EMT Lesson Plans

3.12 Patient Assessment Lab II Station: Unstable Medical Instructor Guidance

Objectives:

Demonstrate how to use the AVPU scale to test for patient responsiveness. (p 262) Demonstrate how to evaluate a patient’s orientation and document his or her status correctly. (pp 262–264) Demonstrate the techniques for assessing a patient’s airway and correctly obtaining information related to respiratory rate, rhythm, quality/character of breathing, and depth of breathing. (pp 265–269) Demonstrate how to assess a radial pulse in a responsive patient and an unresponsive patient. (pp 270–272) Demonstrate how to obtain a pulse rate in a patient. (pp 270–272) Demonstrate how to assess capillary refill in an adult or child older than 6 years. (pp 273–274) Demonstrate how to perform a focused exam of a patient Demonstrate the use of a pulse oximetry device to evaluate the effectiveness of oxygenation in the patient. (pp 289– 290) Demonstrate the use of electronic devices to assist in determining the patient’s blood pressure in the field. (pp 290– 291) Demonstrate how to measure blood pressure by auscultation. (pp 296–300, Skill Drill 8-3) Demonstrate how to measure blood pressure by palpation. (p 300) Setup:

You will need your cohort bag and a REEVES.

Deployment:

DO NOT LECTURE – your students should be working hands-on within 5 minutes of arriving

Deploy your students in one team – one student should be patient, the rest rescuers. The patient should sit and pretend to have very short of breath. Have them transition through the scenario on the back of this sheet like any other scenario from a scenario lab day.

Debriefing:

Give students feedback on the application of the device after it is complete. Some points to discuss:

- Did they ventilate this patient?

- Did they do a focused secondary assessment? This patient should have JVD, pedal edema, and breath sounds examined

- Did they get both SAMPLE and OPQRST?

- Did they try sitting him up? That sometimes improves patients significantly (although not in this case)

- Why not use CPAP? (answer: this patient is in respiratory failure and it’s not indicated)