EMT Curriculum

Equipment for this station: - Cohort Bag

- EMT/Airway Manikin or Quality BLS manikin

- Suction Unit

- Pulse Oxymeter or ET3 - Intubation Kit from Black Airway Bag

You should set this up as a mini-scenario with a manikin in the middle and the students holding their equipment around it. DO NOT let this become a verbalization station – they should be doing all activities as they need to develop expertise with the equipment at this point in the class.

Respiratory Failure 1

Respiratory Failure 2

Respiratory Failure 3

Respiratory Failure 4

The patient is 19 year old who is responsive only to pain and breathing 4 snoring breaths per minute. There is obvious heroin use paraphernalia on the scene. The patient will need BVM ventilations and an adjunct. He will not tolerate an oral adjunct. After about 6 breaths, the patient will vomit and require suctioning. ALS will arrive 5 minutes into the scenario and administer narcan. The patient will vomit again, then begin breathing 22 bpm and begin responding but be confused and agitated. Does not open airway manually Selects inappropriate ventilation device Fails to ventilate at 1 breath / 5-6 seconds Fails to insert adjunct Unacceptable adjunct technique Unable to create visible chest rise Does not connect device to oxygen Does not monitor SPO2 Does not provide NRB to responsive patient Debriefing Points: Were ventilations promptly provided? What caused this scenario? Critical Criteria

The patient is 70 year old with an unknown complaint. You find him sitting on his chair responsive only to pain. He is breathing 3 bpm, and is pale and sweaty. The patient will need BVM ventilations and an adjunct. He will not tolerate an oral adjunct. After about 12 breaths, the patient will have gastric distension, but will not vomit. The person who is bagging should be told that bag compliance is poor and that it’s increasing hard to ventilate. The SPO2 will stay at 91%. ALS will arrive and intubate the patient. The person who is bagging should be told that bag compliance is poor and that it is still hard to ventilate. The SPO2 will stay at 91%. ALS will insert an NG tube and the stomach will decompress. The EMT should be told that his effort at ventilation is now easier and the SPO2 has increased to 97%. Critical Criteria Does not open airway manually Selects inappropriate ventilation device Fails to ventilate at 1 breath / 5-6 seconds Fails to insert adjunct

The patient is a 50 year old who stabbed in the stomach. A bystander controlled his bleeding, and he is responsive to pain only, and breathing at 34 bpm. He is pale and sweaty. The patient will need BVM ventilations and an adjunct. He will tolerate either adjunct. The patient will continue in this situation for the rest of the scenario. The SPO2 will read “NO READING”. Does not open airway manually Selects inappropriate ventilation device Fails to ventilate at 1 breath / 5-6 seconds Fails to insert adjunct Unacceptable adjunct technique Unable to create visible chest rise Does not connect device to oxygen Does not monitor SPO2 Critical Criteria

The patient is an 18 year old who had fallen from a skateboard and is unresponsive. The patient will need BVM ventilations and an adjunct. He will tolerate either adjunct. After about 20 breaths, he will vomit. The patient will need suctioning and resumed ventilation with an adjunct. After about 5 minutes, ALS will arrive and intubate the patient, and ask you to connect him to your ATV so you can help backboard him. Critical Criteria Opens the airway w, Head Tilt/Chin Lift Selects inappropriate ventilation device Fails to ventilate at 1 breath / 5-6 seconds Fails to insert adjunct Unacceptable adjunct technique Unable to create visible chest rise Does not connect device to oxygen Does not monitor SPO2 Does not appropriately connect to ATV Debriefing Points: Were ventilations promptly provided? What caused this scenario? Why not use head-tilt/chin-lift?

Unacceptable adjunct technique Unable to create visible chest rise Does not connect device to oxygen Does not monitor SPO2 Debriefing Points: Why were the ventilations hard to

Debriefing Points: Were ventilations promptly provided? What caused this scenario? Why did the SPO2 not read?

perform? Why didn’t the ET tube help? Why did the stomach decompression help?