April 2009 Site Code #107200E-1209 The Patient with Dyspnea
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1 April 2009 Site Code #107200E-1209 The Patient with Dyspnea Prepared by: Bill Hoover, Medical Officer, Wauconda Fire Department Review/revisions by: Sharon Hopkins, RN, BSN, EMT-P To view on the website visit:
2 Date of CE presentation: April 2009 Topic: The Patient with Dyspnea Behavioral Objectives: Upon successful completion of this module, the EMS provider will be able to: 1. Identify the anatomy and physiology of the respiratory system 2. Identify clues which will assist in determining the severity of a patient s respiratory distress. 3. Identify the assessment of patients with dyspnea 4. Identify history and physical exam of patients with dyspnea 5. Identify abnormal respiratory patterns and adventitious breath sounds 6. Identify the main causes of dyspnea 7. Identify signs and symptoms of the main causes of dyspnea 8. Identify treatment options for the main causes of dyspnea 9. Identify hazards of different treatments and procedures associated with dyspnea 10. Identify the following medications and their uses for patients with dyspnea Albuterol, Epinephrine 1:1000, Benadryl, Benzocaine, Lasix, Versed 11. Given a simulated patient and the appropriate equipment, the student shall demonstrate endotracheal intubation on adult patients. 12. Given a simulated patient and the appropriate equipment, the student shall demonstrate endotracheal intubation on pediatric patients. 13. Given a simulated patient and the appropriate equipment, student shall demonstrate proper use of the Combitube or King Airway (if used by the agency) 14. Given a simulated patient and the appropriate equipment, student shall demonstrate assembly of in-line albuterol. 15. Given a simulated patient and the appropriate equipment, student shall review the CPAP device. References: Bledsoe, B. Porter, R., Cherry, R. Paramedic Care: Principles and Practices. Brady Camplbell, J. BTLS Basic Trauma Life Support. 5 th Edition. Brady Condell Medical Center EMS System Standard Operating Procedures, March 2007 Amended version May 1, 2008 a. Conscious Sedation (Page 7) b. Acute Pulmonary Edema (Page 19) c. Airway Obstruction (Page 22) d. Adult Allergic reaction/anaphylactic Shock (Page 23)
3 e. Asthma/COPD (Page 25) f. Pediatric Respiratory Failure (Page 53) g. Pediatric Acute Asthma (Page 55) h. Pediatric Airway Obstruction (Page 56) i. Croup/Epiglottitis (Page 64) j. Pediatric Allergic Reaction/Anaphylaxis (Page 70) Dalton, Limmer, Mistovich, Werman. Advance Medical Life Support, 3 rd Edition, Brady Expected Pre-knowledge: The student shall be expected to know the following topics prior to CE. It is the individual student and their agencies responsibility to determine that the level of knowledge is acquired. 1. EMT-B airway skills: a. Nasal Cannula b. Non-Rebreather Mask c. Bag Valve Mask d. Oropharyngeal Airway e. Nasopharyngeal Airway f. CPAP 2. Use of optional system approved equipment that may be carried by their agency: a. Combitube b. Auto-ventilators c. Continuous Capnography
4 Pre-Quiz Basic & Paramedic Level From April 2009 CE Material The Patient with Dyspnea Name Date 1. List one anatomical difference between the pediatric versus the adult airway. 2. List at least 3 signs or symptoms of respiratory failure adult or child. 3. Describe crackles: - What do they sound like? - In what medical condition would crackles be heard? - What treatment would be indicated for the condition listed above if the patient presented with crackles? 4. Describe wheezes: - What do they sound like? - In what medical condition would wheezes be heard? - What treatment would be indicated for the condition listed above if the patient presented with wheezing?
5 5. Can you list at least 3 signs or symptoms of anaphylaxis? Pre-quiz April 2009 Dyspnea B & P levels 6. List all the signs or symptoms you can think of for pulmonary edema. 7. What is the field treatment for pulmonary edema within your licensure limitations? 8. What are the steps to take to clear a foreign body from: - The conscious adult patient - Any unconscious patient regardless of age 9. What is the field treatment for an acute asthma attack? 10. What steps are taken to confirm endotracheal (ET) tube placement? File: CE, EMS; CE Packets; Quizzes; 2009; Prequiz April 2009 Dyspnea
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