EMT Lesson Plans

Shocky Responsive 4 Patient is a 30-year old with nausea/vomiting Takes appropriate BSI Gloves Scene Size-Up Determines safety Yes MOI / NOI NOI - sick Number of patients 1 Requests additional help Maybe Stabilization of the spine No Primary Survey/Resuscitation General impression Young man kneeling in front of toilet Responsiveness/LOC Alert Determines chief complaint Sick to stomach - vomited Assess airway and breathing Patent, breathing 22 per minute with some distress Assess circulation

Shocky Responsive 3 Patient is a 17-year old hit by car

Shocky Responsive 1 Patient is a 19-year-old though through the abdomen Takes appropriate BSI Gloves Scene Size-Up Determines safety Cops made it safe MOI / NOI MOI – shot in belly Number of patients 1 Requests additional help ALS Stabilization of the spine No Primary Survey/Resuscitation General impression Young man on ground moaning Responsiveness/LOC Alert Determines chief complaint “They shot me!” Assess airway and breathing Patent, breathing 22

Shocky Responsive 2 Patient is a 83-year old in a nursing home bed – staff stated labs were abnormal

Takes appropriate BSI Gloves Scene Size-Up Determines safety Yes MOI / NOI

Takes appropriate BSI Gloves Scene Size-Up Determines safety Yes MOI / NOI NOI sick Number of patients 1 Requests additional help ALS Stabilization of the spine No Primary Survey/Resuscitation General impression

MOI – Car vs. Ped

Number of patients Requests additional help Stabilization of the spine

1

ALS

Yes

Primary Survey/Resuscitation General impression

Young man appears in great pain

Older person appears ill

Responsiveness/LOC Determines chief complaint Assess airway and breathing

Alert

Pain in pelvis

Responsiveness/LOC Determines chief complaint Assess airway and breathing

Alert but sluggish “Don’t feel good”

Patent, breathing 20 per minute with visible chest rise No bleeding, skin pale and sweaty, no pulse at wrist -pulse rapid at neck

per minute with visible chest rise

Patent, breathing 22 per minute with visible chest rise No bleeding, skin hot, pale and dry, pulse rapid at wrist

No bleeding, skin warm/dry, pulse rapid at wrist

Assess circulation

Assess circulation

Minor bleeding, skin pale sweaty, pulse rapid at wrist

Assess circulation

Identifies patient priority

High

Identifies patient priority

High

Vitals

SAMPLE

Identifies patient priority

High

Identifies patient priority

High

BP: 88/60

S – Constant vomiting A – tree nuts

Vitals

SAMPLE

Vitals

SAMPLE

Vitals

SAMPLE

BP: 108/70

S – My belly hurts bad

Pulse: 110

BP: 74/50

S – My hips hurt a lot

BP: 84/62 Pulse: 122

S – Don’t feel good

Respirations: 22

M – None P- None L – pot roast yesterday E – Had a cookie that might have had nuts in it

Pulse: 118

A – None

A – None

Pulse: 126

A – None

Respirations: 22

M – None P- None L – Bagel 1 hr ago E – Standing on sidewalk when car came and sprayed bullets

Respirations: 22

M – Lasix, Aricept P- CHF, dementia L – Meatloaf 2 hrs ago E – Watching TV

Respirations: 20

M – None P- None L – Grilled cheese 1 hour ago E – Hit by car while crossing the street

Critical Criteria Did not take safety or BSI precautions Fails to request ALS Did not fully assess airway Did not fully assess breathing Did not fully assess circulation, including pulse and skin

Critical Criteria Did not take safety or BSI precautions Fails to request ALS Did not fully assess airway Did not fully assess breathing Did not fully assess circulation, including pulse and skin

Critical Criteria Did not take safety or BSI precautions Fails to request ALS Did not fully assess airway Did not fully assess breathing Did not fully assess circulation, including pulse and skin

Critical Criteria Did not take safety or BSI precautions Fails to request ALS Did not fully assess airway Did not fully assess breathing Did not fully assess circulation, including pulse and skin

Debriefing Points:

Debriefing Points:

Debriefing Points:

Debriefing Points:

Is there a need for oxygen in this patient? The complaint is vague – what makes this patient high-priority? (BP, Heart Rate) What kinds of problems might be going on? (Sepsis)

What might be best way to deliver oxygen in this patient? (NC due to vomiting) What is wrong with him? (possible allergy) What makes this high-priority? (BP mostly)

Is there a need for oxygen in this patient? Where is most of this patient’s problem located? (pelvic Fx with hypovolemic shock)

Is there a need for oxygen in this patient? What is wrong with him? (internal bleed causing shock)