Al-Ghad International Colleges for Applied Medical Sciences

Emergency Medical Specialist Program 2017

SPECIAL POPULATIONS CARE 2
Date: Time:
TECHNIQUES IN COMMUNICATING GERIATRIC PATIENTS
PHYSIOLOGICAL CHNAGES IN AGING
1. RESPIRATORY SYSTEM
2. CARDIOVASCULAR SYSTEM
3. RENAL SYSTEMNERVOUS SYSTEM
4. MUSCULOSKELETAL SYSTEM

EQUIPMENT LIST:
Stethoscope
Blood Pressure apparatus

PROCEDURE:
Patient Assessment
_____1. Scene safety and additional help
_____2. Initial assessment: Check mental status.
Check for ABC
Determine the need to transport.*
_____3. Focus history and Physical exam.
Check for the DCAP-BTLS for sexually abuse patient
_____4. Check for the vital signs
Sample history
_____5. Signs and Symptoms
_____6. Allergy
_____7. Medications
_____6. Past medical History
_____7. Last oral intake
_____8. Events leading to illness
____9. Always identify yourself*
____10. Speak at eye level to ensure that the patient can see you as you communicate*
____11. Locate a hearing aid, eyeglasses and dentures
____12. Turn on lights
____13. Speak slowly, distinctly and respectfully
____14. Use the patients surname, unless the patients requests otherwise
____15. Listen closely
____16. Be patient
____17. Preserve dignity*
____18. Use gentleness
*Critical Points
SCORE: _______

Student`s Name: Signature:

Instructor`s Comments / Notes:

Instructor`s Signature:
 Al-Ghad International Colleges for Applied Medical Sciences
Emergency Medical Specialist Program 2017
SPECIAL POPULATIONS CARE 2
Date: Time:

ASSESSMENT OF SEXUALLY ASSAULTED PATIENTS

____1. Scene safety and additional help*

____2. Initial assessment: Check mental status.
____3. Check for ABC*
____4. Determine the need to transport.
____5. Focus history and Physical exam.
____6. Check for the DCAP-BTLS for sexually abuse patient
____7. Check for the vital signs
____8. Sample history
____9. Signs and Symptoms
____10. Allergy
____11. Medications
____12. Past medical History
____13. Last oral intake
____14. Events leading to illness
LEGAL CONSIDERATIONS FOR PROVIDING CARE TO A SEXUALLY ASSAULTED PATIENT

____15. Take steps to preserve evidence.*

____16. Discourage the patient from urinating or defecating, douching or bathing.*
____17. Do not remove evidence from any part of the body that was subjected to sexual contact
unless necessary to provide urgent medical care*
____18. Notify law enforcement personnel as soon as possible*
____19. Be aware that there will be a “chain of evidence” with specific requirements of proof*
____20. Follow local protocol and state requirements in reporting these cases. Consult with medical
direction and follow established protocols.
*Critical Points
SCORE: _______

Student`s Name: Signature:

Instructor`s Comments / Notes:

Instructor`s Signature:
 Al-Ghad International Colleges for Applied Medical Sciences
Emergency Medical Specialist Program 2017
SPECIAL POPULATIONS CARE 2
Date: Time:

ASSESSMENT OF A CHILD ABUSE PATIENT

____1. Scene safety and additional help*

____2. Initial assessment: Check mental status.
____3. Check for ABC *
____4. Determine the need to transport.
____5. Focus history and Physical exam.
____6. Check for the DCAP-BTLS for child abuse patient
____7. Check for the vital signs
Sample history
____9. Signs and Symptoms
____10. Allergy
____11. Medications
____12. Past medical History
____13. Last oral intake
____14. Events leading to illness
Observe for these common behavioral traits*
____15. Does not mind if his or her parents leave the room
____16. Cries hopelessly during treatment or cries very little
____17. Does not look at parents for reassurance
____18. Is wary of physical contact and is extremely apprehensive
____19. On the alert of danger
____20. Constantly seeks favors, food, or comfort items
*Critical Points
SCORE: _______

Student`s Name: Signature:

Instructor`s Comments / Notes:

