ECC EMT Program
ECC EMT ProgramPractice Scenarios forPatient AssessmentsRyan CareyAlex RodriguesUpdated: 07/2019
How to use the scenarios: The following scenarios are scripts for the “patient” while practicing scenarios. The patient must read over the scenario information prior to starting the assessment. Once familiar with the scenario, the patient must do their best to act accordingly to the script.o For example, if the script says “Alert”, the patient should act alert in answeringquestions correctly. Do not state “Alert” when the EMT assess mental status. The patient must use the scripted information in their responses, do not add to the scenario. The EMT practicing should only be given information after properly stating what they areassessing or ask for specific information. The EMT should conduct their assessment as they would with a real patient. Practicingprofessionalism and competence is essential for success. Practicing using the time limit specified for each scenario. The scenarios have information in shaded boxes. This indicates information the EMT mustverbalize to correctly perform and manage the assessment. The items listed in “Treatment & Interventions” should be initiated by the EMT. If these are notcompleted before giving a report, review the topics in relation to the assessment at theconclusion of the scenario.
Patient AssessmentSex ofpatientDescription of the call (Time limits)Medical or TraumaThe dispatch time and information of the call will be found hereBSI:VitalsSecondaryP:Promt to be read to EMTE:Promt to be read to EMTN:S:(1)(2)EMT must decideB:xPromt to be read to EMTE:Promt to be read to EMTP:Promt to be read to EMTL:M:EMT must decideQ:Promt to be read to EMTL:A:EMT must decideR:Promt to be read to EMTS:N:EMT must decideS:Promt to be read to EMTR:T:Promt to be read to EMTP:Treatment & Interventions:PrimaryG.I.:Promt to be read to EMTA:Promt to be read to EMTL.T.:Promt to be read to EMTM:Promt to be read to EMTAVPU:Propmts for PatientP:Promt to be read to EMTC/C:Propmts for PatientL:Promt to be read to EMTA:Propmts for PatientE:Promt to be read to EMTPhysicalPromt to be read to EMTHead:The correct decision will be hereNeck:Promt to be read to EMTChest:Promt to be read to EMTThe correct decision will be hereAbdominal:Promt to be read to EMTD/D:Promt to be read to EMTPelvis:Promt to be read to EMTE:EMT must decideLower:Promt to be read to EMTF:EMT must decideUpper:Promt to be read to EMTG:EMT must decideBack:Promt to be read to EMTC:EMT must explain the following:Any items in this box must beinitiated or verbalized during theEMT must determine if TX is needed and how assessment by the EMT. Discussany items missed at the conclusionof the assessment and thePromt to be read to EMTimportance of them in relation to theassessment.Promt to be read to EMTThe correct decision will be hereB:The EMT shold also practicinggiving a report to ALS or RN at theconclusion of the assessment.Indicates areas or information that must be stated by the EMT before receiving information or moving on in the assessment.**Promts to be read toEMT but must ask forthem individuallyIndicates information in the scenario that has a footnote with further explaination.
