NREMT Skills Step-by-Step Guide

NREMT Skills

● Oxygen Administration by Nonrebreather Mask
o https://www.youtube.com/watch?v=XAaplPEshiA
1. “BSI scene is safe”
2. Crack valve a small amount to expel debris
3. Click valve into place and turn on cylinder
4. Check for leaks
5. Read the pressure value
6. Attach NRB tube to three circles and turn to 10-15 L/min
7. Check that mask is pre-filled and attach to patient’s face
8. Make sure the fit is snug
● BVM of Apneic Patient
o https://www.youtube.com/watch?v=76eUq1CFw80
1. “BSI scene is safe”
2. Check for responsiveness and call for help
3. Check breath and pulse
4. Open airway
5. Measure suction machine to ear, turn on, and plug hole with finger while
inserting
6. Remove finger and suction with a circular motion for <15 seconds inside
mouth
7. Open airway and insert plastic airway sideways, then turn upside down
8. Apply BVM using C-E clamp to open airway
9. Check pulse again
10. Connect wire to oxygen at 15L/min, put wire on BVM, ventilate twice (every
5 seconds)
11. Look for equal bilateral chest rise and fall
● Cardiac Arrest Management
o https://www.youtube.com/watch?v=l5TsO1fDzkY
1. “BSI scene is safe”
2. Check responsiveness
3. Ask for an AED and help
4. Check breathing and pulse
5. Begin chest compressions, 30 compressions and 2 breaths
6. With AED, turn on and attach to shoulder area and hip
7. Stop CPR and clear patient during shock
8. Resume chest compressions after the shock
● Patient Assessment – Medical
o https://www.youtube.com/watch?v=YHLY9upwD30
1. “BSI scene is safe”

, 2. Find out why dispatched
3. Request assistance and/or spine stabilization if needed
4. State patient age and sex
5. Look for life threats/bleeding
6. Check pupils to see if alert and oriented (A&O)
7. Check alert to verbal, painful, or unresponsive (AVPU)
8. Chief complaint (CC)
9. Airway, breathing and breath sounds, cardiac/circulation (ABC)
10. “I’m doing primary assessment and my partner will do vital signs.”
11. Onset, Provocation (pain better/worse how?), Quality and how it feels,
Radiating pain (where?), Severity (1-10), Time since pain (OPQRST)
12. Signs/symptoms, Allergies, Medications, Past medical history, Last oral
intake/Last menstruation, Events leading up to (SAMPLE)
13. Take vitals: blood pressure, pulse, respirations, SpO 2, blood sugar, EKG
14. State impression: “I think it could be …”
15. “I will prepare patient for transport, reassessing every 5/15 minutes, and
provide a verbal report to the arriving unit.”
a. 5 mins if unstable, 15 mins if stable
● Bleeding Control and Shock
o https://www.youtube.com/watch?v=7T0pzonahFQ
1. “BSI scene is safe”
2. Partner applies direct pressure to bleeding
3. If still bleeding, secure tourniquet above the bleeding, by groin or armpit but
at least 2-3in above bleeding site
4. Spin the rod to tighten until bleeding is controlled and there is no distal pulse
5. Secure with time strap and record the time
6. If hypoperfusion occurs, administer oxygen, position patient supine, prevent
heat loss, and transport
● Joint Immobilization
o Wrist
▪ https://www.youtube.com/watch?v=Wy9gvsOgRPw
1. “BSI scene is safe”
2. Partner stabilizes arm
3. Check pulse, motor, sensor in hands (PMS)
4. Measure splint and select correct size, soft side facing skin
5. Tie around arm
6. Check PMS
o Knee
▪ https://www.youtube.com/watch?v=-vR-sDBkUag
o Hip