HomeMy WebLinkAboutPB 405.01F REVISED 5-2015_NebulizerPPPEEERRRFFFOOORRRMMMAAANNNCCCEEE BBBEEENNNCCCHHHMMMAAARRRKKKSSS
405.01F405.01F405.01F405.01F ---- Bronchodilator AdministrationBronchodilator AdministrationBronchodilator AdministrationBronchodilator Administration: : : : NebulizerNebulizerNebulizerNebulizer
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 nebulizer 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 using a
nebulizer. 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
B. Watch or clock which displays seconds
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 405.01F – Bronchodilator Administration-Nebulizer Page 2 of 2
405.01F – Bronchodilator Administration: Nebulizer
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) Adds appropriate volume of medication to nebulizer ................................................................ 1.0_____
g) Assembles nebulizer to protocol and connects to oxygen ......................................................... 2.0_____
h) Verbalizes recheck of the medication label ................................................................................... 1.0_____
i) Adjusts oxygen liter flow to allow mist to flow ............................................................................... 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) 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
11
8
First
Second
Medical Director’s Initials DK Date 5/22/2015