Patient Assessment#1Description: Choking (15 minute Time limit)MedicalSex: M or FStill Alarm @1320: You and your partner are on shift ordering lunch at El Pollo Inka. You suddenly hear a man choking and people yelling for help.BSI:Gloves, GogglesSecondaryVitals(1)(2)P:SafeS:Hoarseness in P:Nothing makes it betterL:WheezesClearbilaterallyM:Nature of illnessQ:I still feel like I'm choking, tightnessL:A/O x 3A/O x 3A:No indication for ALS at this timeR/R:NeckS:FlushedPinkw/hivesN:No Indication for SMR at this timeS:7R:26 Labored20 NTVT:7 minutesP:92 weak106BoundingPrimaryG.I.:Pt is standing, coughing,(his / her) throatL.T.:holdingA/A:PCN, shrimp / 59yoCoughing and beating his chest like he ischockingM:Epi-Pen in my bagAVPU:Alert but can barely speakP:NoneC/C:I'm chokingL:10 min agoA:Partial obstruction -- Full obstructionE:Grubbin' this Lomo Saltado with my familyPhysicalEMT must determine if TX is needed and howEncourage to cough -- ABD thrustDislodged ShrimpB:C:-- Head:NRB @ 15 LPMNeck:Hives, you hear hoarseness in patient's voiceCRT: 2, No bleeding, HR: rapid/weak,Skin: Flushed, warm, dryChest:Hives, Accessory Muscle UsePelvis:E:EMT should expose chest and neckLower:F:Signs of anaphylaxis: stridor/wheezing hives andactivate ALS**Upper:G:ALS, Code 3, MARBack:**PCN penicillinDICE, 6RightsEpinephrineAction: Vasoconstrictor,BrochodilatorContraindications: NoneHow to administer oxygen for thispatientHow to properly deliver abdominalthrustsAbdominal:NoneEMT needs to explain thefollowing:Indications: Anaphalatic ShockRapid and shallow w/ Stirdor and wheezingD/D:Treatment & Interventions:HivesEMT must give report once ALSarrives
Patient Assessment#2Description: Chest pain (15 minute Time limit)MedicalSex: M or FDispatch @0417: EMS 10 respond to a chest pain at a private residence, pt is located in the back guest house.BSI:Gloves, GogglesSecondaryVitals(1)(2)P:SafeS:**Levine's Sign**, nausea, & :1P:When I move it gets worseL:Clear,bilaterallyClear,bilaterallyM:Nature of illnessQ:Elephant sitting on my chestL:A/O x 3A/O x 3A:Activate ALS based off dispatch of CP**epigastric region** radiating to jawS:Pale, Cool,DiaphoreticPink, Cool,DiaphoreticN:No Indication at this timeS:5R:24 NTV20 NTVT:45 minP:54 weak60 weakR/R:PrimaryTreatment & Interventions:G.I.:PT is sitting clutching (his / her) chestA/A:NKA / 74yoL.T.:NoneM:**NTG, Atenolol, ASA**AVPU:AlertP:MI 2 yrs ago, Pacemaker, **CAD**C/C:My chest hurts, I feel super nauseatedL:14 hours agoA:PatentE:I was asleep and the pain woke mePhysicalEMT must determine if TX is needed and howNitroglycerin action, indications,contraindications and administrationHead:No signs of traumaAspirin action, indications,contraindications and administrationB:Increased rate w/NTV : Sp02 95%CRT: 2, NO Bleeding, HR: slow,Skin: Pale, cool, diaphoreticChest:NC @ 1 - 6 LPMAbdominal:D/D:NonePelvis:E:EMT should expose the chestLower:F:Signs of MI; ALS vs STEMI CTR ETAsUpper:G:ALS, Code 3, STEMIBack:Zipper Scar**Levine's Sign clutchingof the chest in pain**CAD Coronary Artery Disease**Epigastric Region is at the midline slightly below the xiphoid process. Patient may complain of their discomfort as heart burn or nausea**NTG Nitroglycerin ASA Aspirin**atenolol** A common blood pressure medication; it is a beta-blockerDICE, 6RightsHow to administer oxygen for thispatientHow & When to reassess pain forthis patientNeck:C:EMT needs to explain thefollowing:Cardiogenic vs Hypovolemic shockEMT must give report when ALSarrives
Patient Assessment#3MedicalDescription: Stroke-like Symptoms (10 minute time limit)Sex: M or FDispatch @1820: EMS 10 Respond to Mimi's Café for a fall. The caller stated the patient slump over at the table for some time and now can't really pronouncewords correctly.BSI:Gloves, E:Tight space inside the resturauntO:suddenly started having trouble speakingE:PEARRLPEARRLN:1P:unable to obtainL:A/O X 3(Slow torespond)A/O X 3(Slow torespond)M:Nature of illnessQ:he/she said tingling before the trouble :Activate ALS due to neurologial emergencyR/R:all along left sideS:Pale, cool,diaphoreticPink, cool,clammyN:No indication at this timeS:unable to obtainR:26 shallow 24 