EMERGENCY! Essential Questin: Wh D Yu Call? Learning Targets: I can: Objectively summarize infrmatinal text. Use evidence frm infrmatinal texts t supprt my claims. Deliver an effective ral argument. Use subjective and bjective infrmatin t make sense f an emergency situatin. Lessn Overview Be prepared fr an emergency! In this lessn, the students take a first persn rle as a Level I Emergency Medical Technician first respnder. An adlescent has an accident skatebarding while at a day camp. A junir cunselr calls the camp directr, a trained Level I EMT, wh respnds t the call and delivers the initial care t the victim. Students encunter the prcess f differential diagnsis and are required t write and summarize a medical reprt in the frm f the D-Chart, a standard frmat in the medical prfessin. Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 1
Lessn Agenda Opening (15 min) Wrk Time (45 min) Clsure (5 min) Health Science Bing (10 min) Emergency! (5 min) The First Respnder (5 min) Making Observatins (20 min) Emergency Simulatin: D-CHART (20 min) Patient Transfer f Care Materials Prjectr Skatebard accident vide Script f the Emergency Scenari (ne per student) D-CHART Patient Assessment Frm (ne per student) D-CHART Patient Assessment Frm (fr teacher reference) FACILITATION NOTES Vide Alert. This lessn cntains sme mildly graphic imagery f a skatebard accident victim. Be aware f negative student reactins t media and prvide a verbal warning pre-vide. Narrative Arc. This lessn and thers in the unit take advantage f the first persn narrative strytelling style. Yu may chse t have students read each narrative independently with accmpanying warm-up questins, engage in a think-pair-share, r act ut the scene. Use yur creativity t craft an engaging pening sequence with the scenaris, and plan ahead fr each enactment. If yu can invite a first respnder r EMT t play a rle in this lessn s enactment, d s; but be careful nt t mdel the incrrect respnse if yu are nt a trained first respnder. Yu may als cnsider inviting a Red Crss vlunteer t teach First Aid/CPR t the class. System fr Organizing Student Wrk. The Yung Allied Health Prfessinals will have many handuts, anntated readings, and prcessed wrk with this mdule. In advance, determine hw yu will supprt them in cnsistently keeping their wrk rganized. https://vime.cm/channels/managementactiveclass/124448650 ffers a brief verview. IN ADVANCE Have vlunteer patient be ready fr the simulatin in make-up and attitude they shuld be prepared t act wunded. Yu shuld be ready t enact the narrative emergency Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 2
scenari. Yu may even have tls available t take his r her bld pressure r ther vital signs. Be prepared with the technlgy required t prject the vide: The Skatebard Accident Vide can be fund at https://www.yutube.cm/watch?v=ctexkhknqgk. Vcabulary Cntent diabetic episde, insulin shck, hypglycemia, laceratin, aspirate, acrnym Tier II summary, summarize, episde, bservatin, numerical, standardizatin, subjective, bjective Opening (15 min) Health Science Bing (10 min) Say: Gd afternn yung prfessinals! Did I just call yu a yung prfessinal? Yes! In this class yu will take n the rles f different health science prfessinals n the jb frm the scene f an emergency t the perating theater as yu fllw yur patient frm health t recvery. Yu will learn what different allied health wrkers d, and d sme wrk yurself. Yu will even get t practice suturing, r giving stitches, but yur patient wn't be human. Fr nw, let s take a mment t get t knw each ther and learn a little abut each ther. In tday s handut, yu have a <Health Science Bing> game. In a mment, yu will: 1. Walk arund the rm and intrduce yurself t a new persn. 2. Ask if any f the bxes apply t them. a. Ask the questin and listen t their answer. 2. Have yur partner write their name n yur sheet. 3. Next, yu will share smething abut yurself and sign their sheet. 4. Finally, yu will shake hands and say Thank yu, (name) and they will say Thank yu, (name). Mdel this with a vlunteer, keeping yur answer shrt but interesting. Remember the final shake, thank yu, and repeat f the name. Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 3
