EMT Lesson Plans

8.10 EMS Operations Station: Nerve Agent Antidote Kit (PEER ADMINISTRATION ONLY) Objectives: 1. Demonstrate the steps an EMT can take to establish and reassess scene safety based on a scenario of a terrorist event. (pp 1430–1432)

2. Demonstrate the steps an EMT can take for the management of a patient exposed to a chemical agent. (pp 1432–1438)

3. Demonstrate the use of the Mark 1 Nerve Agent Antidote Kit (NAAK) and/or the DuoDote Auto-Injector on a peer. (pp 1436–1437)

Set up: Have a Cohort Bag, Suction Unit and a full body manikin at the station. You will also need an old-style EPI-PEN trainer (round) to be the NAAK. Give them one patient at a time and have them actually assess and treat him. Read to Students: “You are standing by outside the mall where a reported terrorist act has taken place involving an explosion. Some rescuers have been struck ill by a secondary Sarin release. The treatment supervisor has instructed you to provide them with stabilizing care, and turf them to the Transport teams for transport. Since there is a rumor that Sarin was disseminated in the building, all patients are getting gross decontamination before they reach you. They will be wet and cold from that process. You only have three Nerve Agent Antidote Kits in your supplies, so you will have to use them wisely. Please tell me how you will care for these patients:” Patient One: Primary Assessment Physical Exam Vitals Desired Treat Mental Status: Alert Airway: Patent Breathing: Labored @ 22 Circulation: Warm, dry, no bleeding A few scrapes and scratches Breath Sounds Wheezy HR:108 RR: 22 BP: 122/74 SPO2: 92 NRB Oxygen

Patient Two: Primary Assessment

Physical Exam

Vitals

Desired Treat

Mental Status: Pain Stim Only Airway: Secretions Breathing: Labored @ 38 Circulation: Pale, Dry, no bleeding

Pinpoint pupils, drooling, tearing HR:132 RR: 38

Suction OPA/NPA BVM NAAK

BP: 96/70 SPO2: 93

Patient Three: Primary Assessment

Physical Exam Seizing Pinpoint pupils

Vitals

Desired Treat

Mental Status: unresponsive seizing Airway: Patent Breathing: Labored @ 14 Circulation: Pale, dry, no bleeding

HR:112 RR: 14 BP: 122/74 SPO2: 88

Nasal Airway NRB Oxygen NAAK

Patient Four: Primary Assessment

Physical Exam

Vitals HR:136 RR: 42

Desired Treat

Mental Status: Unresponsive Airway: Patent Breathing: Shallow at 42 Circulation: Pale sweaty, weak radial pulse, bleeding severely from R arm

Right Arm blown off at elbow Various scrapes and lacerations

OPA/NPA BVM Torniquette Shock management

BP: 94/70 SPO2: 90

Patient Five: Primary Assessment

Physical Exam

Vitals HR:104 RR: 18

Desired Treat

Mental Status: Eyes open but not responding Airway: Patent Breathing: 16, good chest rise Circulation: Pale, dry, no bleeding

Pinpoint pupils Incontinent of urine Incontinent of feces Vomits during assessment

Suction Nasal Airway NRB Oxygen NAAK

BP: 98/70 SPO2: 94

Patient Six: Primary Assessment

Physical Exam

Vitals

Desired Treat Bleeding control

Mental Status: Alert Airway: Patent Breathing: 16, good chest rise Circulation: Pale, dry, no bleeding

Laceration to forehead Complains of severe headache

HR:88 RR: 14 BP: 110/70 SPO2: 96

PLEASE INSURE STUDENTS UNDERSTAND THIS SKILL IS IDENTIFIED AS A PEER ADMINISTRATION SKILL ONLY IN THE EMT INSTRUCTIONAL GUIDELINES, AND MEANT FOR RESCUE OF ANOTHER RESPONDER AND NOT FOR THE GENERAL PUBLIC.