shallowT:10 minutes agoP:68 strongPrimaryEMT should state to ask PT's friendG.I.:Patient is sitting up right but (he/she) slow totracking you as you enter the roomA/A:NKA / 68yoL.T.:NoneM:**Losartan, Metformin**AVPU:Alert but having a hard time pronouncingwordsP:C/C:I feel weak and tingling throughout my leftsideL:1/2 of the sandwhich orderedA:PatentE:just here having lunchPhysicalB:Increased rate and shallowHead:NRB @ 15 lpmNeck:CRT: 2, NO Bleeding, HR: slow,Skin: Pale, cool, diaphoreticChest:Shock ManagementAbdominal:D/D:Speech deficits -- **should assess forF.A.S.T.**Pelvis:E:breifly expose the left side of bodyLower:F:Signs of stroke; ALS vs Stroke Ctr ETAsUpper:G:ALS, Code 3, Stroke centerBack:C:**FAST** cincinatti stroke scale60 strongTreatment & Interventions:Mini strokes, DM II, recently had my hip replaced EMT must explain:how to assess F.A.S.T.how to administer oxygen for thispatientEMT must determine if TX is needed and how CVA vs TIAdifficulty speaking; slight facial droopHow to obtain information fromfamily/friends/bystandersEMT must give report once ALSarrives
Patient Assessment#4Description: Diabetic Emergency (15 minute Time limit)MedicalSex: M or FDispatch @1015: EMS 10 respond to a private residence for weakness, caller states (he / she) doesn’t "feel right".BSI:Gloves, GogglesSecondaryVitals(1)(2)P:SafeS:PT is weak and poor perfusionB:116/82112/78E:Dog barking at the doorO:GradualE:PEARRLPEARRLN:1P:Standing up or moving around makes it worseL:Clear,BilaterallyClear,BilaterallyM:Nature of illness due to weaknessQ:No energy and really thirstyL:A/O x 3A/O x 3A:Activate ALS due to weaknessAll overS:Pale, Cool,ClammyPink, Cool,DryN:No indication at this timeS:I don’t know, I just don’t feel right.R:10 NTV12 NTVT:This morningP:102 weak94 weakTreatment & Interventions:R/R:PrimaryG.I.:After opening the door for you, the PTstumbles back to the couchA/A:None / 56yoL.T.:NoneM:Insulin, LipitorAVPU:Alert but slow to respondP:**DM I**, High CholesterolC/C:I feel so weak, I can barely get upL:Lunch YesterdayA:PatentE:I woke up like this, no energyPhysicalEMT must determine if TX is needed and howEMT needs to explain thefollowing:properly use a glucometer (aseptic) - 52 mm/dLOral GlucoseAction: Increases blood glucosesaturationSlow, NTV ; Sp02 90%Head:Indications: Low blood sugarassociated with ALOCNRB @ 15 LPMNeck:Contraindications: Cant followcommandsCRT 2sec; No bleeding; HR: rapid/weakSkins: pale, cool, clammyChest:How they would provide oxygenShock managementAbdominal:D/D:Pt cant stand on his ownPelvis:E:Expose head to rule out traumaLower:F:should decreased mental status and checkblood sugar, ALS vs M.A.R. ETAsUpper:G:ALS, Code 3, M.A.R.Back:B:C:**DM I** Diabetes Mellitus: Type 1When they would reassess bloodglucose levelsEMT must give report once ALSarrives
Patient Assessment#5MedicalDescription: Respiratory Distress (15 minute Time limit)Sex: M or FDispatch @1600: EMS 10 respond to a local convenience store for a 24 yo male in respiratory distress.BSI:Gloves, GogglesSecondaryVitals(1)(2)P:SafeS:Pt has poor respirationsB:130/98138/92E:Busy parking lotO:SuddenE:PEARRLPEARRLN:1P:Leaning forward helpsL:A/O x 3A/O x 3M:Nature of illnessQ:like I cant get air outL:WheezingClearA:Actiavte ALS due to resp. distressChest/moves to throatS:Pale,Warm, DryPink,warm, dryN:No indication at this timeS:6R:32 Labored24 NTVT:10 min agoP:94 S/R116 S/RTreatment & Interventions:R/R:PrimaryG.I.:Pt is sitting in a chair tripoddingA/A:None / 24yoL.T.:NoneM:Albuterol, Mens One-A-DayAVPU:AlertP:AsthmaC/C:I can't really breath, chest feels real tightL:Pizza one hour agoA:PatentE:I was running to work so I wouldn’t be latePhysicalB:C:EMT