Final Skills

Front 1

Therapeutic effects BVM

Back 1

Manually operated ventilation device that achieves approximately hundred percent oxygen delivery

Front 2

Indications BVM

Back 2

Any patient that requires ventilation assistance affecting rate or depth

Patients with pulmonary edema (rales)

Front 3

Contraindications BVM

Back 3

None

Front 4

Side effects BVM

Back 4

Can result in gastric destination especially in children

Inconstant or inadequate tidal volume

Insufficient face seal can result in poor ventilation or oxygenation

Front 5

Demonstrate BVM 1-3

Back 5

Take standardized precautions If patient is unresponsive open the airway using appropriate techniques head tilt jaw thrust check the airway for foreign bodies or fluids insert an airway adjunct when possible

Front 6

Demonstrate BVM 4-6

Back 6

Select the appropriate size bag valve mask apply the mask with the Apex of the bridge of the patient’s nose and align the base between the lower lip and chin Achieve a proper mask seal using an appropriate method OK EC C3 by placing the thumb over the top portion of the mask and bring the lower jaw up to the mask with the three fingers

Front 7

Demonstrate BVM 7-10

Back 7

Compress the bag smoothly delivering adequate volume over 1 sec Adults 10 to 12 every 5 to 6 seconds pediatrics 12 to 20 every 3 to 5 seconds Connect the BVM to it oxygen source if not already done and set the proper flow rate 15 to 25lpm Successfully ventilate 10× every 5 to 6 seconds look for signs of adequate ventilation’s observed patient’s chest rise and fall heart rate return to normal skin color temperature moisture improve improvement pulse ox

Front 8

Therapeutic effects OPA

Back 8

Improve airway patency

Front 9

Indications OPA

Back 9

Any unconscious patient without gag reflex

Front 10

Contraindications OPA

Back 10

Patient with an intact gag reflex

Front 11

Contraindications OPA

Back 11

Patient with an intact gag reflex

Front 12

Side effects OPA

Back 12

Partial or complete obstruction of the airway usually from

improper sizing localized soft tissue mucosal or dental damage

retching/vomiting caused by an intact gag reflex

Front 13

Demonstrate OPA equipment

Back 13

Take standardized precautions maintained manual C-spine immobilization throughout the procedure if C-spine injury is suspected select an appropriate size OPA measure the corner of the mouth to the earlobe or the mouth to the angle of the jaw

Front 14

Demonstrate primary method OPA

Back 14

Insert tip towards the roof of the mouth rotate 180 when the tip reaches the soft palate The airway can also be inserted sideways in the corner of the mouth and rotate 90 and advanced into place The flange should rest against the patient’s teeth with the other end opening into the pharynx

Front 15

Demonstrate Alternate method OPA

Back 15

Insert the tongue depressor onto the mouth until the tip is at the base of the tongue The tongue is than press down towards the mandible and forward with the tongue depressor The airway is then inserted in it’s normal anatomical position resting against the teeth

Front 16

If the patient begins to retch or a gag remove the device immediately

Back 16

Assess airway patency looking for improvements in chest rise lung sounds and pulse ox

Front 17

Therapeutic effects Oral suctioning

Back 17

To remove mucous vomitus secretions blood and sputum from the hypopharynx

Front 18

Therapeutic effects Oral suctioning

Back 18

To remove mucous vomitus secretions blood and sputum from the hypopharynx

Front 19

Indications oral suctioning

Back 19

Any patient airway or breathing that is compromised by fluid

Front 20

Therapeutic effects Oral suctioning

Back 20

To remove mucous vomitus secretions blood and sputum from the hypopharynx

Front 21

Indications oral suctioning

Back 21

Any patient airway or breathing that is compromised by fluid

Front 22

contraindications Oral suctioning

Back 22

None

Front 23

Therapeutic effects Oral suctioning

Back 23

To remove mucous vomitus secretions blood and sputum from the hypopharynx

Front 24

Indications oral suctioning

Back 24

Any patient airway or breathing that is compromised by fluid

Front 25

contraindications Oral suctioning

Back 25

None

Front 26

Side effects oral suctioning

Back 26

Hypoxia reflex bradycardia injury to the oropharyngeal tissue soft tissue mucosal or dental damage vomiting

Front 27

Side effects oral suctioning

Back 27

Hypoxia reflex bradycardia injury to the oropharyngeal tissue soft tissue mucosal or dental damage vomiting

