2019 EMT Refresher Instructor Manual

A.3.A - Mechanical CPR (~17 minutes) 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 and pulseless” Rescuer 1: Immediately begins chest compressions (adequate depth and rate, allows the chest to recoil completely) Rescuer 2: Immediately begins applying AED electrodes and analyzes NOTE: The examiner must set AED to “Shockable” Rescuer 2: Clears the patient and presses “Shock” button; resumes compressions Rescuer 1: Immediately begins applying AutoPulse device Places device at head of the patient; insures band is open; presses power Cuts clothing off back of patient while Rescuer 2 picks up torso Slides device behind patient; lowers torso on board Closes band over lower sternum Presses START – insures device is set to 30:2 Provides 2 breaths when device pauses compressions NOTE: After 4 cycles, the examiner should advise rescuers that ALS has intubated the patient Switches device to CONTINUOUS mode. Insures patient is ventilated 1 breath every 6 seconds NOTE: After 40 seconds of CPR, prompts students to transport patient Insures appropriate ventilation interval (1 breath every 6 seconds) Stops mechanical compressions during analysis of patient INSTRUCTOR: DEBRIEFS STUDENTS

A.3.A Mechanical CPR (~17 minutes) Adult VF Cardiac Arrest Instructor Guidance

Objectives: Demonstrate how to reposition an unconscious adult for airway management. (pp 417–418, Skill Drill 11-1) Demonstrate how to check for a pulse at the carotid artery in an unresponsive patient. (p 417) Demonstrate how to perform external chest compressions in an adult. (pp 419–420, Skill Drill 11-2) Demonstrate how to perform a head tilt–chin lift maneuver on an adult. patient. (pp 419–421) Demonstrate how to perform one-rescuer adult CPR. (pp 424–426, Skill Drill 11-3) Demonstrate how to perform rescue breathing on an adult.. (pp 432– 433) Demonstrate how to perform two-rescuer adult CPR. (pp 424–428, Skill Drill 11-4) Demonstrate how to use AEDs and perform CPR. (pp 551–553, Skill Drill 14-2) Demonstrate how to utilize a mechanical compressor such as Autopulse

Setup: •

Cohort Bag AED Trainer

• • • •

Suction

EMT Level Full Body Manikin

Autopulse with battery

Deployment: DO NOT LECTURE – your students should be working hands-on within 5 minutes of arriving

This is a lab – not a scenario. Quickly show them how to apply the Autopulse, then have them do several rotations.

Debriefing: Give students feedback on the scenario at the end. Some points to discuss: - Did they assess the patient and perform compressions by hand? - Did they apply the AED as quickly as possible? - Did they place the autopulse on AFTER the steps above? - Did they switch to CONTINOUS after the patient is intubated? Scenario:

“Your patient is a 58-year-old collapsed on the ground. He was witnessed to collapse a few minutes ago.”

Make sure he is pulseless and apneic.