needs to explain thefollowing:DICE, 6RightsMedtered-Dose InhaleradministrationEMT must determine if TX is needed and how Action: BronchodilatorRapid w/audible wheezesHead:Indications: difficulty breathing withwheezesNRB @ 15 LPMNeck:Contraindications: Can't followsimple commands, exceeded RxCRT 2sec; No Bleeding; HR s/rSkins: Pale, warm, dryChest:Normal. No Rash or traumaHow they would provide oxygenAbdominal:D/D:NonePelvis:E:Expose the chestLower:F:high priority patient, NRB due to resp.distrss; ALS vs Hosp ETAsUpper:G:ALS, CODE 3, M.A.R.Back:EMT must give report once ALSarrives
Patient Assessment#6Description: Anaphylaxis (15 minute Time limit)MedicalSex: M or FDispatch @1230: EMS 10 respond to the county fair for a female in respiratory distress.BSI:Gloves, GogglesSecondaryVitals(1)(2)P:SafeS:Possible anaphylaxisB:92/46110/56E:102 degreesO:SuddenE:PEARRLPEARRLN:1P:It gets worse by the secondL:Wheezes,StridorWheezesM:Nature of illnessQ:Hard to breath inL:A/O x 3A/O x 3A:Activate ALS due to resp. distressThroatS:UrticariaFlushedN:No inication at this timeS:10R:30 Labored26 NTVT:20 minP:96 weak112boundingR/R:PrimaryG.I.:Pt is leaning on rail holding her throat,struggling to breathA/A:Peanuts / 30yoL.T.:Respiratory CompromiseM:Epi-Pen, **Lipator**AVPU:AlertP:High cholesterolC/C:My throat is itchy and I feel like its closing(with stridor)L:Someone gave me a deep fried snack. I didn’tknow it was a snickers bar.A:Audible StridorE:we just stopped for a snackPhysicalEMT must determine if TX is needed and howB:Treatment & Interventions:EMT needs to explain thefollowing:DICE, 6 RightsEpinephrine administrationAction: Vasoconstrictor,BrochodilatorIndications: Anaphalatic ShockRapid, Labored ; WheezingHead:NRB @ 15 LPMNeck:HivesContraindications: NoneCRT: 2; No bleeding; HR: rapid/weakSkin: flushed w/urticariaChest:HivesHow to treat shock for this patientSigns of anaphylactic shockAbdominal:D/D:NonePelvis:E:Expose neck and chestLower:F:Suspect anaphylaxis, ALS vs Hosp ETAsUpper:G:ALS, CODE 3, M.A.R.Back:C:**Lipitor** Common medication for high cholesterolHow to administer oxygen for thispatientEMT must give report once ALSarrives
Patient Assessment#7Description: Overdose (15 minute Time limit)MedicalSex: M or FDispatch @0130: EMS 10 respond to a music festival for an unresponsive patient.BSI:Gloves, GogglesSecondaryEMT should ask friends for historyVitals(1)(2)P:SafeS:Pt has poor respirations, possible odB:106/54112/60E:Extremly low lightingO:Unable to obtainE:PinpointPEARRLN:1P:Unable to obtainL:A/O x 0A/O x 2M:Nature of illness at this time, based on calltypeQ:Unable to obtainL:DiminishedClearbilaterallyA:Activate ALS due to unresponsiveR/R:Unable to obtainS:Pale,Pale,Warm, Dry Warm, DryN:Bring SMR due to unresponsivenessS:Unable to obtainR:6 Shallow12 NTVT:Found 11 min agoP:116 weak112 S/RPrimaryG.I.:Treatment & Interventions:A/A:Unable to obtain / Looks 19yoL.T.:PT is propped up against a wall not moving.Appears to be breathing. Security foundfriends of the patient and *they're on scene*M:Unable to obtainAVPU:Responds to pain (grunts)P:Unable to obtainEMT must explain the following:C/C:Possible ODL:Unable to obtainSigns of opiate overdoseA:PatentE:partying at rave and shot up heroinPhysicalB:Very slow and very shallowHead:BVM @ 15 LPMNeck:CRT 2sec; No Bleeding; HR weak;Skins: Pale, cool, diaphoreticChest:Shock ManagementAbdominal:D/D:NonePelvis:E:EMT states what to exposeLower:F:EMT states field impressionUpper:G:EMT states transport decisionBack:C:Naloxone administration -- 2mg INor IMNaloxone actions, indication,EMT must determine if TX is needed and how contraindicationsAbrasions on forhead ; Pinpoint pupilsHow to administer oxygen for thispatientHow to obtain information fromfamily/friends/bystandersDimisheshd lung soundsFresh trackmarksEMT must give report once ALSarrivesThis scenario requires at least 3 students: 1 EMT, 1 Friend of the PAtient, 1 PAtient*Friend on scene* If asked what happened: "we've been drinking all day and then my friend shot up some heroin. We were just sitting down for a bit and he justpassed out." *EMT can rule out trauma*
