1) The person facilitating scenarios can print out the pages below. 2) Cut up the “role” pages, and assign several roles, distributing the “roles” to … PRIMARY ASSESSMENT. The albuterol treatment has had no effect, lungs sounds are actually worse, why? You arrive and find her breathing 3 times a minute, you find out from family members that she had taken some medicine recently. 911: You are called to the residence of a 68 year old female complaining of respiratory distress. 2) Cut up the “role” pages, and assign several roles, distributing the “roles” to … Call type: Dispatched to 1313 Mockingbird Lane for diabetic problems Time and weather: 0630 cool and sunny . Treatment is intended to decrease venous return to the heart, improving myocardial contractibility, decreasing myocardial oxygen demand, improving ventilation/respiration, and rapid safe transport to an appropriate facility. What you see upon arrival: You find the 68 y.o. Sample Scenario for the Recertification Practical Test 2011 EMS Online EMS Online in cooperation with King County EMS, Seattle Fire Department and Eastside Fire and Rescue 2011 CBT 302 Orthopedic Injuries # 3 . What intervention should be initiated soon in order to improve the hypoxic state of your patient? Given this situation, what would you expect the arterial carbon dioxide levels to be? This resource will walk your providers through a scenario containing vital signs, pertinent patient and call information, graphics, The emergency scenarios test section is designed to challenge the critical thinking skills of the EMT. Additionally, he was the Past Chair of the National Registry’s Research … The posted speed limit is marked at 40 MPH. ő%�����oBS6X�]����' ���#�����lS�����qV2&h�T`ľS�u���TSź�lj:p�D|�: F'���&$]mC�fz���8���7E�d�tC �~���z�S��}������J�Gki|7��q��
��d�M��sݮ�|�#❌�wK����&1̨-�� Gq�`�G��U��8(�7�~�k�P/��ro��WX��������Pˠ��Ŵ� Suddenly, your pager advises you differently, you spring from your bunk and answer your call. Number of patients: 1 . You administer an appropriate dose of narcan. You can here audible rales as you approach. Scenario: EMS is dispatched to a 2-car MVC with head on collision. %�쏢 Your initial assessment takes < 2 mins, at this point in the game it is apparent the patient is in severe respiratory distress. x��\Y��F�[+��ՙȒ��ʚYk����vn;~ � ��&�IA� ��H�����]����F�zPo�G�ꫯ�Ƿ�F�U�M��y{�����?�����\~\}�埇o��^|����o����7oW_��b�J;ո��\oT�wM��b+c�*4A�n����W�mN��������Q:���Z��~}is�qƚ��UV{g�%��Z�lN�jto���&����~}-��]����=�G��ƦQ4�&�-x�ݦU�vޮ�7b���͢�2���[��o/�4 *M5��蝰��"��ᷗ��%���.4>��w�bX���"��Z�i��)T}m�\M�(�ԝcTl�k�\��ɳD�[�>� These medical and mental health scenarios are for example purposes only, to illustrate the types of services EMA may cover. Manifold (1963-2020) was an invaluable member of the EMS community and was an especially cherished member of the National Registry family having served on our Board of Directors since 2014. - Patient has + 2 pitting edema noted to both feet with no distal pulses palped, - She has NKDA and takes Lasix and Lotensin daily (unsure of dose). You’re a basic EMT caring for an unresponsive diabetic. On assessment the following is noted: Airway: Patent On assessment the following is noted: Airway: Patent Evaluator’s notes: EMT should consider scene safety, standard precautions. Increasing the O2 has offered little relief and the patient is counting on your expertise to help her breathe better. It is a clear spring day with a temperature of 68°F. MHCP, through its medical review agent, will determine actual cases based on … The patient advises she has had breathing treatments before and you proceed. Yes, EMT candidates are given three attempts to pass the EMT exam. Sample Scenario for the Recertification Practical Test 2011 EMS Online EMS Online in cooperation with King County EMS, Seattle Fire Department and Eastside Fire and Rescue 2011 CBT 302 Orthopedic Injuries # 3 . Pupils are checked and you find them to be pinpoint. The emergency scenarios test section is designed to challenge the critical thinking skills of the EMT. With the findings and assessment, what do you feel is happening with your patient? • Lasix 40 mg IVP, 12. Are there other signs and symptoms you would look for, in order to proceed with a proper treatment modality? patient conscious and sitting on a couch in her living room appearing very anxious. Place the patient on cardiac monitor and record rhythm strips with vital signs, 5. Manifold (1963-2020) was an invaluable member of the EMS community and was an especially cherished member of the National Registry family having served on our Board of Directors since 2014. Albuterol is a sympathomimetic bronchodilator that is effective for causes of bronchoconstriction (i.e., Asthma, Bronchitis) but, has little or no effect on a patient suffering from Pulmonary edema/CHF. As an EMT, I had the opportunity to perfect the basics of collecting a patient history and performing a physical exam, a necessity for any type of physician. What concerns do you have for this patient at this point? Additionally, he was the Past Chair of the National Registry’s Research … Equipment: fully stocked except one backboard, one no-neck collar, one pair headblocks, one icepack. Your patients color and respiratory effort is obviously improving within 5-6 minutes and you continue treatment and assessment while transporting. Required BSI: Standard Precautions . Rather than looking for the answer in the multiple choices right away, try to think about what you would do in a given situation. nK�$v����
��`1�o��ε4? You administer 1 nebulized Albuterol treatment and the patient reports worsening dyspnea. Along with members from the EMSC EMS Committee and pediatric advocates throughout the state, the Kansas Pediatric Scenario Guidebook was developed. I live in KS and understand that we have some of the hardest written exams in … Continue to coach patient to keep mask in place and readjust as needed 13M. A MHCP, through its medical review agent, will determine actual cases based on … Call type: Dispatched to the city zoo for a patient complaining of chest pain Time and weather: 1400 hot and sunny . The scenarios in this document fall into one of four categories, and are organized as: • Fire scenarios • Law enforcement scenarios • EMS scenarios • Multi-discipline scenarios Within these categories, the scenarios are grouped by type of incident, for example, Wildland Urban Interface (WUI) fire, and listed alphabetically. The scenarios may be used with other curricula with little or no modification. All prior scenarios will be listed here in running chronological order. You must wait at least 15 days after each failed attempt before taking the exam another time. Dispatch. Check and document vital signs every 5 minutes. You should: a) Call ALS because you can’t give oral glucose to an unresponsive patient b) Give oral glucose gel anyway-he needs it c) Apply the glucose gel topically-it will absorb d) Give the glucose gel rectally Questions? Many providers report that the change in their patient's condition is so dramatic that they have to convince hospital staff of the original severity level! It wakes her from a sound sleep. In addition, the new curriculum parallels the recommendations of the National EMS Education and Practice Blueprint. Emergency Scenario Chest Pain This emergency scenario reviews chest pain in a primary care patient, and is set up for role-play and case review with your staff. At 1512 hours, you are dispatched to a residence for a non-emergent transport of a woman to her doctor’s office. The circuit is attached to the mask and the patient is encouraged to breathe as normally as possible. The EMT-Basic curriculum is a core curriculum of minimum required information, to be Scenario: EMS is dispatched to a 2-car MVC with head on collision. Family states she has had a high fever and trouble breathing for a couple of days. You are thirty (30) minutes away from the attending physician’s office and fifteen (15) minutes from the community hospital. He quickly leads you down a narrow dark hallway and up a set of stairs to the patients’ bedroom. After evaluating the patient, taking vitals and conducting an interview; it is apparent that your patient will need a better respiratory status, in order to safely move her out of a tight residence to an awaiting unit outside (3-4 minutes away if all goes well). paramedic partner in a suburban EMS system. He recently has had bypass surgery because of clogged arteries. Scenario: You are called to the home of a 78 Year Old Male who's wife called EMS saying her husband has been complaining of chest pain and shortness of breath. patient conscious and sitting on a couch in her living room appearing very anxious. Upon EMS arrival to the scene an unrestrained adult driver is found inside the vehicle with noted + steering wheel deformity. In order for CPAP to work, there must be a pressure-tight seal throughout the system. Rather than looking for the answer in the multiple choices right away, try to think about what you would do in a given situation. Respiratory distress patient - Her prognosis just became a lot better! Since Albuterol is ineffective, would you consider intubation and assisted ventilations? We encourage you to adhere to any mandated state requirements for administration and coordination of EMT psychomotor examinations. EMERGENCY PROTOCOL SCENARIOS American Association of Orthodontists Robert D. Elliott, DMD, MS www.pedospringboard.com At 1512 hours, you are dispatched to a residence for a non-emergent transport of a woman to her doctor’s office. EMS training scenarios are too often simply a reenactment of a really cool or interesting call the instructor was recently on, run from start to finish. As you enter the room, you see an elderly female sitting on the edge of her bed, leaning slightly