Hand ut the day s packet, inviting the YP t turn t the Human Bing page. Debrief. As yung allied health prfessinals, we need t knw ur teammates and have sme clear nrms fr hw we will functin as a grup. If things were chatic at a hspital, culd yu imagine hw that wuld affect patients? Use equity sticks t slicit respnses. Emergency! (5 min) Yu are the directr f a summer day camp. As part f yur training t wrk with children, yu became a certified first respnder. In the middle f yur mrning ffice wrk as children are arriving fr the day, yu receive a phne call frm a junir cunselr. She reprts that a 13- year-ld male camper is uncnscius and bleeding n the sidewalk in frnt f the cmmunity center building. Yu leave yur ffice at a run. Share <Emergency Scenari: First Respnse>. 1. Have the yung prfessinals clse their eyes. 2. Ask: What scenaris are yu seeing when yu picture the scene prvided by the junir cunselr? What might have happened frm wrst case t best case scenari? Prvide adequate wait time fr the yung prfessinals. Invite the yung prfessinals t turn t a clleague and pair-share their ideas. Call n vlunteers t give their imagined scenaris fr the victim. Capture their ideas n an anchr chart r n the bard. 3. If they d nt include the fllwing example, tell the yung prfessinals that a scenari yu imagine is that the persn is experiencing a diabetic episde, als knwn as insulin shck r hypglycemia, due t lw bld glucse (i.e., sugar). In this pssible scenari, they are bleeding after hitting their head after lsing cnsciusness. Wrk Time The First Respnder (5 min) As a first respnder t emergency events, figuring ut what is wrng with a patient is like slving a mystery. Yu cllect data like clues t help yu narrw dwn what is happening t the victim. This begins with the emergency call. Yu imagine every pssible reasn fr the general symptms listed in the call frm wrst case t best case scenari. As yu run t the incident, yur mind cycles thrugh all the pssibilities: what culd be wrng with the patient? By Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 4
answering this questin, yu are trying t figure ut what happened t the patient t give him/her the best care. Reveal the patient, with makeup t reflect the wunds frm the <Emergency Scenari>. The patient makes an appearance with a skatebard (can be a cardbard cutut r paper that reads skatebard ). At first, the patient can man in pain. After that the patient shuld becme uncnscius and shuld nt respnd t any questins. Ask students questins such as the fllwing examples: What d yu ntice abut the patient? Are there any new clues nw that we are n the scene? What shuld I d first? Next? Hw d yu knw? Listen fr: a skatebard is lcated near the accident victim. Check t see if they are breathing r bleeding. Stabilize their neck. Make sure the scene is safe. Making Observatins (20 min) 1. Ask the YP s: The skatebard is a clue abut what has happened. In a first respnder s mind, they wrk thrugh the list f pssibilities. What scenaris are mre likely based n this clue? Which nes are less likely? Mark thrugh any scenaris n the chart paper that have been eliminated. 2. Explain t the yung prfessinals that the initial assessment by first respnders cmbines subjective with bjective data. Subjective data is based n what smene tells us. Fr example, smene saying his legs hurts is subjective data. Objective data is smething yu can bserve r make an bservatin abut: he has a fur-inch laceratin, r cut, n his leg. Objective data ften can be measured: an increase in temperature, lw bld pressure, a tumr, r a fur-inch laceratin. 3. Ask the YP s: What is an bservatin? Invite vlunteers t answer the questin. Listen fr: An bservatin is when yu directly hear r see smething. 4. Prject the <Skatebard Accident Vide>: https://www.yutube.cm/watch?v=ctexkhknqgk. Ask: What injuries might yu expect smene t have wh just crashed n a skatebard? 5. Since ur patient is uncnscius, we will have t lk fr bjective data. Ask the yung prfessinals t turn t a partner and share what they bserve abut the patient. Have students cmplete the <Subjective-Objective Observatins T-Chart> in their student packets. Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 5
Use equity sticks t slicit examples f bjective bservatins. List bservatins n the bard. 6. Ask the YP s: What if ur patient is cnscius after their accident? Hw can we cllect mre data abut ur patient? Listen fr: Yu can ask them questins r talk t them 7 Write n the bard the acrnym SAMPLE (Symptms, Allergies, Medicatins, Patient Histry, Last In/Out & Event) Pass ut the wrksheet fr students t fill ut what each letter represents in the acrnym SAMPLE Emergency Simulatin (20 min) Yu will nw use yur bservatins t help yu write a reprt f yur initial encunter with the patient. While the paramedics give mre advanced treatment t the victim and prepare him fr transprt in an ambulance, yu sit and write yur reprt. 1. Explain: even first respnders must cmmunicate their bservatins, findings, actins, and any ther data t the prviders at the next level f care fr the emergency victim. 2. Inquire: Why wuld it be imprtant t take and pass n ntes? 3. Say: The way these ntes are written is standardized, meaning that they fllw a frm that everyne in emergency services fllws. The frmat emergency ntes take generally fllws the acrnym D-CHART. An acrnym is when each letter in a wrd is the beginning letter f a related wrd. An example f an acrnym is LOL, r laugh ut lud. Acrnyms als help us remember: ROY G. BIV is used t remember the rder f the clrs in a rainbw. Ask: What acrnyms d yu use? If we think abut reprting frm the scene f an emergency, what might the acrnym D-CHART stand fr? Write: D-CHART dwn the bard. 4. Take a few suggestins fr what each letter might stand fr in the acrnym t activate backgrund knwledge. Distribute the <Patient Assessment Frm>. 5. Invite the yung prfessinals t wrk with a clleague t try t cmplete the D-CHART ntes fr the clinic recrds. 6. Tell the yung prfessinals that they can re-read the script and use their bservatins t help them write the patient assessment ntes. Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 6