Patient Assessment#8Description: Vaginal Bleed (10 minute time limit)MedicalSex: FemaleDispatch @1350: EMS 10 respond to 24 Hour Fitness for a female complaining of abdominal pain. She stated she is bleeding.BSI:Gloves, GogglesSecondaryVitals(1)(2)P:SafeS:Vaginal bleeding, signs of hypovolemic :standing up makes it worseL:A/O x3A/O x3M:nature of illnessL:ClearbilaterallyClearbilaterallyA:no indication at this timeR/R:R Abdomen and pelvic regionS:Pale, Cool,diaphoreticPale, cool,clammyN:No indication at this timeS:9R:28 shallow20 NTVT:20 minP:116 weak100 weakQ: really bad cramps, a sharp pain comes and goesPrimaryG.I.:PT is sitting in chair crying, guarding herABDA/A:NKA / 24yoL.T.:NoneM:noneAVPU:AlertP:noneEMT must explain:C/C:"My stomach starting hurting just as I got to the gym. Iwent to the bathroom to change clothes and startedbleeding"L:juice about 3 hours ago, I'm on a cleansepertinent negatives:A:PatentE:I just got to the gym, I haven't started working out.PhysicalEMT must determine if TX is needed and howHead:NRB @ 15 LPMNeck:CRT: 2, NO active Bleeds, HR: rapid,Skin: Pale, cool, diaphoreticChest:Shock ManagementAbdominal:R side of ABD guarding; tendernessD/D:nonePelvis:blood stained shorts; no signs of traumaE:expose abdomenLower:F:high priority patient; signs of shock; ALS vsM.A.R. ETAsUpper:G:ALS, Code 3, M.A.R.Back:C:Is there a possibility you're pregnant?"I don't know"When was your last menstrualperiod? "3 months ago"Do you have regular periods? "yes Ido"Rapid and shallow; speaking in 2-3 wordsper breathB:Treatment & Interventions:EMT must give report once ALSarrives
Patient Assessment#9TraumaDescription: Gun Shot wound (15 minute Time limit)Sex: MaleDispatch @2258: EMS 10 respond to J's Liquor for shots fired, it was reported there is a man down .BSI:Gloves, GogglesSecondaryVitals(1)(2)P:Safe, PD has secured the sceneS:GSW, ALOCB:92/6490/60E:Large crowdO:Unable to obtainE:PEARRLPEARRLN:1P:Unable to obtainL:A/O x 0A/O x 0M:Mechanism of injuryQ:Unable to obtainL:Diminishedon leftDiminishedon leftA:Activate ALSR/R:Unable to obtainS:Pale, cool,diaphoreticPale, cool,diaphoreticN:Bring SMR due to man downS:Unable to obtainR:agonalagonalT:Unable to obtainP:5860PrimaryG.I.:**PT is sitting slumped over against thebuilding**A:Unable to obtain /Looks mid 30sL.T.:You see a bullet hole lower left chestM:Unable to obtainAVPU:Withdraws to painful stimulusP:Unable to obtainEMT must explain:C/C:ALOC w/GSWL:Unable to obtainHow to administer oxygen for thispatientA:Secretions in the mouthE:Unable to obtainHow to identify sucking chest woundSuction neededPhysicalEMT must determine if TX is needed and howAgonal BreathsHead:noneBVM @ 15 LPM W/OPANeck:Tracheal deviation, JVDCRT: 2, No active bleeds, HR: slow,Skin: Pale, cool, diaphoreticChest:Sucking Chest woundShock e the whole bodyLower:noneF:High priority patient; Interventions provided;ALS vs Hosp ETAsUpper:noneG:ALS, Code 3, Level I TraumaBack:GSW exitB:C:**General Impression** EMT should lay the patient supineTreatment & Interventions:How to identify TensionPneumothoraxHow to apply a chest sealEMT must give report when ALSarrives
