emt-basic curriculum module 4

State of WisconsinEMT-Basic: A Practice BasedApproach to EMS EducationE. Restlessness, anxiety or irritabilityF. Feeling of impending doomG. Abnormal pulse rate (may be irregular or rapid)H. Abnormal blood pressureI. Cool, clammy skinJ. Pale or cyanoticK. Epigastric painL. Nausea and vomitingM. InsomniaN. Atypical presentations occur among certain patients (e.g. females)V. Emergency Medical Care - Initial Patient Assessment ReviewA. Circulation - pulse absent1. Medical patient > one year old - CPR with AED and transport2. Medical patient < one year old - CPR and transport, AED iscontraindicatedB. Responsive patient with a known history - cardiac1. Perform initial assessment2. Perform focused history and physical exam3. Place patient in position of comfort4. Cardiaca) Complains of chest pain or discomfort(1) Apply oxygen if not already done(2) Assess baseline vital signsb) Important questions to ask(1) SAMPLE history(2) O-P-Q-R-S-Tc) Has been prescribed nitroglycerin (NTG) and nitro is withthe patient(1) Blood pressure greater than 100 systolic(a) One dose, repeat in 3-5 minutes if no reliefand authorized by medical direction up to aVI.(b)maximum of three dosesReassess vital signs and chest pain aftereach dose(2) Blood pressure < 100 systolic - continue withfocused assessmentd) Does not have prescribed nitroglycerin (NTG) - continuewith focused assessmente) Transport promptlyRelationship to Basic Life SupportA. Not all chest pain patients become cardiac arrest patientsB. One Rescuer CPR - rarely done by EMT-Basics while on duty, may bedone while partner is preparing equipment, or en route to facilityC. Two Rescuer CPR - learning outcomes of a Professional Rescuer CPRCourse must be enhanced during an EMT-Basic course1. EMT-Basics must also learn:Module 4-31