EMT Lesson Plans

Medical Transportation 4

Medical Transportation 3

Medical Transportation 1

Medical Transportation 2

The patient is 56-years old who had a stroke and has a left sided paralysis. The transport order calls for oxygen @ 8 lpm by simple mask and pulse oxymetry monitoring. The baseline SPO2 will be 96% on this therapy. The patient will develop this secretions during transport. He will gurgle violently and develop respiratory distress until his pharynx is suctioned. After suctioning the patient will present with an SPO2 of 87%. Students should switch the patient to a NRB mask at 10lpm or greater and the SPO2 will climb to 95%. The patient will periodically need suctioning with similar decreases in SPO2.

The patient is 24-year-old with a brain tumor that requires 2 lpm of oxygen by nasal canula. The students should set up the canula and SPO2 monitor and transport the patient. Initial SPO2 reading will be 98%. The patient will have a seizure during transport and become apneic. Students should ventilate the patient via BVM and insert an adjunct. The patient will reject the oral airway but tolerate the nasal. If the patient does not get ventilated promptly, make the SPO2 decrease gradually to 80%.

The patient is 79-year-old with a tracheotomy who requires humidified oxygen at 6 lpm and Spo2 monitoring. The students should set up the trach mask and SPO2 monitor and transport the patient. The patient will develop secretions during transport. He will need suctioning via French catheter, and will become unresponsive during that process and breathe only at 4 bpm. Students should ventilate the patient via BV. If the patient does not get ventilated promptly, make the SPO2 decrease gradually to 82%.

The patient is 62-year-old with a COPD that requires 40% oxygen by venturi mask. The students should set up the venturi mask and SPO2 monitor and transport the patient. Initial SPO2 reading will be 88%. The SPO2 will not increase regardless of how much O2 is provided. If they think to look at the patient’s paperwork, they will note that this patient has never been noted to sat above 89%.

Critical Criteria

Does not appropriately set up oxygen Does not monitor SPO2 Does not connect device to oxygen

Critical Criteria

Critical Criteria

Does not appropriately set up oxygen Does not monitor SPO2 Selects inappropriate ventilation device Fails to ventilate at 1 breath / 5-6 seconds Unable to create visible chest rise Does not connect device to oxygen

Does not appropriately set up oxygen Does not monitor SPO2 Selects inappropriate ventilation device Fails to ventilate at 1 breath / 5-6 seconds Unable to create visible chest rise Does not connect device to oxygen

Debriefing Points:

Critical Criteria

Why is the patient’s saturation so low? Is SPO2 88% an emergency? Why not?

Does not appropriately set up oxygen Does not monitor SPO2 Selects inappropriate ventilation device Fails to ventilate at 1 breath / 5-6 seconds Unable to create visible chest rise Does not connect device to oxygen Advises facility of patient condition upon arrival

Have a quick discussion about hypoxic drive without overstressing it’s role in pre- hospital care.

Debriefing Points:

Debriefing Points:

Were ventilations promptly provided? What were the symptoms that signaled decompensation? What caused this scenario?

Were ventilations promptly provided? What would other acceptable devices for this scenario include? What caused this scenario?

Debriefing Points:

Were ventilations promptly provided? Why should this patient be switched to a NRB mask? What caused this scenario?