7. Circulate and assist pairs as necessary. Refer t the Patient Assessment Frm fr teacher reference if needed. 8. When pairs have cmpleted the frm, ask the yung prfessinals: Which parts f the D-CHART reprt are subjective and which are bjective? Hw d yu knw? 9. Invite pairs t discuss the sectins f the reprt t prepare their respnse t the questins. 10. Use equity sticks t cld call n pairs t prvide answers. Clsure (5 min) Patient Transfer f Care: Rle Play Yu are nw ready t cmplete the transfer f the patient t the Emergency Medical Technicians aka the EMTs. The final step in the prcess is t talk t the EMTs abut the case and the actins yu tk t supprt the accident victim, essentially summarizing yur written D- CHART reprt. 1. Ask: What des it mean t prvide a summary fr r t summarize the reprt? Invite vlunteers t answer the questin. Listen fr: Prviding the main pints f the reprt. 2. Explain that they are t chse a clleague. One persn will be the certified first respnder and the ther will be the EMT. 3. Tell the yung prfessinals that they will have tw minutes t rle play the transfer f the patient by prviding the EMT with a verbal summary f the case. 4. When the pairs have finished the patient transfer rle play, ask the yung prfessinals t respnd using the Thumb-O-Meter. Thumbs up indicates that the summary was very clear and thumbs dwn indicates that the summary was hard t understand and they can als chse in between. If yu were the EMT, hw easy was it t understand the summary f the patient s case? Did yu understand the scene f the accident? Was it clear what supprt the first respnder prvided? If yu were the first respnder, hw clear was yur summary? What parts needed mre wrk? If this was difficult, dn t wrry. Certified First Respnders and EMTs g thrugh many hurs f training t assess accident scenes, understand cmmn medical emergencies, and practice apprpriate treatments. If yu like cnstant excitement, can handle the pressure f life and death, and can stand the sight f bld, the First Respnders f the allied health prfessins Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 7
might be an interesting career chice. EMT s, paramedics, and emergency rm nurses and dctrs are ften the first link int the health system fr thse experiencing a critical incident r accident. If yu have gd judgment under pressure and the ability t respnd in a crisis, as well as the patience t learn new skills, these careers might be f interest t yu. Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 8
Name: Date: EMERGENCY! Wh D Yu Call? Tday s Learning Objectives: I can: Objectively summarize infrmatinal text. Use evidence frm infrmatinal texts t supprt my claims. Deliver an effective ral argument. Use subjective and bjective infrmatin t make sense f an emergency situatin. Be prepared fr an emergency! In this lessn, I will take a first persn rle as a Level I Emergency Medical Technician first respnder. An adlescent has an accident skatebarding while at a day camp. A junir cunselr calls the camp directr, a trained Level I EMT, wh respnds t the call and delivers the initial care t the victim. I will encunter the prcess f differential diagnsis and will be required t write and summarize a medical reprt in the frm f the D-Chart, a standard frmat in the medical prfessin. Tday s Activities: Health Science Bing Emergency Scenari Making Observatins Patient Assessment: D-CHART Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 9
Health Science BINGO! Find a yung prfessinal wh... Had brken a bne. Ask: What did yu break and hw did it happen? Has had an X-ray. Ask: What did yu have X-rayed? Has a friend r family member that wrks in a hspital. Ask: What d they d? Wants t wrk in the health sciences? Ask: What d yu want t d? Rides a skatebard. Ask: What is yur favrite trick? Has had stiches. Ask: Hw many stitches did yu get and why? Has seen the medical TV shw Grey s Anatmy? Ask: What is realistic abut medical TV shws? Has ridden in an ambulance. Ask: Hw ld were yu? Has a favrite TV shw set in a hspital. Ask: What is the shw and why d yu lik e it? Is nt afraid f bld. Ask: Hw wuld this help yu as an EMT, nurse r dctr? Has had a tth kncked lse r ut? Ask: What happened? Has been hurt playing a sprt. Ask: What sprt were yu playing? Knws their bld type. Ask: What type are yu? Has visited smene in the hspital. Ask: What medical prfessinals did yu see there? Has had bld drawn. Ask: Did yu lk? Has been helped by a medical prfessinal (dctr, nurse, EMT, etc.) Ask: What did they d t make yu feel cmfrtable? Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 10