Front 28

Demonstrate oral suctioning 1-4

Back 28

Take standardized precautions test set the unit to confirm a vacuum reading > 300 mm/hg Select and measure the appropriate size suction catheter measure from the corner of the mouth to the earlobe or angle of the jaw rigid tip a.k.a. Yankauer or tonsils tip soft catheter a.k.a. French catheter

Front 29

Demonstrate oral suctioning 5-7

Back 29

Open the patients now using the cross finger technique insert suction catheter to the measured depth in the pharynx and then cover the hole on the suction catheter to create a suction suction the pharynx and hypopharyngeal area from side to side as you withdrawl from the catheter

Front 30

Demonstrate oral suctioning 8-9

Back 30

Suction for no longer than adults 15 seconds children 10 seconds infants five seconds re-oxygenate the patient for at least 30 seconds and reassess the needs for additional suctioning

Front 31

Therapeutic effects king airway

Back 31

To establish a patent and protected airway

Front 32

Indications King airway

Back 32

Any unresponsive patient without a gag reflex and not likely to regain consciousness

Front 33

Contraindications king airway

Back 33

Patients with an intact gag reflex patients with esophageal disease or varices patients who have ingested a caustic substance bleach acid

Front 34

Contraindications king airway

Back 34

Patients with an intact gag reflex patients with esophageal disease or varices patients who have ingested a caustic substance bleach acid

Front 35

Side effects king airway

Back 35

Stimulation of the gag reflex and vomiting soft tissue trauma

Front 36

Demonstrate king airway 1-3

Back 36

Take standardized precautions identify select and prepare the correct size size 3 yellow 4 to 5 feet in height 45 to 60 mL inflation size 4 red 5 to 6 feet in height 60 to 80 mL inflation size 5 purple above 6 feet in height and 70 to 90 mL inflation Open the airway and check for fluids or obstructions suction if needed

Front 37

Demonstrate king airway 4-8

Back 37

Ventilate with 100% O2 and insert an OPA test cup inflation system by injecting the maximum recommended volume of air into the cuff remove all air from the cuff prior to insertion apply a water-based lubricant to the beveled distal tip and posterior aspect of the tube position ahead and remove the OPA sniffing position is ideal and may be inserted with the head in a neutral position

Front 38

Demonstrate king airway 9-12

Back 38

Hold the device at the connector with the dominant hand nondominant hand hold mouth open and apply at Chen turn left unless contraindicated by C-spine Goshens hold the device at a 45 to 90° angle with a blue orientation line touching the corner of the mouth introduce the tip into the mouth and advance behind the base of the tongue as a team to pass is the base of the tongue rotate it to you back to midline with a blue line facing the chin without exerting excessive force advance to King LTSD until the proximal opening of the gastric access lumen is aligned with the teeth or gums

Front 39

Demonstrate king airway 9-12

Back 39

Hold the device at the connector with the dominant hand nondominant hand hold mouth open and apply a Chin tongue lift unless contraindicated by C-spine precautions hold the device at a 45 to 90° angle with a blue orientation line touching the corner of the mouth introduce the tip into the mouth and advance behind the base of the tongue As the tube pass is the base of the tongue rotate the tube back to midline with a blue line facing the chin without exerting excessive force advance to King LTSD until the proximal opening of the gastric access lumen is aligned with the teeth or gums

Front 40

Demonstrate king airway 13-16

Back 40

Inflate cuffs with the minimum volume necessary to seal the airway while ventilating the patient to assist placement you may need to use simultaneously with drawl adjust until ventilation is easy and free-flowing confirm proper positioning by auscultation absence of epigastric sounds present lung sounds and chest rise Record the depth first then secure the device using the tool holder or tape without covering the Proximal opening of the gastric lumen

Front 41

Therapeutic effects CPR/AED:Adult/CHILD

Back 41

Maintain blood circulation to the brain and heart CPR Restore cardiac functions to patients V-Fib/V-Tach through defibrillation

Front 42

Indications CPR/AED:Adult/CHILD

Back 42

Adult: Patience you are unresponsive apneic/gasping respirations and pulseless Children: Patients were unresponsive apneic/gasping respirations pulses will have a heart rate less than 60 bpm after 30 to 60 seconds of oxygenation

Front 43

Contraindications CPR/AED:Adult/CHILD

Back 43

Patients with a pulse except as noted above for children cardiac arrest secondary to massive trauma exceptions drowning and electrocutions

