EMT Cheat Sheet - BLS

EMT Cheat Sheet

This is a quick reference guide over skills, procedures, medications, and assessment that an EMT is capable of doing. You have to remember that not everyone is a medical professional so go off of what you are given in regards to signs, symptoms, and vitals.

Assessment

The assessment is something that can be done as you are walking up on a scene by taking in the initial patient presentation. Everyone has heard of the ABCs in EMS and assessing a patient's ABCs you don’t even have to touch them.

Airway: When you walk up to a patient and start talking to them, if they are conscious and see what is going on and what the problem is, and if they talk back to you or are having a hard time talking in general you know there is an airway problem. If they are unconscious, it’s simple to just RP check the patient’s airway.

Breathing: When assessing someone's breathing you can also easily do this by talking to them and usually by the way they are talking you can adequately tell if they are breathing ok or not.

Circulation: Circulation is essentially the presentation of the patient. Do they look pale? What’s their temperature? What circulation means is the patient’s blood going throughout their body adequately.

At Patient:

The first thing you should do when you get to a patient is get a baseline set of vitals, because depending on what is wrong this will dictate what you do going forward. This can be done by hooking the pt up to the monitor or getting a manual set. Most important part of patient assessment is talking to your patient. A lot of the information that will help determine what is wrong with them can be gained from just talking to them. When at a patient, you may not always receive accurate info, and that is okay because not everyone is a medical professional or has the knowledge needed for anything in the medical field.

Ex. You ask for a patient's vitals and you recieve words and not numbers just use it; do not keep asking to check vitals.

History:

Something that can help determine what’s going on with the patient is by gaining a SAMPLE history from them.

SAMPLE is an acronym used to get basic information from your patient to help further diagnose what is wrong with them and help you as the EMS provider take better action when treating your patient.

S: Signs and Symptoms

A: Allergies

M: Medications

P: Past History

L: Last Intake and Output

E: Events To Present

Based on what you get with your patient you can accurately help treat them as well as it will help the doctors later on in patient hand off at the hospital. There may be times in which you may not be able to obtain a whole patient history and that is ok. The main thing to remember is that you have to go with what you are given in regards to when patients answer any questions or /me.

Pain:

When it comes to pain some injuries may be obvious that are causing the pain, but when a patient is in pain and there is not an obvious injury obtaining some info in regards to that pain may be required. The best way to do this is using a mnemonic called OPQRST what that means is what it stands for is…

O: Onset

When did the pain start?

P: Provocation

Do you know what caused the pain? Q: Quality

Is the pain sharp or dull? Can you describe it? R: Radiating

Does it seem to radiate anywhere else besides the initial spot? S: Severity

On a scale of 1-10 can you rate your pain 1 being the least and 10 being the most painful thing you have ever felt? T: Time

About how long has the pain lasted?

Vitals:

The vital signs you need to look for are Blood Pressure, Pulse and what’s their Respiratory rate and are they breathing adequately.

Level of consciousness: The way to score a patient's level of consciousness is by using the Glasgow coma scale. Also to see if a patient is alert and oriented is by asking them simple questions

Hyper/Hypo glycemic shock

Hyper >250 or Hypo <60

As an EMT you are able to obtain a blood glucose on a patient and is in good practice to obtain one on every patient. If the level of blood glucose falls below 60 and a pt is showing signs of Hypoglycemic shock then as an EMT you can give Oral Glucose, which is like a paste, if the patient is alert and oriented and able to protect their own airway. If they are unconscious due to Hypoglycemia, call for an ALS-qualified personnel to proceed and rapid transport. For anything above 250, transport to the nearest hospital due to one of the only things that can be done is the patient is to be given fluids.

Mass-Casualty Incidents (MCI):

A Mass-Casualty Incident, or MCI, is a scene with multiple patients and not enough resources or personnel to provide one-on-one patient care. A MCI will be declared by the first arriving unit at the scene of the incident after they conduct a basic survey of the scene; specifically looking at how many patients are on-scene and what is a rough idea of injuries. This information will then be relayed to Fire Control who in turn will notify responding units. Once additional units arrive on-scene, they will conduct a further sweep and examine patient injuries. When patient injuries are determined, the patients will then be given a colour code (Reference the Colour Code System below).

GREEN - Minimal: Patients who are able to ambulate out of the incident area to a treatment area.

YELLOW - Delayed: Patients who have non-life-threatening injuries, but are unable to walk or exhibit an altered mental status.

RED - Immediate: Patients who have major life-threatening injuries, but are salvageable given the resources available.

GREY - Expectant: Patients whose injuries make survival unlikely with resources available.

BLACK - Deceased: Patients who show no signs of life.

Once codes are determined, this will be relayed to the Incident Commander who will then arrange appropriate transportation and will remain in communication with Fire Control (Fire Comm)

Patient Care

As an EMT, you are able to do a basic level of care for that patient. Essentially, as an EMT, your job is to stabilize the patient to the best of your ability and transport them to the hospital. Your job is to provide the most basic amount of care; this involves bandaging and splinting, as well as giving a basic amount of Medications.

Bandaging and Splinting:

When working on bandaging and splinting your first job is to stop any kind of bleeding that the patient may be having before focusing on anything else. If the cuts to the patient are minor all you have to do is just clean it with some saline.

Cervical Spine:

Depending on the mechanism of injury (what happened) should depend on if you should use a C-collar and backboard or not. If a patient is critical don’t bother putting them on a backboard before you put them on a stretcher, just flat out put them on the stretcher.

Medication:

EMTs can give the most basic medication available, this will outline when to use as well as when to use them.

Oxygen: Used when the patient’s O2 sats are below 92% or any kind of low. It can also be used in some cases of chest pain.

Oral Glucose: Oral Glucose is to be used in diabetic emergencies when the patients blood glucose is low. It’s like a paste that can be used on a patient that is alert and oriented and can support their own airway.

Aspirin: Anti- inflammatory agent and anti-fever agent that prevents blood from clotting, can be used with mild pain, headache, muscle ache: chest pain of cardiac origin.

Nitroglycerin: to be used for individuals whose blood pressure is very high you will typically use it for an individual that has chest pain.

Albuterol: Used when a patient is having difficulty breathing, wheezing, shortness of breath, coughing, and chest tightness caused by asthma. Comes in 250mg ampules can be used 1 every 3 min as needed.

Atrovent: Used for a bronchospasm (narrowing airway) with patients with COPD, can be used in conjunction with albuterol and comes in 500mg ampules given only once.

Epipen: To be used in cases of anaphylactic shock it is .3 mg of epinephrine with a Junior pen having .15 mg of epi. EPIPENS are to not be used during Bradycardia (low pulse) emergencies.

Narcan: To be used intranasally in a pre-loaded dose syringe and is to be given to pt who have overdosed on opioids.

Green Whistle: Basically it's a form of pain relief inhaled through the "whistle", The initial dose is either 1.5ml or 3ml. The patient will generally get pain relief after 6 to 8 breathes and it will last for 25 mins after treatment with it has stopped. If a second dose is needed which is at 3ml it will last an hour after. It's used for managing acute traumatic pain so sporting injuries mostly it can even be used after procedures for pain relief. There are side effects but their mostly benign usually just a good high and if you give someone more than 6ml a day or 15ml a week it can cause kidney damage.

• Oxygen tanks

• Bandaging and splinting supplies

• Monitor

If you would like an in-depth guide; go to this link: SAFR REFERENCE GUIDE