Skills Training Session September 2, 2014

1. Skills Training Session September 2, 2014

2. Agenda • Run Report STS • Shift Review (Fresno St. tailgate) • Grade the homework • Have you do one practice • Go over proper documentation • Write another run report at the end • Get out early wooo!!!

3. Practice Scenario #1: You are working at a campus tailgate when you are called to McCarthy quad. A 26 year old female is sitting in a chair in the shade clutching her face and crying. You introduce yourself and the woman, Rachel Williams, explains that a friend threw a beer at her and it hit her in the left eye. You begin your inspection of the c/c and notice that her eyes, though PERRL, are not looking in the same direction. You notice some bruising around her left orbital bones. She is allergic to Z-Packs, has eaten a hot dog in the last hour and did not drink EtOH. Has a history of smoking cigarettes. You provide necessary treatment and make a transport decision. Keep in mind that this is an eye injury. Vitals: BP 128/88, HR 92, Resp 16, Skin normal, Lungs normal, LOA A&Ox4.

4. Run Reports • Neatness, clarity, completeness • The run report is NOT your first draft • Take notes on separate piece of paper during call • Transport decision • Describing treatment • Legal document • Questions?

6. Get PT’s ID • USC student  USC card • Miscellaneous person  driver’s license/passport • If person does not have ID: • ask for their info • If PT is altered, ask their friend • If PT is altered and no one is there to provide identification  DPS Get as much info as possible!

7. Key things to include in run reports • Did PT hit head? • Does PT have head/neck/back pain? • This goes in EVERY narrative you will write for EMSC • Any important PT/witness statements - info about falls • Any movement of PT by you/PT/someone else • refusal of treatment

8. Field Run Report Cheat Sheet S: A: M: P: L: E: Transport Decision*: Treatment: Misc: Exact supplies used**: *if applies **For EMSC use only AVPU (circle one) Position found ______ Conscious/breathing +/- ID? A&Ox___ Head/Neck/Back Pain +/- C/C: O*: P: Q: R: S: T:

9. Practice Scenario #2: • Scenario: You are dispatched to the university baseball field for an injured player. Upon arrival you are escorted to the dugout, where a player is sitting up, complaining of chest pain and shortness of breath. He was in the batter’s box when he was struck in the left side of the chest with a 90-mile-an-hour fastball.

10. Practice Scenario #2: • SAMPLE history S—Acute onset of left-sided chest pain and shortness • of breath • A—Penicillin • M—None • P—No pertinent previous medical history (PMH) • L—Dinner 2 hours ago • E—Struck in the left chest with baseball • Head assessment No injuries noted • Neck assessment No JVD or tracheal shift; no obvious injury • Focused or rapid assessment Rapid assessment reveals possible rib fractures on the left side, • with diminished lung sounds on the left • Chest assessment Bruising and tenderness over the left ribs; breath • sounds are diminished on the left side • Abdomen and pelvis assessment No injuries noted • Extremities assessment PMS present in all four extremities • Posterior assessment No injuries noted • Secondary wounds No injuries noted • General impression Young man sitting in the dugout in moderate to severe respiratory distress • Level of consciousness Responsive and answers questions appropriately • Chief complaint/life threat Left-side chest pain and shortness of breath • Airway and breathing Open and patent • Oxygen therapy 15 L/min via nonrebreathing mask • Adequate ventilation Patient is breathing at a rate of 24 breaths/min; shallow • Treatment Maintain airway • Circulation No major bleeding seen • Pulse Radial pulse rapid, strong, and equal • Skin Warm, pink, and diaphoretic • Baseline vital signs Blood pressure—95/60 mm Hg • Pulse—122 beats/min • Respirations—24 breaths/min; shallow • SaO2—95% on room air • PEARRL

11. Thank you!