HomeMy WebLinkAboutPB 405.01E REVISED 5-2015_Metered Dose InhalerPPPEEERRRFFFOOORRRMMMAAANNNCCCEEE BBBEEENNNCCCHHHMMMAAARRRKKKSSS
405.01E405.01E405.01E405.01E ---- Bronchodilator AdministrationBronchodilator AdministrationBronchodilator AdministrationBronchodilator Administration::::
Handheld Metered Dose InhalerHandheld Metered Dose InhalerHandheld Metered Dose InhalerHandheld Metered Dose Inhaler
Anne Huff, Fire Chief
Beaumont Fire-Rescue Services
Discipline:Discipline:Discipline:Discipline: EMTEMTEMTEMT----BLSBLSBLSBLS
Effective:Effective:Effective:Effective: 9/9/9/9/16161616/2009/2009/2009/2009
ReviReviReviReviewewewewed:ed:ed:ed: 5/22/20155/22/20155/22/20155/22/2015
Replaces:Replaces:Replaces:Replaces:
I. I. I. I. ObjectiveObjectiveObjectiveObjective
The EMT shall show the proper bronchodilator administration with a handheld metered
dose inhaler using the criteria prescribed.
II. II. II. II. Instructions Instructions Instructions Instructions –––– Procedures for Achieving the ObjectiveProcedures for Achieving the ObjectiveProcedures for Achieving the ObjectiveProcedures for Achieving the Objective
You will explain and demonstrate the proper techniques for a bronchodilator with a
handheld metered dose inhaler. You will begin at my instruction to start. The skill will end when
you have completed all of the identified steps, and you tell me that you are finished. Do you
understand these instructions?
III. III. III. III. Examiner’s NoteExaminer’s NoteExaminer’s NoteExaminer’s Note
The EMT will not be allowed to review the performance steps at the time of evaluation.
IV. IV. IV. IV. Preparation & EquipmentPreparation & EquipmentPreparation & EquipmentPreparation & Equipment
A. Person to act as the patient
V. V. V. V. Reference SourcesReference SourcesReference SourcesReference Sources
A. TDSHS EMT Skills, Bronchodilator Administration-Handheld Metered Dose Inhaler.
B. TDSHS Criteria Sheet, TDSHS website.
C. Brady Prehospital, 7th edition, pages 106-108.
D. Brady Emergency Care, 9th edition, pages 122-126.
E. SOG 203.01A, SOG 203.01C.
PB 405.01E – Bronchodilator Administration/Handheld Metered Dose Inhaler Page 2 of 2
405.01E – Bronchodilator Administration: Handheld Metered Dose Inhaler
Discipline: EMT-BLS
Name:
Officer #:
Evaluator:
Officer #:
Date:
Location:
If the First Responder:
a) Avoids contamination of equipment or replaces contaminated equipment prior
to use ........................................................................................................................................................ 1.0_____
b) Confirms order (medication, dosage and route) ........................................................................ P/F_____
c) Informs patient of order for medication and inquires about allergies and recent
doses of other bronchodilators ......................................................................................................... 2.0_____
d) Selects correct medication from drug box as requested by Examiner ................................... P/F_____
e) Verbalizes check of medication for contamination and expiration date ............................... 1.0_____
f) Shakes the inhaler ................................................................................................................................. 1.0_____
g) Attaches spacer to inhaler, if ordered ............................................................................................. 1.0_____
h) Verbalizes recheck of the medication label ................................................................................... 1.0_____
i) Removes non-rebreather mask from patient. ................................................................................ 1.0_____
j) Verbalizes recheck of the medication label ................................................................................... 1.0_____
k) Performs steps a)-j) prior to step l) and performs at least one (1) recheck of the
medication label .................................................................................................................................. P/F_____
l) Instructs patient to exhale deep………………………………………………………….1.0_____
m) Instructs patient to put the mouthpiece in mouth and make a seal with lip ....................... 1.0 ____
n) Instructs patient to depress the inhaler canister while inhaling and then hold
breath as long as comfortable .......................................................................................................... 1.0_____
o) Replaces non-rebreather mask on patient ..................................................................................... 1.0_____
Time Allocation
Completes skill in allotted time ..................................................................................... P/F ____
Allotted time for this skill: 5 minutes 0 seconds
Actual time: _____ minutes _____ seconds
Points
Possible
Passing
Score
Attempt
Performance Rating
(Points)
PASS
FAIL
13
10
First
Second
Medical Director’s Initials DK Date 5/22/2015