Talk:NREMT Skillset/Example Narratives

The time is 1045 and M145 is dispatched code 3 to a call for a 22 year old man who fell off his bicycle and is now complaining of right arm pain. Enroute at 1047, M145 is downgraded to code 2 by dispatch. M145 arrives on scene at 1054 to a park with minimal traffic and the local fire department arriving on scene. The patient is conscious on approach sitting upright on the grass and is holding his right forearm which shows an obvious deformity upon visual inspection. The patient's bike is next to him and shows minor damage. Bystanders say that the patient was riding on the sidewalk and slowed to avoid a jogger when his front wheel went off the sidewalk and he fell laterally, landing on his side with right arm outstretched. The patient was slowing down and was almost stopped at the time of the accident; estimated speed was 2-3 mph. The patient was wearing a helmet and did not lose consciousness, his story matches with that of bystanders; the patient states that he "heard a crack" from his right arm followed by significant pain similar to the bones that he has broken in the past. Patient contact made by M145 at 1055 The patient is AxO 4 and GCS 15 and is able to recall before, during, and after the event. The patient takes no medications and has no allergies or significant medical history. The patient ate breakfast earlier this morning and has had no issues when he goes to the bathroom. The patient's only complaint is "sharp, stabbing" right arm pain 8/10 with no radiation, palliation, provoked by movement or palpation. The patient denies head, neck, or back pain and has CSM intact x4; patient has pink, warm, and dry skin signs. Assessment of the injury shows early stages of bruising and an obvious deformity to the middle of the right forearm with obvious crepitus on palpation. The patient's arm is immobilized and placed in a sling and swathe with an ice pack by the fire department while M145 performs vital signs and obtains initial readings of 136/88, 100 bpm strong and regular, 16 RR deep, regular and unlabored, pupils 3 mm PERRL, LS clear and equal bilaterally, with a SPO2 of 98% on room air at 1058. ALS response is deemed unneeded due to local protocol; the patient is helped to the gurney and loaded into the ambulance with his bicycle. The fire department clears the call at 1110 after restocking from the ambulance crew. The patient is transported code 2 to the local ER at 1111. Only one other set of vital signs is obtained during transport: 134/80, 92 bpm strong and regular, 16 RR deep, regular and unlabored, pupils 3 mm PERRL, LS clear and equal bilaterally, with a SPO2 of 99% on room air at 1113. The patient's pain reduces to 6/10 with the same quality, radiation, provocation/palliation, and severity. No other treatments are provided enroute. The patient denies any other complaints than his arm pain for the duration of transport. M145 arrives at the hospital at 1120 and transfers patient care to an ER RN at 1124 after obtaining all required signatures. M145 clears the hospital at 1136 after equipment cleaning.

Which code? 203.192.253.131 16:13, 9 April 2025 (UTC)Reply