2019 EMT Refresher Instructor Manual

Situation: 72-years-old dispatched as unconscious

A.5.2

Opiate II

Scene Size-up: Safety:

Scene is safe

BSI:

Gloves

Patients: 1 Mechanism/Nature: NOI – unconscious Resources: ALS

Primary Assessment: General Impression: Person lying quietly in nursing home bed Mental Status: Responsive to pain only Airway: Snoring Breathing: 2 shallow breaths per minute Circulation:

Palpable pulse at wrist, pale cyanotic no severe bleeding

Desired Response: Primary then focused secondary

Physical Exam: Head:

Pupils pinpoint

Neck:

Unremarkable

Chest :

Unremarkable Breath sounds clear

Vitals: 1 Pulse: 58

2

3

Abdomen:

Unremarkable

58

58

Pelvis:

Unremarkable

BP:

114/80

126/88

124/78

Resp:

4

22

22

Extremities:

Unremarkable

SPO2: 82

93

94

Posterior :

Unremarkable

BEFORE NALOXONE

AFTER NALOXONE

SAMPLE: (staff provided) S:

OPQRST: O:

I can’t believe that happened

None None None None None

A:

None

P: Q: R:

M:

Fentanyl patch, aricept

P: L: E:

Chronic back pain, alzheimers Pureed Hot Dog, 2 hours ago In hallway with other residents

S: T:

Not sure – I just came on shift

OTHER: This patient has a dozen Fentanyl patches under his clothing

OTHER: This patient will begin breathing with NALOXONE and then wake up but not be able to sit due to being too weak