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Patient Assessment - VS - Respirations-1

Patient Assessment - VS - Respirations-1 - EMS SKILL...

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EMS SKILL PATIENT ASSESSMENT / VITAL SIGNS RESPIRATIONS / BREATHING PERFORMANCE OBJECTIVES The examinee will demonstrate proficiency in performing an accurate respiratory assessment. CONDITION The examinee will be requested to perform an accurate respiratory assessment for the initial, focused and/or ongoing assessment. The patient is able to answer all questions and follow commands. The patient may be either seated in a chair or lying supine. The examiner will assess respirations with the examinee to determine the accuracy of the assessment. Necessary equipment will be adjacent to the patient. EQUIPMENT Live model, timing device, goggles, mask, gown, gloves. PERFORMANCE CRITERIA y 100% accuracy required on all items designated by a diamond ( ) for skills testing and must manage successfully all items indicated by double asterisks (**). y Documentation, identified by the symbol (§), must be practiced, but is not a required test item. y Appropriate body substance isolation precautions must be instituted. y Reading must be within +/- 2 breaths/minute of examiner’s determination. PREPARATION Skill Component Key Concepts Take body substance isolation precautions ** Place a mask on the patient - if suspected airborne disease ** Place mask on patient and a HEPA respirator on rescuer - if suspected tuberculosis y Mandatory personal protective equipment - gloves y Situational - goggles, mask, gown PRIMARY ASSESSMENT Skill Component Key Concepts Observe or feel for rise and fall of chest or abdomen y Evaluate patient’s respirations as subtly as possible. Patients have a tendency to increase their respirations if they know they are being assessed. y The rescuer may have to feel the patient’s chest or abdomen to check for rise and fall if tidal volume is decreased or patient is dressed in a large jacket or many layers of clothing. Lay patient’s arm over chest or abdomen, watch movement of shoulders, etc. y Infants are “abdominal breathers” which causes the abdomen to protrude and the chest wall to retract. Assess respirations/Manage breathing: y Rate (normal, fast, slow) y Effort/Quality y Tidal volume ** Consider O 2 therapy ** Consider BVM - if inadequate ventilation y Rate - determine if fast or slow. Rate is not counted during the initial assessment. y Effort/Quality - evaluated by the use of accessory muscles, patient position (tripod, reclined, etc.) and the ability to speak in words, sentences or unable due to being short of breath.
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