HomeMy WebLinkAboutPB 405.01L REVISED 5-2015_Oral GlucosePPPEEERRRFFFOOORRRMMMAAANNNCCCEEE BBBEEENNNCCCHHHMMMAAARRRKKKSSS
404040405.01L 5.01L 5.01L 5.01L ---- Oral GlucoseOral GlucoseOral GlucoseOral Glucose
Anne Huff, Fire Chief
Beaumont Fire-Rescue Services
Discipline:Discipline:Discipline:Discipline: EMTEMTEMTEMT----BLSBLSBLSBLS
Effective:Effective:Effective:Effective: 9/16/20099/16/20099/16/20099/16/2009
Revised:Revised:Revised:Revised: 5/22/20155/22/20155/22/20155/22/2015
Replaces:Replaces:Replaces:Replaces:
I. I. I. I. ObjectiveObjectiveObjectiveObjective
The EMT shall show proper administration of oral glucose.
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 oral glucose administration.
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. Oral glucose
B. Manikin
C. Watch or clock which displays seconds
V. V. V. V. Reference SourcesReference SourcesReference SourcesReference Sources
A. Brady Prehospital, 7th edition, pages 357-360.
B. AAOS, 8th edition, pages 411. [*NOTE: tongue depressor removed for benchmark]
C. SOG 203.01A, SOG 203.01G.
PB 405.01L – Oral Glucose Page 2 of 2
405.01L – Oral Glucose
Discipline: EMT-BLS
Name: Officer #:
Evaluator: Officer #:
Date: Location:
If the First Responder: (No partial points given)
a) BSI & Safety ........................................................................................................................... P/F_____
b) Avoids contamination of equipment or replaces contaminated equipment
prior to use ............................................................................................................................ P/F_____
c) Confirms order (medication, dosage and route) ........................................................ P/F_____
d) Informs patient of order for medication and inquires about allergies ...................2.0 _____
e) Selects correct medication from drug box as requested by Examiner ................... P/F_____
f) Verbalizes check of medication for contamination and expiration date ...............1.0 _____
g) Informs patient of procedure of oral glucose ...............................................................1.0 _____
h) Places the tip of tube against the oral mucosa* and give medication...................1.0 _____
i) Removes tube* and monitors airway ...............................................................................2.0 _____
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
7
5
First
Second
Medical Director’s Initials DK Date 5/22/2015