EMT Curriculum

3.12.D.1 Patient Assessment Scenario Lab I Station: Chest Pains Instructor Guidance

Objectives:

1. Demonstrate how to use the AVPU scale to test for patient responsiveness. (p 262) 2. Demonstrate how to evaluate a patient’s orientation and document his or her status correctly. (pp 262–264) 3. 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) 4. Demonstrate how to assess a radial pulse in a responsive patient (pp 270–272) 5. Demonstrate history-taking using the SAMPLE mnemonic and the OPQRST mnemonic 6. Demonstrate how to measure blood pressure by auscultation. (pp 296–300, Skill Drill 8-3) 7. Demonstrate how to measure blood pressure by palpation. (p 300) 8. Demonstrate taking a heart rate on a patient 9. Demonstrate taking a breathing rate on a patient 10. Demonstrate how to obtain a pulse rate in a patient. (pp 270–272) 11. Demonstrate how to assess capillary refill in an adult or child older than 6 years. (pp 273–274) 12. Demonstrate how to perform a focused assessment of a patient 13. Demonstrate the use of a pulse oximetry device to evaluate the effectiveness of oxygenation in the patient. (pp 289– 290) 14. Demonstrate the use of electronic devices to assist in determining the patient’s blood pressure in the field. (pp 290– 291) 15. Demonstrate how to measure blood pressure by auscultation. (pp 296–300, Skill Drill 8-3)

16. Demonstrate how to measure blood pressure by palpation. (p 300) 17. Demonstrate how to solicit a medical history from a patient (pp 278)

Equipment:

Cohort Bag Stairchair

• •

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 be 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 case after it is complete. Some points to discuss:

- Did they provide oxygen? Discuss non-rebreather vs. nasal cannula in the stable patient.

- Did they do a focused secondary assessment for cardiac problems:

Breath sounds

o

Neck veins

o

Foot edema

o

Chest palpation

o

.- Discuss presentation of musculoskeletal pain vs. ischemic chest pain

EMT students always do too little physical exam for medical patients. Make sure they do the above physical exam items.

- Did they seem to know what is going on? (Muscular-skeletal pain)

- Did they think to cancel the medics? (They should)