EMT Curriculum

4.06.F.2 Medical Lab I Station: Psych Restraint 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) Deploy your students in one team – one student should be patient, the rest rescuers. The patient should sit and pretend to be cowering in the corner of the room. 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 take steps to insure their safety? - When the patient permits it, did they assess the patient’s medical status to rule out medical causes of combativeness such as head injury, etc? - Once the identifies behavioral as the issue, did they try: o Verbal de-escalation o Reorienting the patient to reality o If they go as far as restraining the patient, they probably went too far - It is not acceptable to play into delusions/hallucinations, but covering the patient is not necessarily playing into them unless the EMTs validate that the UV light will make him sick. Something like “I understand you think this will help you from becoming ill.” Is acceptable. As long as they don’t say something like “let’s cover you up so the UV light does not make you sick” it’s fine to make the patient comfortable for transport. 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 Deployment: DO NOT LECTURE – your students should be working hands-on within 5 minutes of arriving

This is a nebulous area for EMTs. Be sure to review this.