Instructor$andStudentTemplates - jems.com · DynamicLearningExercise...

for the EMS Classroom

Assessment

Dynamic Learning Exercises Instructor and Student Templates

copyright 2015 Limmer Crea4ve, LLC • h8p://LimmerCrea4ve.com

Dear Educator,

This package contains four ac4ve learning pa4ent assessment exercises for you to use in your classroom. They include:

1. A simple, but insighIul exercise to help define components of the pa4ent assessment process. 2. A vital signs trending exercise. 3. An exercise that strengthens and provides relevance to medical pa4ent assessment. 4. An exercise that strengthens and provides relevance to trauma pa4ent assessment.

I personally created these exercises for use in my EMT classes. I have a core belief that ac4vi4es such as these are mul4pliers in the classroom. They mul4ply your student’s understanding. They mul4ply your reach and ability to teach concepts rather than facts. Perhaps most importantly, they place the student squarely in the role of “learner.”

I recognize that many educators worry that these “mul4pliers” take away from lecture 4me. While I can’t argue the way that 4me passes in class, I can assure that doing a bit less lecture and using these dynamic exercises is truly an investment. If you don’t currently use this type of exercise, please give it a try. If you use other ac4ve learning methods I hope these will fit into your classroom experience.

Wishing the best for you and your students,

Dan Limmer Founder, Limmer Crea4ve

http://LimmerCreative.com


Dynamic Learning Exercise

Pa1ent Assessment Scenario -‐ “One Sentence”


For each of the following parts of the pa4ent assessment process write one sentence that accurately describes the purpose of the part:

e.g. The scene size-‐up is where I would… –or— The scene size up is important because…

Scene Size-‐up

Primary Assessment

Secondary Assessment

Pa4ent History

Vital Signs

Reassessment

Instructor Notes:

This exercise is designed as an icebreaker or introduc4on to the pa4ent assessment process. Students should have done their reading or online coursework. This is a way to facilitate a wider discussion on assessment or set the stage for further exercises.

This may be done individually or in groups.

Time: Plan on about 20 minutes for the students to work and for a brief discussion by the educator.




Pa1ent Assessment Scenario -‐ “One Sentence”


For each of the following parts of the pa4ent assessment process write one sentence that accurately describes the purpose of the part:

e.g. The scene size-‐up is where I would… –or— The scene size up is important because…

Scene Size-‐up

Primary Assessment

Secondary Assessment

Pa4ent History

Vital Signs

Reassessment



2. Normal

P: 76 R: 12 BP: 116/68 Pupils: equal/react skin: warm/dry P: 80 R: 12 BP: 120/72 Pupils: equal/react skin: warm/dry P: 80 R: 14 BP: 120/70 Pupils: equal/react skin: warm/dry

3. Developing shock – note how the rising diastolic represents vasoconstricHon while the declining systolic is the cardiac output dropping; pulse and respiraHons increase. Skin becomes cool and moist.

P: 84 R: 16 BP: 124/64 Pupils: equal/react skin: warm/dry P: 92 R: 22 BP: 120/68 Pupils: equal react skin: cool/dry P: 108 R: 24 BP: 118/66 Pupils: equal/react skin: cool/moist

4. Increasing intracranial pressure -‐ classic trending paOern

P: 72 R: 14 BP: 140/86 Pupils: equal react skin: warm/dry P: 68 R: 18 BP: 152/88 Pupils equal/react skin warm/dry P: 56 R: 10 BP: 192/92 Pupils react/sluggish skin: cool/dry



There are four sets of vital sign trends below. They represent the following condiHons: • Developing shock • Head injury with increasing pressure on the brain • An uninjured paHent who was nervous (like aXer a car crash) and then calmed down. • Normal

For each set of vitals below, give the condiHon that the vitals most closely represent.

Vital Signs Trending Exercise

Instructor Notes: This is a relaHvely quick exercise to provide students the opportunity to idenHfy vital signs trends and realize the importance of mulHple sets of vital signs as opposed to a single set. Some subtleHes (noted below) can be called out to highlight the importance of accuracy and aOenHon to detail. This should take no more than 15 minutes including discussion.

