emt-basic curriculum module 4

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State of WisconsinEMT-Basic: A Practice BasedApproach to EMS Educationb) Embolism2. Hemorrhagic stroke3. Transient Ischemic Attack (TIA)-miniature stroke, usuallyoccurring days prior to a thrombotic strokeB. Emergency medical care for stroke1. Perform initial assessmenta) Airway managementb) Breathing – supplemental oxygen versus assistedventilationsc) Assess responsiveness carefullyd) Cincinnati Prehospital Stroke Scalee) High priority patientC. Perform focused history and physical exam1. OPQRST evaluated2. SAMPLE History3. Baseline Vitals and repeated vitals4. Obtain blood glucose readingD. Rapid transport1. AHA critical time frame to thrombolytic therapy-3 hoursV. The geriatric patient exhibiting signs and symptoms of neurologicalemergenciesA. Likely causes1. Stroke and Transient Ischemic Attack2. Delirium – sudden, rapid deterioration3. Dementia – gradual progression4. Head and spine traumaB. Assessment1. Determine level of consciousness – AVPU2. Assure airway, breathing and circulation are adequate3. Perform focused history and physical exama) Baseline vital signsb) S.A.M.P.L.E. historyc) History of the present illnessd) Limited physical exam4. More detailed assessment of mental statusa) Ask simple questions to determine if responses arelogical and appropriate5. Examine facial structures for symmetry6. Assess pupils7. Assess cranial nerve function for symmetrya) Close eyesb) Smilec) Protrude tongue8. Assess neurological function in the extremitiesC. Management1. Maintain ABCsModule 4-50
State of WisconsinEMT-Basic: A Practice BasedApproach to EMS Education2. Protect against further injury or complications3. Oxygen at 15 lpm by nonrebreather4. Treat specific injuries5. Communicate with medical control as needed6. Transport to the closest appropriate hospitalAPPLICATIONProcedural (How)1. Demonstrate the steps in emergency care for the patient with altered mentalstatus and a history of diabetes who is on diabetic medication.2. Demonstrate the steps in obtaining a blood glucose reading.3. Demonstrate the steps in the administration of oral glucose.4. Demonstrate the steps in the administration of glucagon.5. Demonstrate the assessment and documentation of patient response.Contextual (When, Where, Why)1. Diabetes is a common disease affecting a large population. As the populationages, the number of people affected by diabetes will increase.2. Oral glucose, and/or glucagon, given to a patient with an altered mentalstatus and a known history of diabetes can make a difference betweendevelopment of coma (unconsciousness) and ability to maintainconsciousness.3. Evaluating blood glucose levels provides valuable information about thepatient who has an altered level of consciousness.STUDENT ACTIVITIESNone identified for this lesson.Auditory (Hear)Visual (See)1. The student should see audio-visual aids or materials of patients with alteredmental status with a known history of diabetes mellitus in the prehospitalsetting.2. The student should see obtaining a blood glucose reading.3. The student should see the administration of oral glucose (as a simulatedpaste) to a simulated patient.4. The student should see the administration of glucagons (as a simulated liquidfor injection) to a simulated patient.Kinesthetic (Do)1. The student will practice the steps in emergency care for the patient with analtered mental status and a history of diabetes and taking diabetic medication.2. The student will practice the steps in obtaining a blood glucose reading.3. The student will practice the steps in the administration of oral glucose.Module 4-51
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emt-basic curriculum module 4

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