EMT Lesson Plans

3.12

Situation: 72-year-old dispatched as short of breath

Unstable Medical II

Scene Size-up:

Safety:

Scene is safe

BSI:

Gloves

Patients: 1 Mechanism/Nature: NOI – Shortness of breath Resources: ALS

Primary Assessment:

General Impression: Person lying in bed, great breathing distress Mental Status: Very confused – cannot speak Airway: Pink foamy sputum coming up Breathing: 42 per minute, shallow, pink sputum Circulation:

Rapid pulse at wrist, pale/sweaty, no severe bleeding

Desired Response: Primary then focused secondary

Physical Exam:

Head:

Pink Sputum coughing up

Neck:

JVD

Chest :

Unremarkable Upright:Breath sounds crackles ½ way up Supine:Breath sounds crackles all over

Vitals: 1

2

3

Pulse: 118

120

118

Abdomen:

Unremarkable

BP:

108/78

110/74

108/76

Pelvis:

Unremarkable

Resp:

42

44

48

Extremities:

Feet are swollen

SPO2: 72 Bagged: 92

68 92

66 94

Posterior :

Unremarkable

OPQRST: O:

SAMPLE: (bystander provided) S: He can’t breathe! A: None M: Lasix, Potassium P: CHF L: Soup 1 hour ago E: Was reading the paper

This hasn’t happened in some time

P: Q: R:

N/A N/A N/A

S: T:

I don’t know – I’ve never seen him this bad

25 minutes

OTHER: If they sit this patient up, the breathing does not get better. Paint a picture so they will bag this patient.