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El Camino College EMT Program Skills Workbook

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El Camino College EMT Program Skills Workbook Name: _____________________________________________________ Year: _____________ Semester: ______________________________________________ Section: ____________ El Camino College EMT Program Skills Workbook FTECH – 144 Course Supplement Ryan Carey Alex Rodrigues Updated: 07/2019 Table of Contents PREPARATORY 1 Primary Assessment…………………………………………………………………… 2 Secondary Assessment……………………………………………………………….... 3 LA County Code of Ethics ……………………………………………………………. 4 FISDAP Overview…………………………………………………………………...…5 FISDAP Comprehensive Study Guide………………………………………………… 6 ECC EMT Position Descriptions …………………………………………………..…. 9 Medical Terminology Worksheet ……………………………………………..…..… 12 Common Field Disorders ………………………………………………………….… 17 LA County vs. National DOT Scope of Practice ……………………………………. 27 PATIENT ASSESSMENT 34 Altered Level of Consciousness ……………………………………………………… 35 Perfusion Status …………………………………………………………………….… 36 Pain Assessment ……………………………………………………………………… 37 EMT Skill: Respirations/Breathing ………………………………………………...… 39 EMT Skill: Chest Auscultation …………………………………………………...….. 44 EMT Skill: Pulse ………………………………………………………………….….. 48 EMT Skill: Blood Pressure …………………………………………………...……. 51 EMT Skill: Finger Stick/Blood Glucose Testing ………………………………….…. 57 CARDIOLOGY 63 FISDAP Cardiology Study Guide …………………………………………….….… 64 Cardiology Conditions ………………………………………………………..…...… 65 BLS CPR Pit crew ………………………………………………………………...…. 67 Summary of CPR Components …………………………………………………...….. 68 EMT Skill: Adult/Child Airway Obstruction …………………………………...…… 69 EMT Skill: Adult CPR …………………………………………………………..…... 74 EMT Skill: Child CPR ………………………………………………………………. 80 EMT Skill: Infant Airway Obstruction …………………………………………...….. 86 EMT Skill: Infant CPR …………………………………………………….……...…. 91 EMT Skill: AED ………………………………………………………………….….. 97 AIRWAY 103 FISDAP Airway Study Guide …………………………………………………….… 104 Respiratory System Anatomy ………………………………………………………. 105 Respiratory System Physiology ………………………………………………………123 EMT Skill: Oropharyngeal Suctioning …………………………………………….... 132 EMT Skill: Tracheostomy Tube/Stoma Suctioning …………………………………. 138 EMT Skill: Oropharyngeal Airway ………………………………………………….. 143 EMT Skill: Nasopharyngeal Airway …………………………………………….…… 147 EMT Skill: Bag Mask Ventilation ……………………………………………………. 151 EMT Skill: Oxygen Administration ………………………………………………….. 157 Medical 168 FISDAP Medical Study Guide ……………………………………………………….. 169 Medical Patient Assessment ………………………………………………………….. 170 EMT Skill: Patient Assessment (Medical) ……………………………………………. 173 EMT Skill: Medication (Aspirin) ………………………………………………..…… 187 EMT Skill: Medication (Metered Dose Inhaler) ………………………….……….…..193 EMT Skill: Medication (Epinephrine)……………….……………………………….. 198 EMT Skill: Medication (Naloxone) ……………………………………….………….. 205 EMT Skill: Medication (Nitroglycerin) ………………………………….………..…. 215 EMT Skill: Medication (Oral Glucose) …………………………………..……….….. 220 General Pharmacology for EMT …………………………………………..…….….... 226 TRAUMA 243 FISDAP Trauma Study Guide ……………………………………………………….. 244 Trauma Patient Assessment ……………………………………………..…………… 245 Glasgow Coma Scale …………………………………………………….………….. 246 Bleeding Control …………………………………………………………………….. 247 Burn Injuries …………………………………………………………………….…… 249 Eye Injuries ……………………………………………………………….………….. 252 Amputated Body Parts ……………………………………………………………….. 253 Snake Bite Treatment ………………………………………………………………… 254 EMT Skill: Patient Assessment (Trauma) ………………………………………..….. 255 Spinal Motion Restriction …………………………………………………..……….. 267 EMT Skill: Long Spine Board ……………………………………………….………. 271 EMT Skill: Bleeding Control/Shock Management ……………………………..……. 281 EMT Skill: Abdominal Evisceration …………………………………………………. 288 EMT Skill: Penetrating Chest Injuries …………………………………...…..………. 291 EMT Skill: Long Bone and Joint Injury ……………………………………..………. 295 EMT Skill: Traction Device (Sager/ Hare) ………………………………………….. 300 EMT Skill: Vest-Type Extrication Device …………………………………………... 308 OB/PEDIATRICS 318 FISDAP OB/PEDS Study Guide ……………………………………………………... 319 Pediatric Assessment Triangle ……………………………………………….……….. 320 Pediatric Patient Guidelines …………………………………………………............... 321 Apparent Life Threatening Events ……………………………………………………. 322 Pregnancy Questions …………………………………………………………………. 323 EMT Skill: Emergency Childbirth ……………………………………………………. 324 EMT Skill: Neonatal Assessment & Resuscitation …………………………………… 333 EMT Skill: Pediatric Emergency Resuscitation Tape ………………………………… 339 EMS OPERATIONS 342 FISDAP EMS Operations Study Guide ……………………………………………… 343 LA County Scope of Practice (REF 802.1)…………………………………………… 344 LA County Base Hospital Contact (REF 808.1)……………………………………… 345 LA County EMS Report ……………………………………………………………… 346 Patient Care Report Narrative ………………………………………………………… 351 EMS Report Abbreviations …………………………………………………………… 352 LA County Trauma Triage (REF 506.1) ……………………………………………… 359 LA County MCI Triage Guideline (REF 519.2) ……………………………………… 360 Tactical Emergency Medical Support FRO …………………………………………... 