For the log roll, you want to bend the patient's right arm over their stomach first so it doesn't just flop down behind them, and so they don't have to hold it up themselves like your patient did.
You also want to check and palpate the buttocks and backs of legs during the log roll.
This is really well done. Thank you. One thing - I failed my initial Systematic Exam because I palpated both sides of the hip at one time. They said critical fail on that. Just a thought so just in case anyone else has that issue.
The only thing I would have done differently is every time he assessed lung sounds and was told they were diminished or absent, I'd have burped that chest seal/occulsive dressing. And as an EMT, requested ALS, if available. Otherwise, this is a great demonstration for EMT classes.
Really good assessment with high level of theoretical skills, but not for a critical patient. In Sweden we use PHTLS, (X-ABCDE). A few questions: We are presented with a critical patient in chock after penetrating trauma (Both a B and C problem), where is the need for a distal status on the lower extremities (no found injury)? Why on scene and not during transport? If there is a gun wound, why is log roll first on E and not X or C? (To look for exit hole/wounds). This patient would've a detailed and thorough report but could have died on the way to the hospital because we took time on the scene to do non life saving assessment... If there was no B or C problem and no chock present, THEN this is very good! I know this is a examination and once again it was impressive on many levels. Just get us going after first assessment is done if we think this is critical. A gunshot patient with chock: X- ABCDE: Would dressing or tournique, look for exit holes posterior as well. Chest seal and high O2 on mask. Check for other bleedings. Minimal immobilisation if needed. Minimal time on scene. Reassess and IV during transport keeping BP on max 90mmhg. Be ready for ARS and/or "barping" the chest seal. Be safe! //Paramedic from Sweden.
Just did this assessment yesterday in class, and somehow totally forgot that occlusive dressings existed... When I exposed the patient's chest, my instructor didn't inform me it was a sucking chest wound. Totally spaced, but this video is extremely helpful for review, thank you! Fingers crossed I get it tomorrow during review.
Always show respect to these guys for what they do, I'm such a weiny I cringed just at the scenario - doesn't help that its one of my fears. Thanks for sharing