2019 EMT Refresher Instructor Manual

B.4.C - Stroke Station: CVA Instructor Guidance

Objectives:

Demonstrate how to use the AVPU scale to test for patient responsiveness. (p 262) Demonstrate how to evaluate a patient’s orientation and document his or her status correctly. (pp 262–264) Demonstrate the techniques for assessing a patient’s airway and correctly obtaining information related to respiratory rate, rhythm, quality/character of breathing, and depth of breathing. (pp 265–269) Demonstrate how to assess a radial pulse in a responsive patient and an unresponsive patient. (pp 270–272) Demonstrate how to obtain a pulse rate in a patient. (pp 270–272) Demonstrate how to assess capillary refill in an adult or child older than 6 years. (pp 273–274) Demonstrate how to perform a rapid scan of a patient. (pp 275–277, Skill Drill 8-1) Demonstrate how to perform a focused exam of a patient Demonstrate the use of a pulse oximetry device to evaluate the effectiveness of oxygenation in the patient. (pp 289– 290) Demonstrate the use of electronic devices to assist in determining the patient’s blood pressure in the field. (pp 290–291) Demonstrate how to measure blood pressure by auscultation. (pp 296–300, Skill Drill 8-3) Demonstrate how to measure blood pressure by palpation. (p 300) Demonstrate how to use a stroke assessment tool such as the Cincinnati Prehospital Stroke Scale to test a patient for aphasia, facial weakness, and motor weakness. (pp 581–582)

Equipment: -

Cohort Bag Stairchair

-

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

Deploy your students in one team – one student should be patient, the rest rescuers. The patient should sit in a chair and look confused. Have them transition through the scenario on the back of this sheet like any other scenario from a scenario lab day.

Debriefing: Give students feedback on the case after it is complete. Some points to discuss: - Did they do a full assessment including ABC’s?

Did they administer oxygen?

-

- Did they focus in on the complaint by doing a Cincinnati Stroke Scale?

- Did they obtain a solid time of onset? That’s possibly the most important intervention in this case. Explain the relationship between onset time and clot-dissolving therapy.