Instructor`s Signature:
 Al-Ghad International Colleges for Applied Medical Sciences
Emergency Medical Specialist Program 2017
SPECIAL POPULATIONS CARE 2
Date: Time:
TRACHEOSTOMY TUBE CARE
A tracheostomy is an opening (made by an incision) through the neck into the trachea (windpipe). A
tracheostomy opens the airway and aids breathing. A tracheostomy may be done in an emergency, at
the patient’s bedside or in an operating room. Depending on the person’s condition, the tracheostomy
may be temporary or permanent.
EQUIPMENTS NEEDED
Two non-sterile gloves Clean pipe cleaners or small brush Mask
A clean basin (or sink) Hydrogen peroxide Eye protector
4 x 4 mesh gauze pads Clean cotton-tipped swabs Gown
Normal saline or tap water Clean washcloth Clean scissors
Clean towel Trach tube ties
PROCEDURE:
____1. Gather, prepare and assemble equipment.
____2. Wash hands thoroughly and observed BSI precautions.*
____3. Suction the trach tube, if tube has an inner cannula, remove it.
____4. Hold the inner cannula over the basin and pour the hydrogen peroxide over and into it and
clean the inner cannula with pipe cleaners or a small brush.
____5. Thoroughly rinse the inner cannula with normal saline, tap water or distilled water and
then dry the inside and outside of the inner cannula completely with a clean 4 x 4 fine mesh
gauze pad.*
____6. Reinsert the inner cannula and lock it in place.
____7. Remove the soiled gauze dressing in your patient`s neck and inspect the skin around
the stoma for redness, hardness, tenderness, drainage or a foul smell. If you notice any of
these conditions, call physician after you finish routine care.*
____8. Soak the cotton-tipped swabs in a solution of half hydrogen peroxide and half water to clean
the skin around the stoma. Using a wet the wash cloth with normal saline, tap water or distilled water
wipe away the hydrogen peroxide and clean the skin.
____9. Dry the skin around the stoma with a clean towel.
____10. Change the trach tube ties by measuring and cut a piece of tie long enough to go around your
patient`s neck twice then cut the tie at an angle so it is easier to insert the tie into the neck-plate.
____11. Untie one side of the old tie and remove that side from the neck-plate. Do not completely
remove the old tie until the new one is in place and is securely fastened. Holding the trach tube in
place, lace the tie through one hole of the neck-plate, around the back of the neck, through the other
hole of neck-plate, and again around the back of the neck.
____12. Pull the tie snugly and tie a square knot on the side of your patient`s neck. There should be
enough space for no more than two fingers between the tie and the neck.
____13. Place a fine mesh gauze under the tracheostomy tie and neck-plate by folding it or cutting a
slit in it.
____14. Remove gloves and discard all materials used.
____15. Document the procedure.
SCORE: _______ *Critical Points
Student`s Name: Signature:

Instructor`s Comments / Notes:

Instructor`s Signature:
 Al-Ghad International Colleges for Applied Medical Sciences
Emergency Medical Specialist Program 2017
SPECIAL POPULATIONS CARE 2
Date: Time:

REPLACEMENT OF A TRACHEOSTOMY TUBE

A tracheostomy (trach) tube is a curved tube that is inserted into a tracheostomy stoma (the hole made
in the neck and windpipe (Trachea)). There are different types of tracheostomy tubes that vary in
certain features for different purposes. A commonly used tracheostomy tube consists of three parts:
outer cannula with flange (neck plate), inner cannula, and an obturator. The frequency of these tube
changes will depend on the type of tube and may possibly alter during the winter or summer months.
Practitioners should refer to specialist practitioners and/or the manufacturers for advice.