forward with her hands on her knees, while struggling to breathe. stream Pupils are checked and you find them to be pinpoint. PATIENT ASSESSMENT/MANAGEMENT – MEDICAL. Monitor and document the patient’s respiratory response to treatment. Location: Alpha post. The patient is A & O X 3 but appears restless and agitated. - Patient is pale/cold clammy, diaphoretic; cyanosis is noted around lips and nailbeds. This EMT training video serves as a visual aid for how to pass the NREMT practical skill evaluation, Medical Patient Assessment and Management. She ap-pears to be gasping for air. Dispatch/Description of the problem: You are dispatched to 68 year old female SOB. 1. This resource will walk your providers through a scenario containing vital signs, pertinent patient and call information, graphics, Take the time to take a practice exam under testing conditions before test day. Your patient states the shortness of breath comes on at night but, is worse tonight. SU16C08 EMS1118NACB Emergency Medical Technician. If respiratory status deteriorates, remove device and consider intermittent positive pressure ventilation via BVM and/or placement of non-visualized airway or endotracheal intubation. Normal c. Lowered d. Elevated 2. These medical and mental health scenarios are for example purposes only, to illustrate the types of services EMA may cover. CBT 434 Cardiac Scenario 2 Evaluator’s notes: Patient 68 year old female SOB and consider ASA and MI, quick transport to ER. <> Contact medical control to advise them of CPAP initiation. Evaluator’s notes: EMT should consider scene safety, standard precautions. Knowing it would almost be impossible to bag her on the long stairway and hall, you make a decision. Vitals prior to CPAP: - HR: 154 bpm; EKG showing a sinus tachycardia with 2-4 multifocal PVC’s per minute, - SpO2: 92% on patients 2 lpm O2, GENERAL CPAP PROCEDURE (Always know and follow your local Pulmonary Edema/CHF Protocol), 2. a. You administer an appropriate dose of narcan. Would you decide to start interventions now, or do you need more information and/or assessment? Scenario: You are called to a local residence for a woman in respiratory distress. 5. �}}��!&��0���U}eLV�}O�TQ�� "���{@��=���՛�G9�SI�6g4�������$�W��k,M�����n����h�B��(�QD}�]�K
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{�4�KZ�. After increasing the patient’s own O2 to 6 lpm the SpO2 remains 90. This makes sense: as pressure increases inside the lungs, it also increases pressure on the heart chambers and great vessels, causing cardiac output to drop. Not enough information to determine b. On initial contact with the patient you quickly introduce yourself and partner while obtaining her consent for treatment. %PDF-1.4 NOI: Diabetic . Conditions: Warm and clear. It is a good idea to contact MCP/receiving facility to advise them of your ETA with a CPAP patient. If the patient is hypotensive to begin with — i.e. This will help you identify knowledge gaps and increase your confidence. 911: You are called to the residence of a 68 year old female complaining of respiratory distress. What other sign could you look for effortlessly as you approach the patient? As the patient is being assessed, he suddenly loses consciousness. The posted speed limit is marked at 40 MPH. The patient has very shallow, rapid respirations with minimal chest wall motion and slight wheezing in the upper lung fields. - HR: 100 bpm; EKG showing a sinus tachycardia PVC’s are subsiding. Dr. NOI: Patient was visiting … CPAP accomplishes this with a well-fitted mask that the patient wears over the mouth and nose. The curriculum, Emergency Medical Technician-Basic: National Standard Curriculum, is the cornerstone of EMS prehospital training. Mark the corresponding oval on the answer sheet. He recently has had bypass surgery because of clogged arteries. Time: 10:31 Wednesday. You arrive to find a 24-year-old woman lying in bed. Gen. Administer high flow O2 using a well-fitting NRB while setting up CPAP is appropriate. You are just getting settled into bed at the station, after a long day of running calls. CPAP should be continued until arrival at the ER. Ӏ$'A�j{��Oo�Sٗ���Z�zշ\�Jq�NOţحj�{�ު�F�H���b���IX+�h��_ޜ:Շ�q����ͩUN7MG�h�Vy�i�FH$-�r���XTKB͕A
