2019 EMT Refresher Instructor Manual

B.1.A – Tracheostomy Infant Station: Technology Dependent Children Instructor Guidance

Objectives: 1. Demonstrate assessment of a tracheostomy patient with mechanical ventilation. (pp 1269–1273) 2. Demonstrate ventilation of a tracheostomy patient. (pp 1269–1273)

Setup: -

Cohort Bag

-

Trach Baby Kit

Deployment: DO NOT LECTURE – your students should be working hands-on within 5 minutes of arriving Deploy your students in one team –a special manikin should be patient, the rest rescuers.

Debriefing:

Ventilator:

- What was this patient’s main problem? (imminent respiratory failure due to no ventilator) - Why couldn’t he be off the vent (neuromuscular disease that keeps his muscles from working) - What could you do to keep the vent working (external 110V power source would probably do it, but is not available, so BVM ventilation will have to suffice) - What was the rhonchi about (patients with poor muscle power can’t really cough up secretions so they get mucous backup in their airway and need suctioning) - Discuss the EMT scope of practice (they can suction the appliance, but not the trachea itself)

VP Shunt:

- What was this patient’s main problem? (Increased ICP from shunt malfunction) - How did we get to that conclusion (neuro symptoms – Nausea, vomiting, lethargy, seizure) - What can be done (Rapid transport)? - What can ALS do (Not much, but anti-seizure meds might help stop the seizing)?