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EMT Basic Scenario – Cardiovascular Emergencies
Typology: Exercises
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Dispatch: You are called to the construction site for a man with chest pain. You arrive to find a 64 - year- old man sitting on the tailgate of a truck complaining of severe pain in his chest. Takes, or verbalizes, body substance isolation precautions Scene is Safe Determines the mechanism of injury/nature of illness Chest Pains Determines the number of patients 1 Requests additional help if necessary Yes Considers stabilization of spine None Verbalizes general impression of the patient 64 - year-old man in a chair holding his chest. Complains of Chest pain, nausea Determines responsiveness/level of consciousness Responsive Determines chief complaint/apparent life threats Chest Pain Assesses airway and breathing Indicates appropriate oxygen therapy Assures adequate ventilation Airway is Open 16 breaths/min Symmetrical rise and fall of the chest (Oxygen via NRB mask at 15 L/min) Assesses circulation Assesses/controls major bleeding Assesses pulse Assesses skin (color, temperature, and condition) Bleeding – none Pulse—Tachycardia and Thready Pale, Cool, and Moist Identifies priority patients/makes transport decisions High Priority OPQRST O—Shoveling dirt P—Rest makes it better Q—Crushing R—None S—Rated 3 on a scale of 1–10 with 10 being the worst T— 10 minutes SAMPLE history A—None M—Nitro (Patient states they took 2 nitros prior to EMS arrival – 10 mins) P—Angina, heart attack a year ago L— Eggs, bacon, toast, and coffee 2 hours ago E— Shoveling dirt
Performs Secondary Assessment (assesses affected body part/system) Palpate chest – no crepitus or flail segment found Listen to breathing – Clear Lung sounds in all fields Vitals (obtains baseline vital signs) Blood pressure— 13 8/82 mm Hg Pulse— 94 beats/min Respirations— 16 breaths/min SaO2— 99 % on room air Field Impression (Student should provide appropriate Field Impression from info above) – Patient having a cardiac event with respiratory distress Interventions (obtains medical direction or verbalizes standing order for medication interventions and verbalizes proper additional intervention/treatment) Loosen restrictive clothing and maintain body temperature. Administer 3rd Nitro and baby aspirin (per Med Control Orders) Oxygen via NRB mask at 15 L/min Demonstrate how and when to reassess patient Patient should be reassessed every 5 mins Blood pressure— 1 30/ 78 mm Hg Pulse— 86 beats/min Respirations— 16 breaths/min SaO2— 99 % on room air Patient remain high priority Hand off Report (Student should provide appropriate hand off report from info above)