emt-basic curriculum module 4

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State of WisconsinEMT-Basic: A Practice BasedApproach to EMS Education4-2.18 Demonstrate the emergency medical care for a patient in respiratorydistress. (P-2)4-2.19 Perform the steps in assisting a patient with the use of their metereddose inhaler. (P-2)4-2.20 Perform the steps in administering a nebulizer treatment, via hand-heldand mask, to a patient in respiratory distress. (P-2)4-2.21 Create a management plan to properly evaluate and treat an adultpatient in respiratory distress. (P-3)4-2.22 Create a management plan to properly evaluate and treat a pediatricpatient in respiratory distress. (P-3)PREPARATIONMotivation:Over 200,000 persons die from respiratory emergencieseach year.One large city reported 12% of their ambulance runswere respiratory emergencies. This represented threetimes the calls for heart attacks.A child with severe respiratory distress will deteriorateinto respiratory failure and circulatory collapse, eventuallyresulting in respiratory arrest. The use of oxygen canblock this progression and may even reverse it to somedegree. When possible, deliver humidified oxygen andallow the child to remain in the parent's lap. A morecomfortable, secure child will require less oxygen. Havethe parent accompany the child in the ambulance. Thereis no contraindication to high concentration oxygen in theinfant or child patient.Prerequisites:AV Equipment:EMS Equipment:BLS, Preparatory, Airway and Patient Assessment.MATERIALSUtilize various audio-visual materials relating torespiratory emergencies. The continuous design anddevelopment of new audio-visual materials relating toEMS requires careful review to determine which bestmeet the needs of the program. Materials should beedited to assure meeting the objectives of the <strong>curriculum</strong>.Metered-dose and hand-held nebulizers suitable fortraining purposes and various spacer devices.Module 4-10
State of WisconsinPrimary Instructor:Assistant Instructor:EMT-Basic: A Practice BasedApproach to EMS EducationPERSONNELOne Advanced-Level Provider or EMT-Basic instructorwho is knowledgeable in respiratory diseases andhandheld inhalers.The instructor-to-student ratio should be 1:6 forpsychomotor skill practice. Individuals used as assistantinstructors should be knowledgeable in respiratoryemergencies.PRESENTATIONDeclarative (What)I. AnatomyA. Respiratory1. Nasal cavity (humidify, filter and warm) and oral cavity (airpassage)2. Pharynx - air passagea) Nasopharynxb) Oroopharynx3. Epiglottis - a leaf-shaped structure that prevents food and liquidfrom entering the trachea during swallowing4. Trachea – air passage5. Larynxa) Thyroid cartilage – cartilage forming the upper portion ofthe larynx, providing protection for vocal cordsb) Cricoid cartilage - cartilage ring forming the lower portionof the larynx6. Bronchi, right and left main stem - two major branches of thetrachea, passing air into the lungs7. Bronchioles - subdivisions of the bronchi, responsible forcontinued air passage8. Alveoli – single celled structures within the lung where gasexchange occurs9. Diaphragm and intercostals musclesa) Inhalation (active phase)(1) Diaphragm and intercostal muscles contract,increasing the size of the thoracic cavity(a) Diaphragm moves slightly downward, flareslower portion of rib cage(b) Ribs move upward/outward(2) Air flows into the lungsb) Exhalation (relaxation phase)(1) Diaphragm and intercostal muscles relax,decreasing the size of the thoracic cavityModule 4-11
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