Administration of Epinephrine



Administration of EpinephrineLesson Plan 1FIRE FIGHTER 1LESSON PLAN #1TOPIC:Administration of EpinephrineLEVEL:Emergency Medical Assistant Basic (EMT-B)TIME:15-20 MinutesBEHAVIORAL OBJECTIVES:PsychomotorAudience:EMT-BBehavior (Performance):Will administer a single dose of epinephrineCondition:Given a simulated patient, a single dose of Epinephrine (EpiPen? trainer), gloves, alcohol swabs, sharps containerDegree (Standard):Accomplish all 15 operational steps within 60 seconds as per __________ Emergency Medical Services Patient Care Guidelines for Basic Life SupportCognitiveAudience:EMT-BBehavior (Performance):will verify cognitive knowledge by successfully passing a written testCondition:Given a course study guideDegree (Standard):By achieving a minimum score of 80%REFERENCES:__________ Emergency Medical Services Patient Care Guidelines for Basic Life Support 2007MATERIALS NEEDED:One (1) EpiPen? for illustration purposesTwo (2) EpiPen? trainers for practiceOne (1) Sharps containerSix (6) Alcohol swabsOne (1) box of glovesOne (1) Communication tool (cell phone or radio)One (1) Simulated patientOne (1) Projectable mediaOne (1) Non-projectable mediaTwo (2) Sets of handoutsOne (1) Class rosterOne (1) Stop watchTwo (2) Manipulative Performance testsTwo (2) Cognitive testsOne (1) Answer Key for cognitive testPREPARATION (Step One):Consistent with House Bill 1317 passed by the 57th Legislature 2001, all EMTs will have preloaded epinephrine auto injectors (EpiPen? auto injector).The EMT may administer epinephrine to:Patients greater than 18 with prescriptionPatients less than 18 with patient, parental, or guardian providing written or oral consent/requestPatient greater than 18 and no previous prescription, or less than 18 and no patient, parent or guardian consent or request. Must call for permission from online Medical Control.Dosages:Adult (30 kg or 66 lbs and heavier):EpiPen? auto injector = 0.3 mgChild (under 30 kg or 66 lbs):EpiPen? auto injector = 0.15 mgAlways request paramedics because, in rare cases, a single dose of epinephrine may not be enough. The patient may continue to have hypotension, along with a decreasing level of consciousness, and/or increasing breathing difficulty. If the patient’s condition does not improve, consult online Medical Control about injection of a second dose.Safety Considerations:Rescuer shall wear proper PPE which includes gloves and eye protection. When administering the EpiPen? do not place your thumb over the end of the pen.PRESENTATION (Step 2):OPERATIONAL STEPSKEY POINTS1.Request Medic unit2.Explain procedure to patient3.Don personal protective equipment3a.Gloves and eye protection4.Check EpiPen? dose and match to patient’s size4a.0.3 mg for adults4b.0.15 mg for children5.Check EpiPen? expiration date6.Check for cloudiness and/or discoloration7.If exposed, wipe patient’s thigh with alcohol swab8.Remove safety GREY cap and locate injection site on lateral thigh9.Place BLACK tip of EpiPen? against patient’s thigh9a.Do not place thumb over the end of EpiPen?10.Push hard against patient’s thigh until EpiPen? activates10a.Note time of administration11.Hold EpiPen? in place for 10 seconds12.Remove EpiPen? and massage patient’s thigh for 10 seconds13.Dispose of EpiPen? into biohazard (sharps) container14.Reassure patient15.Update en-route Medic unitAPPLICATION (Step 3):Manipulative Performance TestEpiPen? Auto InjectorObjectiveAdminister a single dose of epinephrine within 60 sec. completing all 15 operational steps as per the Patient Care Guidelines for Basic Life SupportEMT’s NameDateInstructionsPoints possiblePoints achieved1.Request Medic unit12.Explain procedure to patient13.Don personal protective equipment (gloves & goggles)14.Check