Emergency Scenari: First Respnse Yu arrive n the scene t find the uncnscius, bleeding bdy f the accident victim surrunded by the junir cunselr and bystanders. Yu survey the crwd t determine that the scene is safe and that there is nly ne victim. Next, yu put n latex glves and begin t inspect the patient fr immediate threats t his life by assessing his ABCs: airway, breathing, and circulatin. The cunselr tells yu that the victim was skatebarding at a high speed when he tried t jump a railing and crashed; she reprts that she already called 911. Even as yu survey the victim s injuries and try t bring him t cnsciusness by tuching his shulder, he remains uncnscius. Yu nte that he is breathing nrmally but he has sustained a severe facial laceratin, a deep cut in the skin. The laceratin extends frm the side f his nse thrugh bth f his lips, expsing bne and teeth. Yu begin t wrk t stp the bleeding. After caring fr the victim s face, yu request that the junir cunselr hld his neck t stabilize his C-spine a vertebra in the neck. This helps prevent spinal injuries when yu turn him n his side a practice used s patients d nt aspirate, r inhale vmit. Yu then cllect data n his vital signs. During the curse f yur assessment, yu als identify that the victim has a brken arm. Yu prceed t splint his arm, as yu wait fr the ambulance t arrive. Yu place a blanket ver the victim and pat his shulder, saying, Yu re ding fine. Everything will be OK. Yu check his pulse again and his heart rate has decreased. The City Emergency ambulance arrives and yu transfer the victim s care t the Emergency Medical Technicians the EMTs. Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 11
Subjective-Objective Observatins T-Chart Subjective Observatins Objective Observatins Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 12
Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 13
The D-CHART Patient Assessment Frm D Dispatch What was reprted t yu in the emergency call? What inf were yu given? C Chief Cmplaint What des the patient say is his r her chief cmplaint? If there is n infrmatin, make yur best guess. H Histry Histry includes the patient s age, sex, hw the injury happened, any allergies and medicatins being taken, and ther medical histry. Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 14
A Assessment Include a statement abut hw and where yu find the patient upn yur arrival. Include results frm the primary survey (ABCDE): Share results frm the secndary survey (head-t-te exam) R Treatment (Rx) Describe all treatments and interventins dne in the field. T Transprt Describe hw the patient was transferred and t what lcatin. Recrd time and patient status. Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 15
Facilitatin Dcuments: The D-CHART Patient Assessment Frm fr Teacher Reference D Dispatch (Subjective- based n what dispatch heard frm smene else.) What was reprted t yu in the emergency call? The junir cunselr cmmunicated that a 13-year-ld male camper was uncnscius and bleeding. He was lcated utside the cmmunity building lying n a sidewalk. C Chief Cmplaint (Subjective- based n the pinin f the patient.) What des the patient say is his r her chief cmplaint? The patient is uncnscius and des nt cmmunicate a cmplaint. H Histry (Subjective- based n being cmmunicated by the patient r thers at the scene nt directly bservable). Histry includes the patient s age, sex, hw the injury happened, any allergies and medicatins being taken, and ther medical histry. The patient is a 13-year-ld male. He sustained injuries while skatebarding at high speed and jumping a railing. A Assessment (Objective- based n data cllected with instruments.) Level f Respnsiveness Heart Rate Respiratry Rate Skin Clr Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 16
Bld Pressure Pupil Respnse Temperature R Treatment (Rx) (Objective- based n it being what yu actually did fr the patient.) Describe everything yu did t treat the patient in the field. In the field, the patient s bleeding frm his facial laceratin was cntrlled. His arm was splinted and his spine stabilized. He was prvided a blanket and wrds f cmfrt and his heart rate decreased in respnse. He was prepared fr transfer f care t the EMTs. T Transprt (Objective- based n it being what yu actually did fr the patient.) Describe hw the patient was transferred and t what lcatin. The patient was transferred t the City Emergency Ambulance service EMTs. Health Sciences Mdule: Emergency Pathways t Prsperity Netwrk 17