EMT Lesson Plans

6.14 Trauma Skills II Station: Penetrating Injury I 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. (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) 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 proper emergency medical care of a patient who has a penetrating abdominal injury with an impaled object. (pp 979–980) Setup: You will need your cohort bag. 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. 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 quickly provide supplemental oxygen by non-rebreather? - Did they identify the patient’s respiratory depreciation and use a BVM on the 3 rd reassessment? - Did they manipulate the patient a lot to get him transported? Moving the patient and causing bending at the abdomen might cause further injury - Ask them what the primary life threat was. Discuss hypovolemic shock’s role in this case. - Ask them what the long-term threats to this patient are. Discuss the risk of infection with peritoneal penetration. - Ask them if they know what the significance of blood at the urinary meatus is. Discuss injury to the bladder.