Patient Assessment# 10TraumaSex:FemaleDescription: Cheerleading Accident (15 minute time limit)Dispatch @1937: EMS 10 respond to a high school football stadium for a fall. FAMILY IS ON SCENEBSI:Gloves, GogglesSecondaryEMT should ask family for the followingVitals(1)(2)P:SAFES:UNRESPONSIVE, SHOLDER DEFORMITYB:128/70132/78E:LARGE CROWD OF SPECTATORSO:"she fell quickly, hit her head and was out"E:N:1P:UNABLE TO OBTAINL:A/0 X 0A/O X 0M:MECHANISM OF INJURYQ:UNABLE TO OBTAINL:CLEARBILATERALLYCLEARBILATERALLYA:NO INDICATION AT THIS TIMER/R:UNABLE TO OBTAINS:N:YES DUE TO FALLS:UNABLE TO OBTAINR:T:UNABLE TO OBTAINP:PrimaryG.I.:**PT IS PRONE**A/A:NKA / 17yoL.T.:APPEARS TO NOT BE MOVINGM:NONEP:NONEAVPU:**UNRESPONSIVE**EMT should activate ALSUNEQUAL UNEQUALPALE,PINK,COOL,COOL,DRYDRY2824SHALLOW SHALLOW118STRONG114STRONGTreatment & Interventions:C/C:UNRESPONSIVEL:NONEA:PATENTE:"SHE FELL WHILE BEING HOISTED UPDURING CHEERLEADING STUNT"PhysicalEMT must determine if TX is needed and howHOW TO IDENTIFY A TRAUMATICBRAIN INJURYRAPID AND SHALLOWHead:UNEQUAL PUPILS; HEMATOMA ON RIGHTSIDEHow to obtain information fromfamily/friends/bystandersBVM @ 15 LPM W/OPANeck:NONECRT: 2, NO Bleeding, HR: RAPID,Skin: PALE, COOL, DRYChest:NONESHOCK MANAGEMENTAbdominal:NONED/D:DEFORMITY IN THE RIGHT SHOULDERPelvis:NONE
C: Promt to be read to EMT Chest: Promt to be read to EMT The correct decision will be here Abdominal: Promt to be read to EMT D/D: Promt to be read to EMT Pelvis: Promt to be read to EMT E: EMT must decide Lower: Promt to be read to EMT F: EMT must decide Upper: Promt to be read to EMT G: EMT must
suitable for the wall material and the weight of the water heater filled to capacity (EMT 1 25 lbs. - EMT 2.5 37 lbs. - EMT 4 52 lbs. - EMT 6 80 lbs.). Hang the water heater on the bracket and pull downwards on the water heater to insure that both "fingers" of the bracket are seated in the mounting slots.
Lupe is certified to teach EMT-B and EMT Refresher Course. 7 Hannah Barakzoy, EMT-B has served as an AHE EMT-B skills instructor since July 2017. She is currently pursuing a nursing degree. Hannah is certified to teach EMT-B. Barry Rose, EMT-P, American Heart Association certified instructor and teaches BLS, ACLS
The EMT-Basic-Intermediate Technician (EMT-Basic IV) is an advanced level EMT-B who has completed additional training beyond that of an EMT-Basic, and is authorized under Wis. Stats. 1460.50 (5) and Wis. Admin. Rule 110 to perform selected advanced procedures under physician direction. Patient
13934 01320 EMT Shoe Group, 1/2” to 2” X 23803 01322 EMT Shoe Group, 1/2” to 2” X 01323 01323 IMC Roller Support, 1-1/2” to 2” X 13856 13856 1-1/2" & 2" IMC Squeeze Roller X ELECTRIC BENDER COMPATIBILITY 555 SHOE GROUPS 555CX BENDING RADII CONDUIT SIZE CONDUIT TYPE INCHES MM 1/2" EMT 4-5/16 109.5 3/4" EMT 5-1/2 139.7 1" EMT 7 177.8
eral factors that regulate EMT have been identified, with SNAIL (SNAI1), SLUG (SNAI2), TWIST1, ZEB1, and ZEB2 representing the core EMT-TFs (EMT-inducing transcription factors) that also mediate EMT during development
that it hung just below the center of the longest chime. I then hung the wind sail from the striker. DIY Outdoor EMT Wind Chimes: Page 11. DIY Outdoor EMT Wind Chimes: Page 12. DIY Outdoor EMT Wind Chimes: Page 13. DIY Outdoor EMT Wind Chimes: Page 14. Step 9: Conclusion
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Nutrition of ruminants Developing production systems for ruminants using tropical feed resources requires an understanding of the relative roles and nutrient needs of the two-compartment system represented by the symbiotic relationship between rumen micro-organisms and the host animal. Fibre-rich, low-protein forages and crop residues are the most abundant and appropriate feeds for ruminants .