1. Excited Calming down – if students think this is shock, note the skin color, temperature and condiHon.

P: 104 R: 24 BP: 138/86 Pupils: equal/react Skin: warm/dry P: 88 R: 16 BP: 120/76 Pupils: equal react Skin: warm/dry P: 86 R: 16 BP: 122/78 Pupils: equal react Skin: warm/dry

copyright 2015 Limmer CreaHve, LLC • hOp://LimmerCreaHve.com



2. ________________________________________________________________________

P: 76 R: 12 BP: 116/68 Pupils: equal/react skin: warm/dry P: 80 R: 12 BP: 120/72 Pupils: equal/react skin: warm/dry P: 80 R: 14 BP: 120/70 Pupils: equal/react skin: warm/dry

3. _________________________________________________________________________

P: 84 R: 16 BP: 124/64 Pupils: equal/react skin: warm/dry P: 92 R: 22 BP: 120/68 Pupils: equal react skin: cool/dry P: 108 R: 24 BP: 118/66 Pupils: equal/react skin: cool/moist

4. _________________________________________________________________________

P: 72 R: 14 BP: 140/86 Pupils: equal react skin: warm/dry P: 68 R: 18 BP: 152/88 Pupils equal/react skin warm/dry P: 56 R: 10 BP: 192/92 Pupils react/sluggish skin: cool/dry



There are four sets of vital sign trends below. They represent the following condiKons: • Developing shock • Head injury with increasing pressure on the brain • An uninjured paKent who was nervous (like aRer a car crash) and then calmed down. • Normal

For each set of vitals below, give the condiKon that the vitals most closely represent.

Vital Signs Trending Exercise

1. ________________________________________________________________________

P: 104 R: 24 BP: 138/86 Pupils: equal/react Skin: warm/dry P: 88 R: 16 BP: 120/76 Pupils: equal react Skin: warm/dry P: 86 R: 16 BP: 122/78 Pupils: equal react Skin: warm/dry

copyright 2015 Limmer CreaKve, LLC • hZp://LimmerCreaKve.com



You are called to the residence of a 67 year old man who complains of respiratory difficulty. You arrive at a safe scene to find the pa;ent si<ng in the tripod posi;on in a living room chair. He is only able to speak 3 – 4 words without catching his breath.

Using your textbook, Internet resources and reference books you have available, research each element of the pa;ent’s condi;on (below). Not all findings are found simultaneously in the pa;ent. Look at each one individually. Determine what each might mean to you as an EMT if you were called to care for the pa;ent.



Pa9ent Assessment Scenario: “I’m having trouble breathing”

Instructor Notes: The purpose of this scenario is to expand the student’s view into the rest of the course and provide context to the pa;ent assessment process. The students shouldn’t feel they have to understand every medical condi;on at this point. For example in the “fever” bullet below it would simply be enough for the student to say, “They probably have an infec;on.” You have an excellent opportunity to relate assessment to pa;ent care.

In most cases the educator will ask various students to answer. There are 19 points here. You may add more to match your class size if necessary. You may also choose to split the class into groups and assign some or all of the bullets below.

This is an important opportunity for the educator to expand on each point to provide insights into assessment and medical condi;ons. Avoid teaching medical emergency lectures during this exercise.

Students should use their books, any electronic or internet-‐enabled devices they have available to them. Be prepared to direct the students to reliable medical reference sites.

copyright 2015 Limmer Crea;ve, LLC • h`p://LimmerCrea;ve.com

• Fever • Abdominal ascites • Produc;ve cough with brown sputum • Dull substernal chest pain • Chest pain which can be reproduced with a

deep inspira;on • Sca`ered wheezes • Crackles bilaterally lower lobes • Capoten (medica;on) • Albuterol (medica;on) • Atrovent (medica;on) • Tripod posi;on

• Increasing to 3 pillow orthopnea over the past week

• Con;nuing to smoke • Atrial fibrilla;on • Pulse oximetry = 91 • 2 lpm oxygen at home via nasal cannula • His wife states he “almost died and they had to

put a tube down his throat” aeer a similar episode.