�Y(i��S&4����id� x����j��A�G5�?��ÍWMm(�C�w��� Emergency Scenario Chest Pain This emergency scenario reviews chest pain in a primary care patient, and is set up for role-play and case review with your staff. - Respirations are 28 bpm labored; BBS are =, diminished in the lower lobes with audible coarse rhonci/rales on inspiration/expiration w SpO2 90 on her 2lpm O2 at home. Would you intubate this patient at this point? You’re parked under a shady tree, and Steve is snoozing … Follow Part V – C (CPAP) if you decide CPAP therapy is warranted. Practice exams are very helpful when preparing for the EMT exam. Your glucometer reads “LOW”. EMT Scenario: M004 DISPATCH . What you see upon arrival: You find the 68 y.o. Skip To Content the patient is experiencing cardiogenic shock with pulmonary edema — CPAP is not indicated. an EMT or other person authorized by a medical director to give medications and provide emergency car. 5 0 obj Sample questions Directions: Choose the best answer to each question. �w7:(�t���:?�cx�:��3��ͱ.����p��^Sa�����F���|�Z�+l�8jp����a�]_}8���u�P�PAc�/6�!��/Ɠd9�>L�R��ԅ�����=R{���%�CkP�t*:�}���[-���Zd�e���9 ��9K�Ԋ�'�q��V�c_6���i:v���$ What could you do to improve oxygenation immediately? Suddenly, your pager advises you differently, you spring from your bunk and answer your call. CBT 434 Cardiac Scenario 2 Evaluator’s notes: Patient 68 year old female SOB and consider ASA and MI, quick transport to ER. Scenario: You are called to the home of a 78 Year Old Male who's wife called EMS saying her husband has been complaining of chest pain and shortness of breath. Great assessment! administration of the Emergency Medical Technician psychomotor examination. Impression: Patient lying in bed SCENE SIZE-UP Scene safety: Yes . Would any of the findings prompt the initiation of a second Albuterol treatment? 911: You are called to the residence of a 68 year old female complaining of respiratory distress. After completing a thorough assessment you decide to initiate an Albuterol treatment hoping it will improve the patients’ respiratory distress. The main concern is that CPAP can, and will, lower blood pressure. Although it is apparent she in is in respiratory distress, would you ask her about her complaint? Dispatch/Description of the problem: You are dispatched to 68 year old female SOB. Since the Albuterol did not help, would you initiate a second nebulized treatment? Christina: Volunteering as an EMT for Tulane and New Orleans EMS was the most influential experience that I had prior to medical school. Along with members from the EMSC EMS Committee and pediatric advocates throughout the state, the Kansas Pediatric Scenario Guidebook was developed. Off-Line medical direction. Upon EMS arrival to the scene an unrestrained adult driver is found inside the vehicle with noted + steering wheel deformity. You perform a quick assessment and find: - Patient is conscious, but confused to time and events with a GCS-14, - The patient has a bounding radial pulse at 150 bpm. The medic should place the patient in a sitting position with legs dependent to increase lung volume and capacity while decreasing the work of breathing and venous return to the heart. Clinical scenario: A patient found unresponsive by the road You are dispatched to a report of a male found down on the sidewalk in a suburban neighborhood Squad 24, ALS Medic 3, respond Priority 1. Place the delivery device over the mouth and nose, 6. [5/13/13] 21 Chapman St — unknown [4/22/13] 720 Mass Ave — MVA [4/8/13] 322 Stowecroft — unknown medical [4/1/13]… State EMS officials may choose to alter the format and design of these materials in order to meet local requirements for state licensure. Pulmonary edema secondary to CHF can be life-threatening if aggressive airway treatment isn’t initiated by EMS. care. These scenarios were developed for use in EMT-I training programs in Alaska. EMT: EMR Material PLUS: Fundamental depth, foundational breadth The EMT Instructional Guidelines in this section include all the topics and material at the EMR level PLUS the following material: • Investigation of the Chief Complaint o The Chief Complaint Is a Very Brief Description of the Reason for Summoning EMS to the Scene Scenario Sunday: You are thirty (30) minutes away from the attending physician’s office and fifteen (15) minutes from the community hospital. The first step in treating a patient with severe chest pain is: You are just getting settled into bed at the station, after a long day of running calls. - The patient is now on the monitor with a heart rate of 148-156 showing a sinus tachycardia with multifocal PVC’s noted at 4 per minute. A Would you consider another treatment modality for this patient after Albuterol proves ineffective. These example scenarios are not EMA coverage policy. Scenario Sunday: Respiratory distress patient Part I. Copyright 2018 MedicTests LLC | All Rights Reserved |, Mental Strategies for Rookie Paramedics and EMTs, Quick and Dirty Guide to Burn Classification, The Quick and Dirty Guide to Burn Injuries, Quick and Dirty Guide to Childbirth II : OB Emergencies. Scenario Sunday: Respiratory distress patient Part I. Emergency Medical Technician Scenarios 120 Questions 1. Respiratory status and BP should improve often within minutes. 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!�� FVIT - Once again, we'll use EMT chest pain protocol as an example. On arrival, you are met at the front door by the patients’ husband, he advises you to “please hurry, she is not doing well, she can’t breathe”! 10. These example scenarios are not EMA coverage policy.