EQUIPMENTS NEEDED

Tracheostomy tubes (Same size and smaller size) 5 cc syringe

Tracheostomy care kit Mask
Padding or Cloth Gloves
Suction machine Medical Gown
Normal saline solution Eye Protector
Sterile gauze

PROCEDURE:

____1. Explain the procedure to the patient.

____2. BSI precautions.
____3. Position the patient with padding under the shoulders
____4. Select a tube the same size or one size smaller than the one removed and moisten with
sterile, water-soluble lubricant.*
____5. Suction the stoma and trachea before insertion of the new tube.
____6. Insert the tube gently into the trachea with the curve pointing downward.*
____7. If the tube has an obturator, remove it; if it is cuffed tube, inflate the cuff.
____8. Assess for correct tube placement.*
____9. Secure the tube
____10. Monitor patient and documentation.
*Critical Points
SCORE: _______

Student`s Name: Signature:

Instructor`s Comments / Notes:

Instructor`s Signature:
 Al-Ghad International Colleges for Applied Medical Sciences
Emergency Medical Specialist Program 2017
SPECIAL POPULATIONS CARE 2
Date: Time:
PROPER TECHNIQUE OF DRAWING BLOOD
FROM A CENTRAL VENOUS LINE

Phlebotomy Via Central Venous Access Device

The following procedure must only be undertaken and followed by IV competent staff. It is vital that the
staff member has sound knowledge and skill in intravenous therapy and aseptic non touch technique:
as interventions such as blood sampling from CVADs pose a greater risk of infection and subsequent
complications to the patient.

EQUIPMENTS NEEDED

3-4 pieces of 10 ml syringes Mask

0.9% sodium chloride Eye protector
Povidone iodine Sterile gloves
Clean plastic tray Medical gown
Dry cotton balls

PROCEDURE:

____1. Prepare all equipment.

____2. Use 10 ml syringe or larger syringe and draw up 3-5 ml normal saline.
____3. Put on gloves – use aseptic technique.
____4. Explain the procedure to the patient.
____5. Clamp the catheter with the attached clamp or padded smooth shunt clamp.
____6. Wipe the site with povidone-iodine and allow it to dry.*
____7. Connect the syringe and unclamp the catheter, and withdraw 5 ml of blood.
____8. Replace the clamp.
____9. Attach the syringe of normal saline to the catheter. Remove the clamp and flush
____10. Replace the clamp and remove the syringe.
____11. Discard all materials used.
____12. Documentation.
*Critical Points
SCORE: _______

Student`s Name: Signature:

Instructor`s Comments / Notes:

Instructor`s Signature:
 Al-Ghad International Colleges for Applied Medical Sciences
Emergency Medical Specialist Program 2017
SPECIAL POPULATIONS CARE 2
Date: Time:

MALE URETHRAL CATHETERIZATION

(Indwelling Foley Catheterization, IFC)

In urinary catheterization a latex, polyurethane, or silicone tube known as a urinary catheter is inserted
into a patient's bladder via the urethra. Catheterization allows the patient's urine to drain freely from the
bladder for collection. It may be used to inject liquids used for treatment or diagnosis of bladder
conditions. Catheterization should always be an aseptic technique, a technique reduces the risk of
introducing infection into the bladder.

EQUIPMENTS NEEDED
Gloves 10 cc Syringe IFC F16 Water Soluble Lubricant
Mask Antiseptic solutions 0.9% NaCl Solution Drapes (2)
Eye Protector Cotton Balls Catheter tubing Kidney basin
Medical Gown Tape Urine Collection bag
PROCEDURE:
____1. Explain procedure to the patient.
____2. Prepare equipment.
____3. Place the patient in supine position and remove patients pants and undergarments
____4. BSI precautions.
____5. Place one sterile drape under the patient’s penis and another above the penis to cover the
abdomen.
____6. Open a package of antiseptic solution and saturate sterile sponges (or cotton balls).
____7. Attach the syringe to the catheter and test the balloon to make sure it inflates.*
____8. Open a package of water – soluble lubricant and lubricate the first several inches of the
catheter.
____9. Grasp the patients’ penis with one hand and retract the foreskin (if present). With the other
hand, cleans the glans with a sterile cotton ball and then discard it. Repeat the procedure.
____10. Raise the shaft of the penis upright to straighten the penile urethra and pass the catheter
through the meatus.
____11. Continue passing the catheter with gentle, steady pressure until the urine flows and
then advance the catheter another 2 inches.*
____12. Attach the syringe to the catheter and inflate the balloon with 3 – 5 ml normal saline.
____13. Gently pull back on the catheter until the balloon rests against the prostatic urethra and then
attach the drainage bag to the catheter.
____14. Run the catheter tubing along the patients leg and tape the connecting tubing to the patients
thigh.
____15. Attach the collection bag to the bed or stretcher at a level below that of the patient to facilitate
drainage by gravity.
*Critical Points
SCORE: _______
Student`s Name: Signature:

Instructor`s Comments / Notes:

Instructor`s Signature:
 Al-Ghad International Colleges for Applied Medical Sciences
Emergency Medical Specialist Program 2017
SPECIAL POPULATIONS CARE 2
Date: Time:
Transfer of patients with muscle paralysis and weakness. (bed to wheelchair)

EQUIPMENT:
Wheelchair
Bed
Personal Protective Equipment

PROCEDURE

____1. Position the wheelchair nearby at the small angle to the bed for transfer.*
____2. Allow space for the helper to come in. Make sure that there is enough space at the edge of the
bed before rolling the patient over.
____3. Place the opposite arm on the patient’s body and move the other arm closer to you and away
from the patient’s body.
____4. Bend the opposite knee. With one hand on the pelvis, and the other hand on the patient’s
shoulder blade, roll the patient towards you.
____5. Next, bring the legs off the edge of the bed, stabilize the patient’s hip with one hand, and with
the other hand under the patient’s upper trunk, lift the patient up to a sitting position. You helper could
assist you with the patient’s trunk.
____6. Never lift by putting your hand under the patient’s neck.
____7. If the patient is sitting too far in the bed, shuffle the patient’s bottom forward, first lean the
patient on the right and guide the left forward and vice versa on the other side.
____8. Ensure that the patient’s feet are placed flat on the floor.
____9. Place the chair near the patient; ensure that the breaks are applied. And ensure that
your helper are ready to help you.*
____10. The helper will assist you by lifting the buttocks across. You can cue your helper by saying: “1,
2, 3, lift.”
____11. Lower yourself to the patient’s eye level. Make sure you bend your knees and keep
your back straight. Stabilize the patient’s knees between yours.*
____12. To transfer, lean the patient forward. Ensure that the patient’s weight is well forward.
Keep your back straight for the transfer.
____13. Make sure that your path of view is not blocked by the patient’s head. Pivot at the
patient’s knees and bring the hips over to the chair.*
____14. Put the patient further back into the chair, first lean the patient forward and to one side. With
one hand supporting under the patient’s thigh and your helper assisting under the patient’s hip together
bring the hip backwards and vice versa.
*Critical Points
items SCORE: _______

Student`s Name: Signature:

Instructor`s Comments / Notes:

Instructor`s Signature:

Al-Ghad International Colleges for Applied Medical Sciences

2017
 Emergency Medical Specialist Program
SPECIAL POPULATIONS CARE 2
Date: Time:

Management of Patients with Seizure

EQUIPMENT:
Oxygen mask / Non-rebreather mask Long spine board
Nasopharyngeal Airway Oxygen tank
Suction Machine

PROCEDURE

Size-up the scene

____1. Make sure the area is safe (clear the environment for the safety of the patient)*
____2. Look around the environment for signs that may have cause seizure*
____3. Additional help
____4. Spinal precaution/ Protect their head and their extremities as they convulse.*
Primary assessment
____1. Check level of consciousness (AVPU)
____2. Check the airway. Use nasal airway (avoid applying oral pharyngeal airway)*
____3. Place the patient on their side in a recovery position (to drain secretion)
____4. Suction if necessary
____5. Assess respiratory status and check pulse rate.
____6. Give oxygen via non-rebreather mask
____7. Transport patient per local protocol
.Secondary assessment
____1. Perform a head-to-toe assessment for other possible injury.*
____2. Check blood glucose levels and treat per local protocol.
____3. Provide medications if necessary. Usually if the seizure attack last more than 5 minutes.
Lorazepam, diazepam, or midazolam via intravenous route.
____4. Obtain history. Talk to witnesses. Use SAMPLE history
____5. Detailed physical exam if necessary.
____6. Ongoing assessment
____7. Transport
*Critical Points
items SCORE: _______
Student`s Name: Signature:

Instructor`s Comments / Notes:

Instructor`s Signature: