2019 EMT Refresher Instructor Manual

Patient Assessment - Trauma Takes or verbalizes appropriate BSI Scene Size-Up Determines the scene/situation is safe Determines the MOI / NOI

Determines the number of patients Requests additional help if necessary Considers stabilization of the spine Primary Survey/Resuscitation Verbalizes general impression of patient Determines responsiveness/level of consciousness (AVPU) Determines chief complaint/life threats Airway

Opens and assesses airway Inserts adjunct as indicated

Breathing

Assesses breathing Assesses ventilation Initiates oxygen therapy Manages any injury which may compromise breathing/ventilation Assess circulation Assesses/controls major bleeding Checks pulse Assesses skin [either color, temp or condition] Initiates shock management Performs Rapid Scan (if major mechanism of injury or serious injury is present) Identifies patient priority and makes treatment / transport decision (based on calculated GCS) History Taking Attempts to obtain SAMPLE history Secondary Assessment Assesses affected body part / system HEAD – Inspects mouth, nose, facial area, scalp, ears, eyes NECK – Checks position of trachea, checks jugular veins, palpates cervical spine CHEST – Inspects chest, palpates chest, Auscultates chest ADBOMEN/PELVIS – Inspects and palpates abdomen, Assesses pelvis, verbalizes assess of genitals as needed LOWER EXTREMITIES – Inspects, palpates, and assesses motor, sensory, and circulatory functions UPPER EXTREMITIES – Inspects, palpates, and assesses motor, sensory, and circulatory functions POSTERIOR THORAX / LUMBAR / BUTTOCKS – Inspects & palpates posterior thorax lumbar and buttocks Vital Signs Pulse Respiratory Rate and Quality Blood Pressure Manages secondary injuries and wounds appropriately Reassessment Demonstrates how and when to reassess the patient to determine changes in condition Connects patient to appropriate monitoring equipment ___ Failure to take or verbalize body substance isolation precautions ___ Failure to determine scene safety before approaching patient ___ Failure to assess for and provide spinal protection when needed ___ Failure to voice and ultimately provide appropriate oxygen therapy ___ Failure to assess/provide adequate ventilation ___ Failure to find or appropriately manage problems associated with airway, breathing, hemorrhage or shock ___ Failure to differentiate patient’s need for immediate transportation versus continued assessment or treatment at the scene ___ Performs other assessment before assessing and treating threats to airway, breathing and circulation Critical Criteria: ___ Failure to initiate or call for transport of the patient within 10 minute time limit

___ Orders a dangerous or inappropriate intervention ___ Failure to manage the patient as a competent EMT ___ Exhibits unacceptable affect with patient or other personnel