EMT Curriculum

4.06.D.1 Medical Lab I Station: DKA 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 an unresponsive patient (pp 270–272) 5. Demonstrate how to assess a carotid pulse in an unresponsive patient (pp 270–272) 6. Demonstrate history-taking using the SAMPLE mnemonic and the OPQRST mnemonic 7. Demonstrate how to measure blood pressure by auscultation. (pp 296–300, Skill Drill 8-3) 8. Demonstrate how to measure blood pressure by palpation. (p 300) 9. Demonstrate taking a heart rate on a patient 10. Demonstrate taking a breathing rate on a patient 11. Demonstrate how to obtain a pulse rate in a patient. (pp 270–272) 12. Demonstrate how to assess capillary refill in an adult or child older than 6 years. (pp 273–274) 13. Demonstrate how to perform a focused assessment of a patient 14. Demonstrate the use of a pulse oximetry device to evaluate the effectiveness of oxygenation in the patient. (pp 289– 290) 15. Demonstrate the use of electronic devices to assist in determining the patient’s blood pressure in the field. (pp 290– 291) 16. Demonstrate how to measure blood pressure by auscultation. (pp 296–300, Skill Drill 8-3)

17. Demonstrate how to measure blood pressure by palpation. (p 300) 18. Demonstrate how to solicit a medical history from a patient (pp 278)

Equipment: -

Cohort Bag Stairchair

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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 lie down and breathe deeply and loudly. 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 do a full assessment including ABC’s? - Did they administer oxygen? - What symptoms suggested diabetic emergency? o Altered mental status o Acetone breath o Bystander mentioned “insulin” o Should this patient get sugar? No because: ▪ Not awake enough to swallow ▪ Symptoms and history suggest hyperglycemia / DKA

Review hypoglycemia vs. hypoglycemia:

HYPO

HYPER

Fast Onset (minutes) Pale, sweaty skin No distinct breath

Slow Onset (days, hours)

Generally dry skin Acetone breath