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Medical assessment focuses on specific scenarios such as chest pain, shortness of breath, altered mental status, and anaphylaxis. Nitro is contraindicated in some cases, but aspirin is always given. It's important to follow the protocol and administer medications accordingly. The assessment includes establishing responsiveness, assessing airway and breathing, checking vital signs, and performing a focused assessment based on the chief complaint. The six rights of medication administration should be followed, and reassessment is done after five minutes. Medical assessment doesn't have the body assessment, because you're going to do a focused assessment. The patient will be conscious and alert, maybe confused, but conscious and alert. So you won't have to, that's why it's shorter, it's only a 14 versus 25, because you're not checking the body. So let's talk about the scenarios. You'll get a chest pain with nitro. You'll get a chest pain, but nitro is contraindicated, maybe they don't have it, maybe they took sexually enhancing drugs within the last 24 hours, maybe they've already taken three doses. So you won't give it, but both of those patients get what as well? Aspirin. Aspirin. Aspirin. Aspirin is definitely given, you have to give aspirin. Aspirin, and by the way, aspirin is not... If you have a chest pain patient that has nitro and it's not contraindicated and you only give aspirin, you're going to fail. So make sure you recognize. So there's chest pain with nitro, chest pain without nitro, shortness of breath, metered dose inhaler, history of asthma, altered mental status, known diabetic, we'll check her blood sugar and we'll do glucose. And then anaphylaxis patient, you'll have a 30-year-old male playing in the park or at the ballgame, gets stung by a bee, now he has shortness of breath, urticaria, hives, dull, anaphylaxis. I know we talk about EpiPen has to be given right away in anaphylaxis. Do not do that in this station. You administer meds when it tells you to. Don't jump ahead. And the first thing you want to do is hit with the EpiPen. Don't do it in this station. Make sure you follow the sheet. What was the hormone after the shortness of breath? Altered mental status, known diabetic, and so that's glucose. I do not know of or ever heard of a NARCAN scenario for medical because your patient has to be conscious and answer questions. NARCAN patients do not. You should know how to use it, know how to do it in the station, but we're not going to practice it because I don't know of any station that has it, but you should know how to use it. So let's look at it. First of all, scene safety BSI for myself and my partner, your time starts. Again, you have to have your start time, your transport time, and then your completion time. Same thing. Now, will 1A get a general impression? Again, it's the classroom. You were a victim in the examiner. So Mr. Examiner, where am I walking into? Walking into an office. What is the environment like? Not cloudy or smoky, it's clear. Is my patient following me with their eyes? Are they conscious? Yes, they're sitting up. Are there bystanders and people around? Yeah, there's a co-worker with them. Paint the picture. You don't have to ask the questions, but you can. Is there any life-threatening injuries? Are there signs of trauma? No. It's a medical patient. And by the way, all these patients are adults, no children. So I've got my general impression, then I'm going to establish responsiveness. I'm going to go to the patient. Now, when you're dealing with these patients, it's going to be a real person on the floor in trauma and a real person in the medical room. Go up and say, hello ma'am, my name is Ian. Act like it's real. Now, the patient will not say a word to you. You're the examiner. So I'm going to say, hello ma'am, my name is Greg, I'm an EMT. What's your name? Can you tell me what's going on today? See how we do that? You interact with the patient like you're a real patient, but the patient won't say a word. It's the examiner that does. So I'm going to ask, can you tell me where you are? Can you tell me what time it is, what day it is? Can you tell me what happened? I'm going to observe their responsiveness. I'm going to assess their airway and assess breathing. So this is what you're going to do for this patient. It's very easy. So I'm going to come up to this patient, scene safety DSI. I'm going to ask a couple of general impression questions. I'm going to approach the patient. Hello ma'am, my name is Greg, I'm an EMT. Can you tell me your name, where you are, what time is it, what day it is? Mr. Examiner, my patient is conscious and alert, though a little confused. She has a patent airway. Therefore, I don't need an OPA. I am going to apply 15 liters high flow O2 by a non-rebreather mask because she's short of breath, chest pain, whatever. Or whatever the issue is. I know my patient is not a trauma patient. Therefore, she does not need a collar. See how I did that? Just by talking to the patient. Bam! My whole thing's done. Now, it says, for number four, it says assess his breathing. This is where you're going to take your stethoscope out, a funny little necktie, and you're going to listen to lung sounds. I recommend you take the stethoscope and put it around your neck when you start the station. Both stations. So you remember to do it. So that's where you're going to listen to lung sounds and assess. Mr. Examiner, I'm listening to lung sounds. What am I getting for lung sounds? What is the rate of