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When you hit a snag, take a step back and reassess. Metaphorically, this gives you a running start to jump over whatever obstacle is snagging you up. By taking a moment to ensure basic life critical systems are in place (ABC), then checking how bad things are (D for disability), then exposing and doing your secondary evaluation (E), buys you time for your lizard brain (aka: your inner voice) to whisper the next step to your conscious mind. In other words...follow your gut.

 

As you go down your ABCDE list, fix the obvious life threatening issues quickly. (hemovolemia/hemorrhage, tension pneumo, cardiac tamponade, hypoxia..the basics of trauma). The other stuff will fall into place such as your imaging and labs. Trust yourself. And if you get stuck...re evaluate again. I see people struggle in trauma management when they let one little thing trip them up. They start getting tunnel vision on some fairly inconsequential item and just lose focus on the big picture. It's like they get grease on their feet and lose traction. When you feel that happening....back up, take a running start and jump over that hurdle.

 

Disclaimer: not a PA...have worked a bit of trauma here and there though. Good luck to ya

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they take a lot of questions from the physiology at the beginning of each chapter;

changes associated with normal aging include...

the airway of a child is different than the airway of an adult in the following ways....

physiologic changes in pregnancy include the following....

they give you a practice practical before the final at most places.

they make the practical fun. just relax, you will do fine. nmake sure they give you a completion card(not a cme cert) as we are now eligible for these. got my first one 2 years ago after several cycles of cme certs only, 1 at which they asked me to be an instructor before realizing I was a pa and revoking their offer....

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Relax and remember the basic stuff. Your primary assessment (ABC) should look for AND FIX all immediate life threats. Remember that you have to verbalize EVERYTHING...starting IVs, checking vitals, monitoring, drawing labs (and what labs your want), imaging, examine the pt and note pertinant negatives, if you do a procedure/intervention make sure you reassess and are prepared to troubleshoot. Know how to read any imaging you order. Remember that you will always be a solo provider in a community hospital (non trauma center) so you will have to transfer the pt. Be prepared to give a coherent and organized report to the trauma center.

I audited the course a couple years ago (I'm a paramedic) and now I assist with the practical exams. I don't know if it helps with the written exam, but the people who ace the practical are usually former EMTs/paramedics.

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a few more thoughts...don't do a diagnostic study (say a dpl) if you don't have a surgeon at your facility to act on it. remember c-spine/chest/pelvis xrays for almost everyone. if you decompress the chest your NEXT STEP should be the chest tube. remember lots of fluids for electrocutions so the foley runs clear at a reasonable rate. remember to state when you would call for the transfer and when you would call the receiving facility. they will make you give a "report" so make sure you have enough info before you do this. also remember to roll trauma pts and examinje their backs...know what size a chest tube or pericardiocentesis needle or tube should be. be able to describe landmarks for placement of same.

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