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Michigan Tech EMS Back to the Basics Training
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Transcript

  • 1. Back to Basics Blood Pressure, Pulse Oximetry, Blood sugar, Oxygen administration, GCS scoring, CPR, AED
  • 2. Patient Dispatch tells you a 79 y/o male has collapsed in at the SDC after a basketball game. They say he is breathing and is confused. He is pale, cool and sweaty on your arrival. He is sitting in a chair.
  • 3. On Scene Scene safety BSI Introduce yourself and team members AVPU
  • 4. On Scene Airway - He is able to talk so he has a patent airway Breathing - Respirations are 24 and labored Circulation - No obvious bleeding, skin is cool, pale, and moist
  • 5. On Scene Secure Airway do you need a device? NPA, OPA, King Airway • or will a manuever work? head-tilt-chin, jaw thrust • Patient: 02 Saturation is 93%, Pulse: 115bpm
  • 6. On Scene If advanced airway is needed AND you are an EMT...
  • 7. On Scene Find Pulse Manually Pulse Oximetry what is a good number to see? what are things to be aware of?
  • 8. On Scene O2 administration which device? non-rebreather nasal cannula • • what flow rate? Patient: 02 Saturation is 93%, Pulse: 115bpm
  • 9. On Scene Blood Pressure where do you put stethoscope? what if you can't hear? How do you determine systolic number? How do you determine diastolic number? Patient: 02 Saturation is 96%, Pulse: 105bpm Where are your gloves!
  • 10. On Scene Blood Sugar when should you check sugar? what are the steps to check sugar? Patient: 02 Saturation is 96%, Pulse: 105bpm, Blood Pressure is 100/60
  • 11. On Scene GCS Scoring what are you looking for? how would you rate this patient? Patient: 02 Saturation is 96%,Pulse: 105bpm, Blood Pressure is 100/60, Blood sugar 78
  • 12. On Scene • • • • • • Pupils - PEARL / PERRL Lung sounds - clear and present bilaterally Heart tones - something doesn't sound right Capillary Refill - 3 or 4 sec SAMPLE OPQRST Patient: 02 Saturation is 96%,Pulse: 105bpm, Blood Pressure is 100/60, Blood sugar 78
  • 13. On Scene Radio Relay-Patient Condition Update Who and how do you call to give update? What information do you give? What do you do if radio reception is bad? How do you express transport priority? • • • • Practice-use VMEDTAC channel Patient: 02 Saturation is 96%,Pulse: 105bpm, Blood Pressure is 100/60, Blood sugar 78
  • 14. Patient Conditions Your patient all of a sudden becomes unresponsive. where do you check for pulse what are immediate next steps Patient: 02 Saturation is 96%, Pulse is n/a, Blood Pressure is n/a, Blood sugar 78, GCS 14 now is 3
  • 15. On Scene CPR what rate? what depth? Patient: 02 Saturation is n/a, Blood Pressure is n/a, Blood sugar n/a, GCS 14 now is 3, no pulse, no respirations
  • 16. On Scene http://statter911.com/2013/09/18/must-seeems-video-bystander-captures-rochester-nycardiac-arrest-save/ http://www.youtube.com/watch?v=t6nbcmeh_l0
  • 17. On Scene AED where / how to apply patches? how to use?
  • 18. Radio Mercy • • • • • 79 y/o male CPR in progress Any shocks delivered Location and entrance Signs/Symptoms leading up to arrest
  • 19. Next steps Mercy Ambulance - MEDIC SKILLS Cardiac Monitor Asystole or VF IV or IO (bone drill) access Medication push Intubation Capnography Transport or Terminate Code YOU: Possibly ride with and assist Mercy