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Needle decompression is beyond the EMR scope. Providing high-flow oxygen and arranging rapid transport are the EMR’s priorities. Bulky dressings and prone positioning do not address the problem. EMRs focus on recognition and supportive care while awaiting ALS providers.

The AVPU scale stands for Alert, Verbal, Pain, Unresponsive. “Alert” means the patient is awake and aware. This is the best level of responsiveness. EMRs use AVPU during primary assessment for a quick neurological evaluation.

Alert and oriented ×4 means the patient knows who they are, where they are, the time/date, and what happened (event). This is considered normal mental status. EMRs use this assessment to document baseline neurological function.

If circulation is compromised, gentle realignment is permitted once to restore distal perfusion. If unsuccessful, the limb is splinted in the position found and the patient is transported rapidly. EMRs are trained to preserve limb viability while prioritizing overall patient stability.

Eviscerated organs must never be pushed back inside. The EMR covers them with moist sterile dressing and then an occlusive dressing to prevent drying. Tight bandages cause further damage. EMRs stabilize and protect exposed organs while arranging rapid transport.