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Module 12: Emergency Procedures California Community Colleges

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Module 12: Emergency Procedures California Community Colleges Module 12: Emergency Procedures Module 12: Emergency Procedures Minimum Number of Theory Hours: 2 Recommended Clinical Hours: 1 Statement of Purpose: The purpose of this unit is to introduce the student to the concepts and procedures related to emergency procedures, signs and symptoms of distress, and the role of the Nurse Assistant in Long Term Care (LTC) in the response to immediate and temporary intervention in emergency situations. Terminology: 1. Abdominal thrusts 19. Emergency Medical Services (EMS) 2. Advance directive 20. Heimlich maneuver 3. Agitation 21. Hemiplegia 4. Airway 22. Hemorrhage 5. Aphasia 23. Hyperventilation 6. Aspirate 24. Hypoglycemia 7. Automated External Device (AED) 25. Hypoventilation 8. Barrier device 26. Hypoxia 9. Bradypnea 27. Pallor 10. Breathing 28. Pocket mask 11. Cardiac arrest 29. Recovery position 12. Cardiopulmonary Resuscitation (CPR) 30. Respiratory arrest 13. Compressions, Airway, Breathing (CAB)-formerly (ABC) 31. Respiratory distress 14. Cyanosis 32. Stat 15. Defibrillator 33. Syncope 16. Diaphoresis 34. Tachypnea 17. Do Not Resuscitate (DNR) 35. Unconscious 18. Dyspnea Patient, resident, and client are synonymous terms referring to the person receiving care California Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018 Page 1 of 24 Module 12: Emergency Procedures Performance Standards (Objectives): 1. Define key terminology. 2. Identify common signs and symptoms of conditions associated with patient/resident distress and describe the Nurse Assistant’s role and responsibility in preventing and/or responding. 3. Describe the immediate interventions in a medical emergency. 4. List the causes and signs of choking and discuss the use of abdominal thrusts for relief of obstructed airway. 5. Describe common emergency codes used in long-term care facilities. This module may be taught concurrently with Module 4: Safe Environment References: 1. Acello, B. & Hegner, B. (2016). Nursing Assistant: A Nursing Process Approach. (11th ed). Boston, MA. Cengage Learning. 2. Acello, B. (2016). Workbook to accompany: Nursing Assistant: A Nursing Process Approach. (11th ed). Boston, MA. Cengage Learning 3. Carter, P. J. (2017). Lippincott Essentials for Nursing Assistants: a Humanistic Approach to Caregiving. (4th ed.) Philadelphia, PA. Lippincott Williams & Wilkins 4. Deck, M. L. (2004). Instant Teaching Tools for the New Millennium. St Louis, MO. Mosby 5. Hedman, S. A., Fuzy, J., & Rymer, S. (2018). Hartman's Nursing Assistant Care: Long-Term Care (4th ed.). Albuquerque, NM. Hartman Publishing, Inc. 6. Hartman Publishing. (2018). Workbook for Hartman's Nursing Assistant Care: Long-Term Care (4th ed.). Albuquerque, NM. Hartman Publishing, Inc. 7. Haroun, L. & Royce, S. (2004). Teaching Ideas and Activities for Health Care. Albany, NY. Delmar Publishers 8. Pearson Vue (2018) California Nurse Assistant Candidate Handbook for National Nurse Aide Assessment Program. Philadelphia, PA. Pearson Education, Inc. 9. Sorrentino, S. A., Remmert, L., & and Kelly, R. (2018) Workbook and Competency Evaluation Review for Moby’s Textbook for Nursing Assistants (9th ed.) St. Louis, MO. Mosby Company 10. Sorrentino, S.A. and Remmert, L. (2018) Mosby’s Textbook for Nursing Assistants. (9th ed.). St Louis, MO. Elsevier 11. Weaver, L. & Wilding, M. (2013) The Dimensions of Engaged Teaching: a Practical Guide for Educators. Bloomington, IN. Solution Tree Press. California Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018 Page 2 of 24 Module 12: Emergency Procedures Recommended Teaching Clinical Demonstration/ Content Outline Strategies and Method of Evaluation Assignments Objective 1 Define Key Terminology. A. Review the terms listed in the terminology section A. Lecture/Discussion A. Have students select B. Spell the listed terms accurately B. Games: word searches, five words from the list C. Pronounce the terms correctly crossword puzzles, of key terminology and D. Use the terms in their proper context Family Feud, Jeopardy, write a sentence for bingo, spelling bee, each defining the term hangman, and B. Administer vocabulary concentration pre-test and post-test C. Encourage use of C. Uses appropriate internet, medical terminology when dictionary, and charting and reporting to textbooks licensed personnel D. Create flashcards E. Handout 12.1a- Emergency Procedures Crossword F. Handout 12.1b- Emergency Procedures Crossword- KEY Objective 2 Identify common signs and symptoms of conditions associated with patient/resident distress and describe the Nurse Assistant’s role and responsibility in preventing and/or