361 LA County Policies Related to Death & Dying …………………….……………….... 375 Do Not Resuscitate Forms ………………………………………………..…………... 379 Child/Adult/Elder Abuse Reporting ………………………………………………….. 384 9-1-1 Receiving Hospital Directory (REF 501) ……………………………………… 387 Incident Command System Training ………………………………………………… 395 Section 1: Preparatory EL CAMINO COLLEGE Page 1 EMT PROGRAM Initial Assessment (Primary) Body Substance Isolation Personal, partner, patient safety Environmental hazards SITUATIONAL AWARENESS Scene Size-up Number of patients (Look Up, Down, All Around) MOI (trauma) / NOI (medical) Additional resources/ equipment General Impression/ Need for SMR / extrication Life Threatening conditions Patient rapport/ consent Chief Complaint Alert (person, place, time) Determine responsiveness Verbal (voice only) Painful (interdigital pressure) Patent or Obstructed: Unresponsive (C - A - B) - FBAO maneuvers Airway - Suctioning Breathing CHECK: - Rate (rapid / slow) - Depth (shallow / deep) Capillary refill Circulation - Breath sounds Obvious bleeding Oxygenation (O2 lpm via device) Pulse: - Rate (rapid / slow) Ventilation (BVM) - Quality (strong / weak) Disabilities / Deformities Skin signs Expose Chief Complaint - Sick vs Not Sick - Past, Present, Future Level (ALS vs BLS) Formulate Field Impression (interactions) Mode (Code 2 vs 3) - Identify Priority Status Destination (M.A.R.) Go: Transport Decision EL CAMINO COLLEGE Page 2 EMT PROGRAM Focused History and Physical (Secondary) MEDICAL INITIAL ASSESSMENT TRAUMA (Minor Trauma) (Unresponsive medical) Rapid Trauma Assessment: Signs/ Symptoms Deformities Onset Contusions Provoke / Palliation Abrasions Quality Punctures/ penetrations Region/ Radiation Burns Severity Tenderness (palpate) TimeAllergies Lacerations Allergies / Age Swelling Medications Instability (palpate) Pertinent Medical History Crepitus (palpate) Last Oral Intake/ Last Exit Events Blood Pressure VITAL SIGNS Eyes (PERLA) VITAL SIGNS LOC (AEIOU-TIPS) Lung Sounds Pertinent Body Check SAMPLE/ OPQRST Skin Signs (If possible/ as needed) Respirations Pulse Detailed Physical Exam Reassessment UNSTABLE: 5 MINS Reassessment STABLE: 15 MINS EL CAMINO COLLEGE Page 3 EMT PROGRAM Los Angeles County Prehospital Code of Ethics Los Angeles County Prehospital Code of Ethics he Emergency Medical Services (EMS) System consists of health care professionals Tthat include EMT’s, paramedics, nurses, physicians, educators, and administrators. This Code defines Losour ethical Angeles responsibilities and Countybeliefs in the following principles for guiding practice…Prehospital Code of Ethics Respect • Recognize, acknowledge, listen, and encourage all members of the health care team • Uphold and maintain patient confidentiality and privacy • Honor the patient’s rights and autonomy to make decisions regarding their medical care Caring • Provide professional, compassionate, and competent care to all patients • Advocate for the patient’s care needs • Participate and support the advancement of the EMS system through education, training , and continuous quality improvement • Support prehospital care research to validate, improve and promote evidence-based practice Fairness • Provide competent medical care to all persons with compassion and respect for human dignity regardless of nationality, race, creed, religion, sex, status, or financial considerations • Ensure justice by treating all individuals equally and fairly • Encourage and support impartiality in the delivery of patient care. Decisions should be absent of bias, prejudice or benefit one person over another for improper reasons but based on objective criteria Integrity • Promote honesty, truthfulness, and consistency in action and practice by all members of the health care team • Demonstrate responsibility and accountability by maintaining licensure/certification, operating within one’s scope of practice, and providing thorough documentation • Inspire fidelity by adhering to professional code(s) of ethics, following policies and procedures, ensuring team members are respectful, competent and capable of performing duties, and honoring agreements with patients and colleagues • Maintain trustworthiness and excellence in the delivery of patient care and medical practice EL CAMINO COLLEGE Page 4 EMT PROGRAM How to Succeed on a Fisdap Exam Fisdap exams are uniquely designed to assess your knowledge and critical thinking ability. Questions are authored by instructors across the country and reviewed by subject matter experts and a board certified Emergency Physician. After you finish the exam, we hope you
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