Scenario Details

Scenario title 0201- Unresponsive

Chief complaint AMS

Notes
(Moulage, equipment, scene-size up info, etc.)
Equipment: 1st in bag, Cardiac Monitor Objectives
Scene: Private Residence, Bedroom,
patient supine in bed
Props: Half
Current full bottle
selected itemsof(Clear
Acetaminophen,
all): Airway Management, Adequate
and Inadequate Respiration ,one
Atenolol bottle with fill date week
Supplemental Oxygen Therapy,
previous, only 10 pills in the bottle.
Artificial Ventilation, Adequate and Inadequate Ventilation ,
Personnel:
Cardiac, One
ECG patient, one Pharmacology,
Interpretation, spouse Medication
Moulage: Cool,
Administration clammy skin.
Sound Clips: clear lung sounds.
Additional Equipment: Capnography
waveform- shallow. Cardiac monitor- 3rd
Patient Information
degree block. Transcutaneous Pacing-
Failure to capture.
Information provided by dispatch (read aloud to student)
Medic 2 respond to 12345 1st Street- Unconscious subject.

Age 65 Gender Male Ethnicity Caucasian

Weight 75 kgs
SAMPLE
Signs & Symptoms: Unresponsive. Allergies: PCN Medications: Aricept, Atenolol.
Prior History: HTN, Alzheimers Last Oral Intake: 8pm last night
Events: Met by the spouse at the front door. Leads them to the bedroom where the patient is supine in bed.
States she was unable to wake him up this morning.

OPQRST
Onset: Headache began last night around 7pm Provocation: Took some Tylenol when he went to bed.
Quality: N/A Radiation: n/a Severity: n/a
Time: "I think he took some more tylenol during the night, but I'm not sure".

Physical Examination
Vitals #1
Blood Pressure: 70/p Pulse: 30 Irregular Weak Respirations: 8 Shallow SpO2: 88
Skin: Clammy, Cold, Pale Pupils: PERRL: No Lung Sounds: Clear Blood Glucose: APGAR:
84
GCS: 3

Vitals #2
Blood Pressure: 72/P Pulse: 30 Regular Weak Respirations: 8 Shallow SpO2: 86
Skin: Clammy, Cold Pupils: PERRL: No Lung Sounds: Clear Blood Glucose: APGAR: GCS: 3

Vitals #3
Blood Pressure: 68/P Pulse: 28 Regular Strong Respirations: 6 Shallow SpO2: 80
Skin: Clammy, Cold, Pale Pupils: PERRL: No Lung Sounds: Clear Blood Glucose: APGAR:
88
GCS: 3

Vitals #4
 Blood Pressure: 70/P Pulse: 34 Regular Strong Respirations: 6 Shallow SpO2: 80
Skin: Clammy, Cold, Pale Pupils: PERRL: No Lung Sounds: Clear Blood Glucose: APGAR:
86
GCS: 3

Add new vital

Physical Exam
HEENT: normocephalic Neck: 0 JVD, Trachea Midline Chest: Intact Abdomen: SNT Pelvis: Stable
Lower Extremities: Pulses Upper Extremities: Pulses Posterior: Unremarkable

Assessment
Primary Cardiac

Secondary
Altered level of consciou…
Special Considerations
(Vital patient information not covered in other sections)
Vitals #1- GCS 1,1,1. Capnography 50, shallow
waveform.

Essential
Nasopharyngeal airway (Observed)

3rd Deg. Block; Pacing (Observed)

12 Lead
Oxygen (Observed)
15; BVM
Successful IV (Observed)
18 gauge; Antecubital right; 1 attempts
Dopamine (Intropin) (Observed)
2-10mcg/kg/min; IV Drip
Atropine (Observed)
0.5; IV Push
Midazolam (Versed) (Observed)
5mg; IV Push

Oropharyngeal airway (Observed)

Successful Manual ventilation (Observed)

Important
Not Important
Epinephrine 1:1000 (Observed)
2-10mcg; IV Drip
Successful Orotracheal Intubation (Observed)
Size: 7.00; 1 attempts

Capnography - Capnometry (Observed)

Glucagon (GlucaGen) (Observed)

1mg; IV Push
Inappropriate / Dangerous actions
Defibrillation
Synchronized Cardioversion.
Administration of any anti-arryhythmic

Curveball
Change in condition / event to be read to the student
At Minute 11, the patient will develop tonic/clonic seizure that will last 5 minutes.

Critical Failures
Failure to ventilate at a rate of 10-12 breaths per minute or Capnography of 35-45mmHg.
Failure to recognize and treat Bradycardia with poor Perfusion.
Failure to treat seizure with an appropriate benzodiazipine.
Failure to function as a competent EMT.