emt-basic curriculum module 4

State of WisconsinEMT-Basic: A Practice BasedApproach to EMS Educationb) Semi-automated - defibrillator uses a computer voicesynthesizer to advise EMT-Basic as to the steps to takebased upon its analysis of the patient's cardiac rhythm2. Analysis of cardiac rhythmsa) Attach defibrillator to only unresponsive, pulseless, nonbreathingpatients to avoid delivering inappropriateshocksb) Patients in cardiac arrest may present with agonalrespirations – do not delay defibrillationc) Defibrillator computer microprocessor evaluates thepatient's rhythm and confirms the presence of a rhythmfor which a shock is indicatedd) Accuracy of devices in rhythm analysis has been highboth in detecting rhythms needing shocks and rhythmsthat do not need shockse) Analysis is dependent on properly charged defibrillatorbatteries3. Inappropriate delivery of shocksa) Human errorb) Mechanical error4. Pulseless ventricular tachycardiaa) Pulselessness must be determined before attaching AEDto avoid shocking inappropriatelyb) Attach defibrillator to only unresponsive, pulseless, nonbreathingpatients to avoid delivering inappropriateshocksc) Defibrillator advises shocks for ventricular tachycardiawhen the rate exceeds a certain value, for example,above 180 beats per minute5. Interruption of CPRa) No CPR performed at times shocks are deliveredb) No person should be touching patient when rhythm isbeing analyzed and when shocks are deliveredD. Advantages of automated external defibrillation1. Initial training and continuing educationa) Easier to learn than CPR, however, must memorizetreatment sequenceb) EMS delivery system should have:(1) Necessary links in chain of survival(2) Medical direction(3) EMS system with audit and/or quality improvementprogram in place(4) Mandatory continuing education with skillcompetency review for EMS providersc) Continuing competency skill review consistent with Stateand local requirementsModule 4-33