2019 EMT Refresher Instructor Manual

A.5.1 Resuscitation Other Opiate overdose (don’t let them know what it is) Instructor Guidance

A.5.1 Resuscitation Other Scenario

Takes or verbalizes appropriate BSI Determines the scene/situation is safe Attempts to question bystanders about arrest events Checks patient responsiveness NOTE: The examiner must now inform the candidate: “The patient is unresponsive Assesses pt for signs of breathing, determines absence of abnormal breathing (gasping or agonal); Checks carotid pulse (no more than 10 seconds) NOTE: The examiner must now inform the candidate: “The patient is apneic but has a pulse” Rescuer 1:

Objectives:

Demonstrate how to use the AVPU scale to test for patient responsiveness. (p 262) Demonstrate how to evaluate a patient’s orientation and document his or her status correctly. (pp 262–264) 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) Demonstrate how to assist a patient with ventilations using the bag-mask device for one and two rescuers. (p 354 Demonstrate how to assess a radial pulse in an unresponsive patient. (pp 272) Demonstrate how to obtain a pulse rate in a patient. (pp 270–272) Demonstrate how to assess capillary refill in an adult or child older than 6 years. (pp 273–274) Demonstrate the use of a pulse oximetry device to evaluate the effectiveness of oxygenation in the patient. (pp 289–290) Demonstrate the use of electronic devices to assist in determining the patient’s blood pressure in the field. (pp 290–291) Demonstrate how to perform a rapid scan for injury. (pp 291–295, Skill Drill 8- 2) Demonstrate how to perform a full body scan for injury. (pp 291–295, Skill Drill 8-2) Demonstrate how to measure blood pressure by auscultation. (pp 296–300, Skill Drill 8-3) Demonstrate how to measure blood pressure by palpation. (p 300) Demonstrate the set up and administration of intra-nasal naloxone Deployment: DO NOT LECTURE – your students should be working hands-on within 5 minutes of arriving Deploy your students in one team – a manikin should be patient, the rest rescuers with one team leader. The patient should sit and pretend to be collapsed in bed. 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 immediately assess primary assessment? - Did they use an airway adjunct? (Probably needs one since he is snoring) - Did they ventilate the patient? - What were the indications for Naloxone? (shallow respirations, pinpoint pupils) - Did they properly administer Naloxone? - Did they continue ventilating until the patient began breathing spontaneously? 270– Equipment: - Cohort Bag - Flexible Stretcher

Inserts adjunct as tolerated

Begins rescue breathing 1 breath every 5- 6 seconds Other Rescuers:

Performs physical exam

Solicits SAMPLE history from bystanders

Checks scene for relevant information about the situation Provides treatment as indicated by situation Performs post-resuscitation care such as BP and pulse oxymetry INSTRUCTOR: DEBRIEFS STUDENTS