2019 EMT Refresher Instructor Manual

Ventilator

Situation: 4-month-old – lying in bed at home

B.1.A

Scene Size-up: Safety:

Safe

BSI:

Gloves

Trach with ventilator

Patients: 1 Mechanism/Nature: NOI Resources: ALS

Primary Assessment: General Impression: Infant in bed Mental Status:

Alert – looks restless

Airway:

Mouth is patent

Breathing: Circulation:

30 per minute ventilated by machine

Rapid pulse at wrist, pale and dry, no bleeding

Desired Response: Primary, vitals, focused secondary exam.

Full Body Scan: Head:

Unremarkable

Neck:

Tracheostomy

Chest :

Unremarkable

Abdomen:

Unremarkable

Pelvis:

Unremarkable

Extremities:

Unremarkable

Posterior :

Unremarkable

SAMPLE (by family) S: She very weak A: None M:

Vitals: 1

2

OPQRST: O:

N/A N/A N/A N/A N/A N/A

Pulse: 122

124

P: Q: R:

Pulmozyme, albuterol

BP:

88/60

82/62

P: L: E:

Cystic fibrosis Soup 1 hour ago

Resp:

30 (vent)

30 (vent)

S: T:

Power went out 2 hours ago and ventilator is

SPO2: 94

93

on critically low power

OTHER: If taken off the vent, the patient will breathe 30 bpm but with no chest rise and be panicked. The vent will run out of power in 3 minutes. If they bag him, they will note heavy mucous around the trach (at the surface) that will require suctioning. ALS is 15 minutes out.