: 31 Occupation: NCPD Lt.
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