EMT Curriculum

4.12.B.2 Medical Lab II Station: Behavioral Instructor Guidance

Objectives:

1. Demonstrate how to use the AVPU scale to test for patient responsiveness. (p 262) 2. Demonstrate how to evaluate a patient’s orientation and document his or her status correctly. (pp 262–264) 3. 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) 4. Demonstrate how to assess a radial pulse in a responsive patient (pp 270–272) 5. Demonstrate history-taking using the SAMPLE mnemonic and the OPQRST mnemonic 6. Demonstrate how to measure blood pressure by auscultation. (pp 296–300, Skill Drill 8-3) 7. Demonstrate how to measure blood pressure by palpation. (p 300) 8. Demonstrate taking a heart rate on a patient 9. Demonstrate taking a breathing rate on a patient 10. Demonstrate how to obtain a pulse rate in a patient. (pp 270–272) 11. Demonstrate how to assess capillary refill in an adult or child older than 6 years. (pp 273–274) 12. Demonstrate how to perform a focused assessment of a patient 13. Demonstrate the use of a pulse oximetry device to evaluate the effectiveness of oxygenation in the patient. (pp 289– 290) 14. Demonstrate the use of electronic devices to assist in determining the patient’s blood pressure in the field. (pp 290– 291) 15. Demonstrate how to measure blood pressure by auscultation. (pp 296–300, Skill Drill 8-3)

16. Demonstrate how to measure blood pressure by palpation. (p 300) 17. Demonstrate how to solicit a medical history from a patient (pp 278)

Setup:

Cohort Bag

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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 and pretend to be sad. 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:

- Once the identifies behavioral as the issue, did they try:

Verbal convincing

o

o Explaining the limitations of RMA when the patient confesses to self-harm

- If they opted to restrain the patient, they did not attempt getting through verbally hard enough.

Review guidelines for RMA

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o Mentally capable (suicidal ideation makes this person not capable)

18 or older

o

o Informed of risks and consequences of refusal

This is a nebulous area for EMTs. Be sure to review this.