EMT Curriculum

Equipment:

- Cohort Bag - Cohort Bag

Setup: Have a students hit in a chair or lie on floor as appropriate for the scenario. Have students walk in and treat the patient after reading them the patient’s age and circumstances. Make sure the students work the patient with the equipment - do not allow the station to become a talk-through.

Respiratory Distress 1 Patient is a 22-year old called for shortness of breath Takes appropriate BSI Gloves Scene Size-Up Determines safety Safe MOI / NOI NOI – SOB Number of patients 1 Requests additional help ALS Stabilization of the spine No Primary Survey/Resuscitation General impression Young person sitting in chair Responsiveness/LOC Alert Determines chief complaint Short of breath Assess airway and breathing Patent Breathes 22 / minute Assess circulation No bleeding, pulse present at wrist, skin warm dry Identifies patient priority Low Vitals SAMPLE BP: 106/72 S – Short of breath Pulse: 68 A – None Respirations: 22/min M – Albuterol P- Asthma

Respiratory Distress 2 Patient is an 80-year old called for shortness of breath Takes appropriate BSI Gloves Scene Size-Up Determines safety Safe MOI / NOI NOI – SOB Number of patients 1 Requests additional help ALS Stabilization of the spine No Primary Survey/Resuscitation General impression

Respiratory Distress 3 Patient is a 38-year old called for a fight Takes appropriate BSI Gloves Scene Size-Up Determines safety Safe MOI / NOI MOI - fight Number of patients 1 Requests additional help

Respiratory Distress 4 Patient is an 89-year old – called for SOB Takes appropriate BSI Gloves Scene Size-Up Determines safety Safe MOI / NOI NOI – SOB Number of patients 1 Requests additional help ALS Stabilization of the spine No Primary Survey/Resuscitation General impression Elderly person in chair Responsiveness/LOC Alert Determines chief complaint Short of breath Assess airway and breathing Patent Breathes 18 / minute Assess circulation No bleeding, pulse present at wrist, skin warm dry Identifies patient priority High Vitals SAMPLE BP: 152/80 S – Short of breath Pulse: 82 A – None Respirations: 18/min M – Albuterol, spiriva P- COPD

No, but will need to reconsider after assessment

Stabilization of the spine

No

Primary Survey/Resuscitation General impression

Elderly person lying flat on back in bed

Adult sitting in fetal position holding side of chest

Responsiveness/LOC Determines chief complaint Assess airway and breathing Assess circulation

Alert

Responsiveness/LOC Determines chief complaint Assess airway and breathing Assess circulation

Alert

“I can’t breathe!”

I can’t breathe

24 / minute with pink frothy sputum No bleeding, pulse present at wrist, skin warm dry

Patent Breathes 24 / minute Moderate bleeding from side of chest, pulse present at wrist, skin warm dry

Identifies patient priority

High

Identifies patient priority

High

Vitals

SAMPLE

BP: 148/78 Pulse: 98

S – Short of breath

Vitals

SAMPLE

A – None

BP: 104/60

S – Short of breath, Bleeding from side of chest

Respirations: 24/min

M – Lasix,Potassium P- CHF L–Hot dog 1 hr ago E – Trying to nap

L–Tea 1 hr ago E – Reading the paper

Pulse: 118 Respirations: 24/min

A – None M – None

L–Sandwich 1hr ago E – Doing homework

P- Asthma L–6 beers 30 min ago E – got into a fight and was stabbed

Critical Criteria Did not take safety or BSI precautions Fails to request ALS Did not fully assess airway Did not fully assess breathing Did not fully assess circulation, including pulse and skin

Critical Criteria Did not take safety or BSI precautions Fails to request ALS Did not fully assess airway Did not fully assess breathing Did not fully assess circulation, including pulse and skin What is the most significant thing you could do this patient? (Sit him up) Is there a need for oxygen in this patient? (yes) Is there a need to bag this patient? Why? (hopefully not if you improve his own breathing by sitting him up) Debriefing Points:

Critical Criteria Did not take safety or BSI precautions Fails to request ALS Did not fully assess airway Did not fully assess breathing Did not fully assess circulation, including pulse and skin

Critical Criteria Did not take safety or BSI precautions Fails to request ALS Did not fully assess airway Did not fully assess breathing Did not fully assess circulation, including pulse and skin Did not control severe bleeding Debriefing Points: What was his most immediate threat? (bleed) Is there a need for oxygen in this patient? Is there a need to bag this patient? Why? (borderline, but he seems to talk so no) What do you think is going on here? (lung puncture)

Debriefing Points:

Debriefing Points:

Is there a need for oxygen in this patient? Is there a need to bag this patient? Why? (no - 22 breaths/minute w/ OK symptoms) What do you think is going on here? (asthma attack)

Is there a need for oxygen in this patient? Is there a need to bag this patient? Why? (no - 18 breaths/minute w/ OK symptoms) What do you think is going on here? (COPD exacerbation)