respiration? Is it shallow or deep? Initiate oxygen therapy. High flow O2, 15 liters by a non-rebreather. I'm going to assess the pulse of the skin. I'm going to get a radial pulse, because the patient is conscious. Mr. Examiner, while I'm getting a pulse, I'm assessing the skin. Do I see any life-threatening bleeds? And I'm going to make my transport decision. Mr. Examiner, this patient is a high-priority patient. I'm going to transport high priority, calling ALS and hopefully linking up with them. Boom! Done. That should take you three minutes. From there, we're going to do our OPQRC and sample history. I'm going to ask my patient, but I'm going to look to the examiner for the answers. Because the patient isn't going to speak. But I'm going to assess just like it's a real patient. And I don't care if you do O-S-A-T-L-E-R-T-S-P-M-Q. I don't care what order you do it in. But they're going to check off each letter that you do. So you must do sample and OPQRC completely. Then you're going to perform a focused assessment. You're going to focus on the chief complaint. So ma'am, I'm going to listen to lung sounds again. If it's shortness of breath, what do the lung sounds like? If it's chest pain, ma'am do me a favor. Push down for me with your arm. Does that hurt? Take a deep breath. Does that hurt? Does it hurt when I palpate your chest? So if she says no, then I know that it's substernal. It's not pleuratic. It's not musculoskeletal. I know that it's chest pain cardiac. If it's shortness of breath, I'm going to listen to lung sounds. Altered mental status. Numb diabetic. All altered mental status patients, what do we check? Blood sugar. This is where we check the blood sugar. And just explain what you're going to do. I'm going to take a glucometer. I'm going to prick her finger with a lancet. And I'm going to set up the glucometer. And I'm going to assess her blood sugar. Mr. Examiner, what's her blood sugar? Sixty, fifty, whatever. If it's anaphylaxis, you're going to assess the skin and respiratory rate and lung sounds. Then I'm going to get my baseline vital signs. You must get vital signs before you can do an intervention. You have to. Now remember, you've got most of the vitals already. So if you don't remember them, ask what they are. The only one you need to get really is blood pressure. In the medical, you don't have to do pupillary response. You can if you want. You don't have to. You can get pulse oximetry if you want to. You can ask for that. Then it says on number 13, verbalize this intervention. This is what you're going to say. Mr. Examiner, because of my standing orders and protocols, I know I'm allowed to assist a patient with their nitroimmune dose inhaler. I know I'm allowed to administer aspirin. I know I'm allowed to administer epinephrine or glucose or the EpiPen. I mean, yeah, yeah. All right? So I'm going to explain that. But before I do, Mr. Examiner, I'm going to check my six rites of the day. Right patient, right dose, right route, right time, right date, right documentation. And I'm going to say, right patient, Mr. Examiner, this is the patient's med. Or it's my med giving it to the right patient. Right dose, give them the dose. Right? You should know the doses for your meds. Right row, is it oral? Is it sublingual? Is it IM? Is it rectal? And if you're doing rectal, you're doing it wrong because there's no rectal in EMS. It's not in basic. Right patient, right dose, right route, right time, right date, right documentation. Right dose, right time. I did my vital signs. This is the time to give it. And right med. Now this is an important one because you have to think a little bit because when you have a cardiac patient, you're going to have shortness of breath and chest pain. When you have a respiratory patient, you're going to have shortness of breath. So the chest pain is going to be the telltale. So do not give your respiratory patient or like do not give your cardiac patient albuterol because you're hurting shortness of breath. Shortness of breath and chest pain get nitro and aspirin. Shortness of breath only gets albuterol. Does that make sense? So because of my, now number 13, Mr. Examiner, because of my standing orders and protocols, I know I'm allowed to assist or administer whatever med you're going to give. Explain it. I'm going to administer the, I'm going to check the six rights of the meds and I'm going to administer it. Ma'am, do me a favor, put this, you know, chew up these tablets. Put this under your tongue or explain what you're going to do for the inhaler or just explain how you're going to administer the glucose, how you're going to administer the epi-pens. I'm just going to explain it. And then 14, Mr. Examiner, I'm going to reassess my patient after about five minutes. If my patient is still showing discomfort, I'll administer another dose of meds after I give, after I do another set of vital signs. We're going to do vitals every five minutes. Hopefully link them with ALS and transport as quickly as possible. He's going to say, okay, do you have any other questions or anything you want to add? No? Okay, you're done. Or he might say, is there anything else you want to do? And think about it. Once you do both of those, you're done. Okay? Any questions on that? Okay. So now, I'm sorry. All right, so now I'm going to demonstrate the station to you. I'm not going to demonstrate it, but believe me, I'm going to demonstrate it a couple more times for you. So first thing I need is we'll do it back there in that open area. Okay? Okay? Okay. Okay. Okay. Okay. Okay. Okay.