A. Lecture A. Written test responding. B. Discussion B. Recognizes A. Myocardial infarction (MI, heart attack) Show online video (13 patients/residents in 1. A disruption of the flow of blood to an area of the muscle of min) “Act in Time to distress and reports the heart with subsequent death of the tissue at that area Heart Attack Signs” from signs and symptoms 2. Signs and symptoms National Heart and Lung immediately to charge a. Chest pain Institute. (May need to nurse 1) May be described as crushing, squeezing, or pressure download RealPlayer) C. Provides appropriate http://www.nhlbi.nih.gov/ 2) May radiate down arms, jaw, or back actintime/video.htm California Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018 Page 3 of 24 Module 12: Emergency Procedures 2) Complaint may be severe indigestion, heartburn, or D. Go to American Stroke care or emergency stomach pain Association website for measures until qualified b. Shortness of breath, Dyspnea or absence of breathing stroke information: help arrives c. Diaphoresis http://www.strokeassoci D. Documents according to d. Wet, cold, clammy skin ation.org/STROKEORG/ facility policy AboutStroke/Lets-Talk- e. Confusion, mental status change, anxiety About-Stroke-atient- f. Syncope, fainting Information- g. Weakness, fatigue Sheets_UCM_310731_ h. Nausea, vomiting Article.jsp i. Irregular pulse 3. Nurse Assistant Role a. Call for help loudly and pull the emergency light if available b. Remain calm c. Stay with the patient/resident d. Place patient/resident in comfortable position (some heart attack victims can breathe easier in a sitting rather than lying position) e. Reassure the patient/resident f. Intervene at level of competence as directed by licensed nurse g. Assess condition and vital signs while awaiting assistance from licensed nurse h. Keep the patient/resident warm as needed B. Cardiac Arrest 1. Absence of heart function 2. Signs and symptoms a. No Pulse, no circulation b. Loss of consciousness c. No effective breathing (may be agonal breathing) d. Enlargement of pupils e. Gray color to skin, cyanotic nail beds California Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018 Page 4 of 24 Module 12: Emergency Procedures 3. Nurse Assistant Role - See Objective 3 for role in medical emergency C. Cerebrovascular accident (CVA, Stroke, or brain attack) 1. A disturbance or obstruction of the flow of blood to a particular area of the brain with subsequent death of tissue 2. Signs and Symptoms a. Hemiplegia or weakness of one side of the body or numbness or tingling on one side of the body b. Aphasia-difficulty in speaking or understanding speech c. Headache d. Vision changes, blurred vision, pupils unequal e. Facial changes 1) Cheeks may “puff “on exhalation 2) One eyelid or eye may droop 3) Face may appear asymmetrical 4) Drooling f. Loss of bowel or bladder control g. Shaking or trembling 3. Give Me 5 for Stroke Tool from American Stroke Association a. Walk (Is their balance off?) b. Talk (Is their speech slurred or is their face droopy?) c. Reach (Is one side weak or numb?) d. See (Is their vision all or partly lost) e. Feel (Is their headache severe?) 4. FAST from American Stroke Association a. Face drooping b. Arm weakness c. Speech difficulty d. Time to call 9-1-1 5. Nurse Assistant Role a. Call for help loudly and pull emergency call light if available b. Remain calm California Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018 Page 5 of 24 Module 12: Emergency Procedures c. Stay with the patient/resident d. Place patient/resident in a position of comfort e. Reassure patient/resident f. Intervene at level of competence as directed by the licensed nurse g. Assess patient’s/resident’s condition and take vital signs while awaiting assistance from the licensed nurse h. Keep patient/resident warm as needed D. Syncope, fainting episode 1. A feeling of dizziness with possible temporary loss of consciousness 2. Signs and Symptoms a. Dizziness b. Visual changes-temporary loss of vision c. Pallor or paleness of the skin d. Cool, moist skin e. Eyes may roll back f. Unsteadiness or loss of upright position (patient/resident may fall) g. Weak pulse 3. Nursing Assistant Role a. Before loss of consciousness and during dizziness 1) Remain calm, call for help loudly, pull call light 2) Assist to floor, protect from injury 3) If sitting, place head towards knees 4) If lying flat on back, elevate legs slightly if no spinal, head or back injuries (If unsure, leave flat on back) 5) Loosen tight or binding clothing 6) Observe for any changes in condition b. After loss of consciousness 1) Raise legs approximately 8-12 inches if no spinal, head or back injuries (If unsure, leave flat on back) California Community Colleges Chancellor’s Office Nurse Assistant Model
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