2019 EMT Refresher Instructor Manual

B.1.C – Patient with a VP Shunt, Peg, And Foley (~13 minutes) Instructor Guidance

Objectives: 1.

Demonstrate assessment of a technology assisted patient 2. Name two symptoms that might occur from VP Shunt malfunction 3. Name two symptoms that might occur from PEG tube malfunction 4. Name two symptoms that might occur from Foley Catheter malfunction

Setup: -

Cohort Bag

-

Special Needs Child Manikin

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:

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)?

Peg Tube:

- What does a PEG tube do? (assists with placing food into the stomach for a patent who cannot swallow ex.stroke) - What are some problems patients with PEG tubes can have? (displacement, infection, and aspiration) - What are the signs of DISPLACEMENT? (Loose tube, abdominal pain, blocked tube) - What are the signs of INFECTION? (fever, redness at the site, pus at the site) - What are the signs of ASPIRATION? (Wheezing, difficulty breathing, rhonchi).

Foley Catheter:

- What does a Foley Catheter do? (collects urine for a patient with no control over urinary flow, or establishes a patient urinary tract in a patient with a blockage) - What are some problems patients with Foleys? (migration of catheter, infection) - What are the signs of MIGRATION? (bleeding at the urinary meatus, lack of flow)’ - What are the signs of INFECTION? (fever, redness at the site, pus at the site)