Front 44

Side effects CPR/AED:Adult/CHILD

Back 44

Possible broken ribs/sterno due to chest compressions possible vomiting due to gastric inflation ventilating (too fast or too forcefully) Defibrillating the patient while in water on metal or in contact with the patient can cause injury

Front 45

Demonstrate

Back 45

J

Front 46

Demonstrate CPR/AED:Adult/CHILD 1-6

Back 46

Take standardized precautions general impression of patient asked bystandards as you approach downtime and started CPR check for unresponsiveness within 10 seconds call for help getting an AED ALS airway bag checked breathing and circulation

Front 47

Demonstrate CPR/AED:Adult/CHILD 6

Back 47

Adult no pulse expose the patients torso and start chest compressions children exposed patients torso and start chest compressions if pulse is less than 60 bpm ventilation 30-60 seconds If it doesn’t improve begin compressions

Front 48

Demonstrate CPR/AED:Adult/CHILD 7

Back 48

Perform high-quality CPR for AHA standards CAB adults/children 30:2 5 cycles two minutes child 2 rescuers 15:2 10 cycles hand placement between the nipple line one hand for small child at least 100 to 120/minute 30 compressions and less than 18 seconds adequate depth compress at least 2 inches allow complete chest recoil minimize interruptions give 2 breaths in 10 seconds switch rescuers every five cycles 2 minutes

Front 49

Demonstrate CPR/AED:Adult/CHILD 8-12

Back 49

Attempt to administer 2 ventilations when time allows size and apply an airway adjunct OPA NPA king airway after the AED arrives position it on the same side as the rescuer and turn it on remove hair or medical patches Apply pads and allow AED to analyze

Front 50

Demonstrate CPR/AED:Adult/CHILD 13-14

Back 50

If AED indicates a shockable rhythm clear the victim and deliver shock resume high-quality CPR switch rescuers every two minutes five cycles if AED indicates a rhythm that is not shockable no signs of life resumes CPR signs of life check for a pulse assess breathing ventilations if necessary reassess a carotid pulse every 30 seconds power off and leave on pads

Front 51

Therapeutic effects Nitroglycerin

Back 51

Dilates blood vessels increase blood flow to the heart decrease workload of the heart

Front 52

Therapeutic effects Nitroglycerin

Back 52

Dilates blood vessels increase blood flow to the heart decrease workload of the heart

Front 53

Indications nitroglycerin

Back 53

Patients who are exhibiting signs and symptoms of chest pain the patient is prescribed this medication direction allows on or off line

Front 54

Therapeutic effects Nitroglycerin

Back 54

Dilates blood vessels increase blood flow to the heart decrease workload of the heart

Front 55

Indications nitroglycerin

Back 55

Patients who are exhibiting signs and symptoms of chest pain the patient is prescribed this medication direction allows on or off line

Front 56

Contraindications Nitroglycerin

Back 56

Patients systolic blood pressure is below 90 mmHg or a 30 mmHg drop the baseline heart rate is less than 50 bpm greater than 100 bpm ingestion of sexually enhanced drugs in the past 24 hours viagra cialis Levitra patient have a suspected head injury the patient has already taken three doses prior to arrival

Front 57

Side effects Nitroglycerin

Back 57

Headache Drop in blood pressure with an increase in heart rate to compensate

Front 58

Side effects Nitroglycerin

Back 58

Headache Drop in blood pressure with an increase in heart rate to compensate

Front 59

Demonstrate Nitroglycerin 1-8

Back 59

Standardize precautions investigate chief complaint record/obtain sample opqrsti baseline vitals physical exam pt has their own nitro and protocol allows use six rights

Front 60

Demonstrate Nitroglycerin 9-13

Back 60

Confirm blood pressure is greater than 90 mmHg confirm the patients Loc confirm the patient’s heart rate is greater than 50 and less than 100 confirm patient has not taken any sexually enhanced drugs within 24 hours confirm that does 0.3 0.4 mg tablet or sublingual spray

Front 61

Demonstrate Nitroglycerin 14-18

Back 61

Primed the spray into 4 x 4 avoiding eyes assist patient placing one tablet or one meter dose spray under the tongue instruct patient to close there mouth and not swallow reassess/report patient condition and vital signs if the pain persist continue with nitro according to protocol up to 3 doses

Front 62

Demonstrate Nitroglycerin 19-20

Back 62

Document medication Dose action route time dart patients pos and neg If it worsens continue oxygenation obtain medical direction for additional doses if improves continue oxygenation monitoring vitals and transport