EpiPen? dose and match to patient’s size15.Check EpiPen? expiration date 16.Check EpiPen? for cloudiness and/or discoloration17.If exposed, wipe patient’s thigh with alcohol swab18.Remove safety GREY cap from EpiPen?19.Place BLACK tip of EpiPen? against patient’s (lateral) thigh110.Push hard against patient’s thigh until EpiPen? activates111.Hold EpiPen? in place for 10 seconds112.Remove EpiPen? and massage patient’s thigh for 10 seconds113.Dispose of EpiPen? into biohazard container114.Reassure patient115.Update en-route Medic unit1TOTAL SCORE15Start Time:Stop Time:Total Time:Comments:PASSFAILEvaluator’s Name & Signature:MANIPULATIVE PERFORMANCE TEST SHEETManipulative Performance TestEpiPen? Auto InjectorObjectiveAdminister a single dose of epinephrine within 60 sec. completing all 15 operational steps as per the Patient Care Guidelines for Basic Life SupportEMT’s NameDateInstructionsPoints possiblePoints achieved1.Request Medic unit12.Explain procedure to patient13.Don personal protective equipment (gloves & goggles)14.Check EpiPen? dose and match to patient’s size15.Check EpiPen? expiration date 16.Check EpiPen? for cloudiness and/or discoloration17.If exposed, wipe patient’s thigh with alcohol swab18.Remove safety GREY cap from EpiPen?19.Place BLACK tip of EpiPen? against patient’s (lateral) thigh110.Push hard against patient’s thigh until EpiPen? activates111.Hold EpiPen? in place for 10 seconds112.Remove EpiPen? and massage patient’s thigh for 10 seconds113.Dispose of EpiPen? into biohazard container114.Reassure patient115.Update en-route Medic unit1TOTAL SCORE15Start Time:Stop Time:Total Time:Comments:PASSFAILEvaluator’s Name & Signature:CLASS ROSTERSUBJECT:DATE:TIME:STUDENT LEVEL:INSTRUCTOR:RE/CERTIFICATION:LOCATION:NAME & SIGNATUREWRITTEN SCOREPRACTICAL PASS/FAIL12345678910SPECIAL NOTE: The instructor is responsible for ensuring that the class roster is complete and handed in to the Training Division by the end of the shift.EpiPen? AUTO-INJECTORCOGNITIVE TEST QUESTIONSEMT’S NAME:DATE:INSTRUCTIONS: Choose only one answer for each question.The correct dose of epiniphrine for the “adult” patient is:0.03 mg0.3 mg0.15 mg0.05 mgThe correct dosage of epinephrine for the “child” is:0.03 mg0.3 mg0.15 mg0.05 mgWhen shall a Medic be requested?Only when the patient becomes unconsciousBefore the EpiPen? is administeredOnly after the EpiPen? is admnisteredIt is not necessary if an EpiPen? is administeredThe EpiPen? Auto-Injector must be held against the patient’s lateral thigh for:5 seconds10 seconds15 seconds20 secondsFor the rescuer, the most important consideration is to:Check the EpiPen? Auto-Injector’s expiration dateCheck the EpiPen? Auto-Injector’s doseDo not hold injector with your thumb over the endDon personal protective equipment (gloves & goggles)Both a) and c)Both c) and d)EpiPen? AUTO-INJECTORCOGNITIVE TEST ANSWER KEYEMT’S NAME:DATE:INSTRUCTIONS: Choose only one answer for each question.The correct dose of epiniphrine for the “adult” patient is:0.03 mg0.3 mg0.15 mg0.05 mgThe correct dosage of epinephrine for the “child” is:0.03 mg0.3 mg0.15 mg0.05 mgWhen shall a Medic be requested?Only when the patient becomes unconsciousBefore the EpiPen? is administeredOnly after the EpiPen? is admnisteredIt is not necessary if an EpiPen? is administeredThe EpiPen? Auto-Injector must be held against the patient’s lateral thigh for:5 seconds10 seconds15 seconds20 secondsFor the rescuer, the most important consideration is to:Check the EpiPen? Auto-Injector’s expiration dateCheck the EpiPen? Auto-Injector’s doseDo not hold injector with your thumb over the endDon personal protective equipment (gloves & goggles)Both a) and c)Both c) and d) ................
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