• Poor compliance with medica;on • Onset of this incident aeer considerable

exer;on





Pa9ent Assessment Scenario: “I’m having trouble breathing”


• Fever • Abdominal ascites • Produc4ve cough with brown sputum • Dull substernal chest pain • Chest pain which can be reproduced with a deep inspira4on • Sca8ered wheezes • Crackles bilaterally lower lobes • Capoten (medica4on) • Albuterol (medica4on) • Atrovent (medica4on) • Tripod posi4on • Increasing to 3 pillow orthopnea over the past week • Con4nuing to smoke • Atrial fibrilla4on • Pulse oximetry = 91 • 2 lpm oxygen at home via nasal cannula • His wife states he “almost died and they had to put a tube down his throat” aWer a similar episode. • Poor compliance with medica4on • Onset of this incident aWer considerable exer4on

You are called to the residence of a 67 year old man who complains of respiratory difficulty. You arrive at a safe scene to find the pa4ent si]ng in the tripod posi4on in a living room chair. He is only able to speak 3 – 4 words without catching his breath.

Using your textbook, Internet resources and reference books you have available, research each element of the pa4ent’s condi4on (below). Not all findings are found simultaneously in the pa4ent. Look at each one individually. Determine what each might mean to you as an EMT if you were called to care for the pa4ent.



You arrive on the scene of a rollover accident on the major highway that runs through your town. As you arrive bystanders run up to you and tell you how bad the crash is. The police officer nods his agreement as you head toward the pa=ent.

You find a female who appears to have been par=ally ejected from the car. The car is res=ng on her legs. She is moaning but doesn’t respond to you.

Using your textbook, Internet resources and reference books you have available, research each element of the pa=ent’s condi=on (below). Not all findings are found simultaneously in the pa=ent. Look at each one individually. Determine what each might mean to you as an EMT if you were called to care for the pa=ent.



Pa9ent Assessment Scenario: “It was a horrible crash!”

Instructor Notes: The purpose of this scenario is to expand the student’s view into the rest of the course and provide context to the pa=ent assessment process. The students shouldn’t feel they have to understand every trauma=c condi=on at this point. For example in the “clear fluid coming from the ear” bullet below it would simply be enough for the student to say, “They probably have a head injury.”

In most cases the educator will ask various students to answer. There are 18 points here. You may add more to match your class size if necessary. You may also choose to split the class into groups and assign some or all of the bullets below.

There is an important opportunity for the educator to expand on each point to provide insights into assessment and trauma=c condi=ons. Avoid teaching trauma lectures during this exercise.

Students should use their books, any electronic or internet-‐enabled devices they have available to them. Be prepared to direct the students to reliable medical reference sites.

copyright 2015 Limmer Crea=ve, LLC • h[p://LimmerCrea=ve.com

• Narrow pulse pressure • Lung sounds absent on one side • Rapid pulse • She moans louder when you palpate her neck. • Rapid respira=ons • The vehicle le_ the road and is quite a ways

into the woods. • Clear fluid coming from her ear • Gurgling in her airway • Crackles bilaterally lower lobes • A second pa=ent who was ejected and was

found about 30 feet from the car.

• A sec=on of the chest wall that seems to be moving opposite the rest of the chest.

• Snoring coming from her airway • Very slow pulse • A smell of an alcoholic beverage on the

pa=ent’s breath • The pa=ent’s legs pinned under the car • Ejec=on from the vehicle • The pa=ent is elderly • The vehicle isn’t stable





Pa9ent Assessment Scenario: “It was a horrible crash!”


• Narrow pulse pressure • Lung sounds absent on one side • Rapid pulse • She moans louder when you palpate her neck. • Rapid respira4ons • The vehicle leH the road and is quite a ways into the woods. • Clear fluid coming from her ear • Gurgling in her airway • Crackles bilaterally lower lobes • A second pa4ent who was ejected and was found about 30 feet from the car. • A sec4on of the chest wall that seems to be moving opposite the rest of the chest. • Snoring coming from her airway • Very slow pulse • A smell of an alcoholic beverage on the pa4ent’s breath • The pa4ent’s legs pinned under the car • Ejec4on from the vehicle

You arrive on the scene of a rollover accident on the major highway that runs through your town. As you arrive bystanders run up to you and tell you how bad the crash is. The police officer nods his agreement as you head toward the pa4ent.

You find a female who appears to have been par4ally ejected from the car. The car is res4ng on her legs. She is moaning but doesn’t respond to you.

Using your textbook, Internet resources and reference books you have available, research each element of the pa4ent’s condi4on and scene (below). Not all findings are found simultaneously in the pa4ent. Look at each one individually. Determine what each might mean to you as an EMT if you were called to care for the pa4ent.




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Instructor$andStudentTemplates - jems.com · DynamicLearningExercise...

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