2019 EMT Refresher Instructor Manual

C.4.B – Trauma Scenario 2 Station: 3 Patient Assessment

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 how to assist a patient with ventilations using the bag-mask device for one and two rescuers. (p 354) Understand the importance and techniques of suctioning. (pp 343–345) Demonstrate the insertion of an oral airway. (pp 339–340, Skill Drill 9-3) Demonstrate the insertion of a nasal airway. (pp 341–342, Skill Drill 9-5) 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 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 for injury. (pp 291–295, Skill Drill 8-2) Demonstrate how to perform a full body scan for injury. (pp 291–295, Skill Drill 8-2) Demonstrate how to measure blood pressure by auscultation. (pp 296–300, Skill Drill 8-3) Perform the rapid extrication technique to move a patient from a vehicle. (pp 1301–1306, Skill Drill 35-6) 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)

Setup: -

Cohort Bag

- - -

Stretcher

Longboard with accessories

Suction

- Bring a Vest Extrication Device to this station to see if they (incorrectly) use it

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. You will need to place objects on the ground to be fingers. 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 application of the device after it is complete. Some points to discuss: - Did they stem the bleeding quickly? This bleeding was light and should not be prioritized over the patient’s airway needs and extrication.

- Did they suction the airway in the vehicle? This patient should have airway cleared before extrication.

- Did they immobilize the head and apply a collar before extrication? This patient should be removed rapidly once the ABC concerns have been addressed and a rapid scan performed - Ask them if they know what clinical syndrome the patient has. Discuss why Cushing’s Syndrome causes the patient to be hypertensive and bradycardic.

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