THE QUICK AND DIRTY GUIDE TO MEMORIZING THE NATIONAL REGISTRY MEDICAL ASSESSMENT

Category: Medical

Topic: Basic Medical Assessment

Level: EMR

9 minute read

Memorizing the National Registry Medical Assessment

As usual, I want you to break it down into parts that are easy to remember, and then practice them in order until they are second nature.

 

Assessment mnemonics - For this lesson, we're not focusing on HOW to do an assessment as much as how to REMEMBER the steps!

Your ENTIRE medical assessment for the registry can be broken down into mnemonics - (BSMAC-GACCAT-OPQRST-SAMPLE-FVIT)

We're going to go into each category and explain, but instead of trying to remember every single line of the assessment in order, this is a way to remember the whole list simply. 

 

1. B-SMAC is the first section of the assessment, they are the first thing you do on a scene.

BSI
Scene Safe?
Mechanism?
Additional Units?
C-spine?

 

2. GACCAT - is your initial assessment. It stands for:

General Impression?
AVPU?
CC/Life Threats?
ABC's (good Airway?, O2 and Breath sounds? Skin color, temp, condition?)
Transport Decision - Load and Go now (There are no stay and play scenarios in the registry practical!)

 

3.  OPQRST-I: These are slightly different based upon the type of medical call. We will use Chest pain as an example.

Onset- when did this start?
Provocation - what started it?
Quality - how would you describe it?
Radiation - Does the pain travel anywhere?
Severity - Scale of 1-10, how severe?
Time - How long has this been going on?
Interventions What have you done about it?

 

4. SAMPLE: This should be familiar!

Signs and Symptoms - chief complaint and pertinent findings
Allergies - Are you allergic to anything?
Medications - What prescription medications do you take on a regular basis?
Past Med Hx - History of present illness (Has anything like this happened before?)
Last Oral Intake - When was the last time you had anything to eat or drink?
Events - What was going on just prior or leading up to the problem today?

 

5. FVIT - Once again, we'll use EMT chest pain protocol as an example.

Focused History (Verbalized)
Vitals
Interventions - Nitro Example, but similar for all meds
1.  Get orders for nitro (0.4mg sublingually) or state that you have a standing order
2. Check the expiration date, right patient right dosage, right drug, make sure fluid is right consistency and color (not precipitated), check for contraindications
3.  Explain to patient effects of Nitro and reason for administration; doublecheck systolic over 100 and no ED meds or hx of sensitivity
4.  Administer 1 spray or tablet of 0.4mg nitro under the tongue
5.  Monitor for changes every 5 minutes (if poor, repeat 1-5 to a max of 3 doses.)
Transport (Reevaluate transport decision)

GACCAT again
Vitals again
Focused again

 BSMAC-GACCAT-OPQRST-SAMPLE-FVIT

 

Now look at the national registry skillsheet for EMT Medical or Paramedic Medical 

Try to break it down in your mind so you can see the mnemonic

B-smac - Bsi, Scene safe, Mechanism, additional units, C-spine
Gaccat - General impression, AVPU, Chief complaint, ABCs, Transport
OPQRST - SAMPLE ( you know these!)
F-VIT - Focused, Vitals, interventions transport

 
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