Daily Archives: November 12, 2020

How could you confirm clinically that the ventilator’s operation is actually resulting in adequate ventilations for the patient?

1.After managing the situation described, you continue your assessment. You find that the pupils are midsize and responsive, the airway remains patent, peripheral pulses are present, capillary refill is ,2 seconds, the skin is warm and slightly diaphoretic, the blood pressure is 138/86, the heart rate is now 88 beats per minute, and the pulse oximeter reads 96 percent. After placing the patient back on the ventilator, the ventilator resumes functioning without any alarms sounding.

1) How could you confirm clinically that the ventilator’s operation is actually resulting in adequate ventilations for the patient?

2) What conditions are you still considering as the possible cause? Would you consider any other conditions as a possible cause?

3) Explain why this patient is at a greater risk for:

a. Respiratory….

Discuss what types of problems you may encounter in moving the patient.

1.You are called by the family for an obese patient who underwent adjustable-banded gastroplasty surgery two weeks earlier. On your arrival, you estimate the patient’s weight to be about 210 kg. The patient is complaining of severe nausea with vomiting for the past few days. On closer assessment, the patient presents with a fever, is tachycardic, and says he is very “uncomfortable.” You call for backup to help move the patient, but they are still 20 minutes away from your location.

(a) Discuss what types of problems you may encounter in moving the patient.

(b) What type of preparation, considering both equipment to use and skills to employ, should the AEMT incorporate into the assessment, management, and movement of the patient?

(c) For the circumstances listed below, discuss….

What would be at least two critical interventions the AEMT should take now, before continuing on with the assessment of the patient?

1.You are called to the home of a 30-year-old male patient who is complaining of respiratory distress. On arrival to the home, you are escorted into the living room, where you see an obese patient lying on a hospital bed. Your primary survey reveals that the patient is in acute respiratory distress, with shallow breathing. The patient has an altered mental status, the pulse is tachycardic, peripheral perfusion is poor, and your partner reports no alveolar breath sounds on auscultation. The pulse oximeter displays a reading of 82 percent on room air.

a. Based on this brief history and presentation, would this patient be classified as a high or low priority? Support your answer with facts taken from the scenario.

b. What would be at least two critical….

What could be done to help your partner better ventilate the patient?

1.After initiating care, you gather the SAMPLE history from the family and learn that the patient was released from the hospital five days earlier after bariatric surgery. The patient is also an insulindependent diabetic with a history of hypertension. He has been taking his insulin, but because of a recent history of nausea with vomiting, he has been unable to keep his oral antihypertensive or any food down. Ongoing ventilatory assistance only produces breath sounds in the upper and middle lobes with minimal sounds to the lower lobes. Your partner reports that it is hard to keep a good seal with the BVM during ventilations.

a. What could be done to help your partner better ventilate the patient?

b. Is this patient a candidate for CPAP therapy by….

What additional techniques could be employed to make the PPV more effective?

1.The secondary assessment reveals that one of the patient’s drain appears infected. In addition, the pulse oximetry has only improved slightly with PPV and oxygen. The vitals are currently blood pressure 102/80, pulse rate 110, and pulse oximetry is 92 percent with oxygen and PPV. Blood sugar is 42 mg/dL. The patient’s temperature is 101.7°F. The patient is morbidly obese, weighing 180 kg. The findings during the balance of the secondary exam were benign and noncontributory. 6. What intravenous solution should be initiated?

a. Should this patient receive D 50 or oral glucose? Why or why not?

b. What additional techniques could be employed to make the PPV more effective?

c. What would be key indicators of patient improvement with treatment?

d. What would be key indicators of….

Differentiate between primary and secondary triage.

1.Differentiate between primary and secondary triage.

2.You and your partner are the first on the scene of a motor vehicle collision. Dispatch has advised you that, because of another major incident, you are the only unit available. Dispatch advises that backup will not be able to arrive on the scene for approximately 10 minutes. As you approach the scene, you note that three vehicles are involved, one of which is a motorcycle that appears to be missing a driver.

a. What concerns do you have as you approach the scene?

b. What information do you need to obtain?

As the most experienced AEMT on scene, what should you do now?

1.After you determine that the scene is safe, you approach the vehicles. You are met by a patient who approaches you and states that he and his wife were inside vehicle 1. Their vehicle is an SUV with minor front-end damage. The driver, a 25-year-old man, states that they were on their way to the hospital because his wife is in labor when a man on a motorcycle passed them and hit the car ahead of them. The woman, who is 27 years old and obviously pregnant, states she is having contractions that are 10 minutes apart. She states says her abdomen is hurting, but she has never been in labor before. Her husband denies any pain or complaints. Both patients are alert and oriented, deny any loss….

What priority status would be assigned to each patient? Why?

1.After reassuring the patients in vehicle 1, you proceed to vehicle 2, as your partner begins to look in the nearby ditch for the driver of the motorcycle. Vehicle 2 is a minivan with extensive damage to the front passenger side. The driver of the vehicle is a 60-year-old woman who is alert and oriented. She is complaining of neck pain. She denies any loss of consciousness and says she was the only passenger in her vehicle. Your partner states that he found the motorcycle driver, who was ejected into the ditch. The patient appears to be a teenage boy who is currently unresponsive, has a weak radial pulse, and has multiple abrasions and deformities to his upper and lower extremities.

a. Based on the scene size-up characteristics, what resources do….

What are the six “patient rights” that should be applied to this episode of drug administration?

1.You are called to back up another ALS unit for a patient who is unresponsive from a narcotic drug overdose. The patient is currently receiving PPV with an oropharyngeal airway placed, and the paramedic on scene is initiating an IV line of normal saline. While he is doing so, he asks you to prepare a 2-mg dose of naloxone (Narcan). The medication is packaged in a vial.

a. List the equipment needed to perform this medication setup.

b. What are the six “patient rights” that should be applied to this episode of drug administration?

c. If the vial of naloxone contains 2 mg of drug in 5 mL of solution, what is the exact concentration of medication, and how many milliliters will you withdraw to achieve the ordered….

What would be at least two critical interventions the AEMT should take now, before continuing on with the assessment of the patient?

1.You are called to the scene of an elderly patient in cardiac arrest. The patient was found in bed by family members after he didn’t wake up for breakfast. On your arrival, the family had already taken the patient from the bed and started compressions for CPR on the floor, according to EMD directions given to them from the EMS dispatcher. While you move to the patient’s head to start ventilations with a BVM, your partner attaches the monitor to see the presenting rhythm, which is ventricular fibrillation.

a. Based on this brief history and presentation, would this patient be classified as a high or low priority? Support your answer with facts taken from the scenario.

b. What would be at least two critical interventions the AEMT should….