New York State Department of Health Emergency Medical Technician - Basic Curriculum
Aspirin Administration by Emergency Medical Technicians HISTORY
The New York State Emergency Medial Advisory Committee and the New York State Department of Health have approved Emergency Medical Technician – Basics (EMT-B) to administer aspirin to those patients who are classified as “cardiac related” patients. The American Heart Association 2005 Guidelines have stated that prehospital providers should administer aspirin to those patients who may be suffering from an acute coronary syndrome. CHANGES The New York State EMT-B Basic Life Support Protocols have been updated to reflect this change. In particular the “Adult Cardiac Related Problem” protocol, M-5 has been updated and is available from our web site. The NYS EMT-B Original Curriculum has been updated to reflect the change as well. In particular module 4-3 “Cardiac Emergencies” has been updated. The updated curriculum is available from out web site at: http://www.health.state.ny.us/nysdoh/ems/basic.htm.
IMPLEMENTATION
Course Sponsors – The use of the updated EMT-B module 4-3 will start immediately upon receipt of the updated module and training of instructor staff has been completed. This training will occur in all original certification courses as well as all recertification courses. Agencies – It is strongly encouraged by the Bureau of EMS that a NYS Certified Instructor Coordinator or Certified Lab Instructor complete the in-service training of all NYS certified personnel at the EMT-B level and above. If a CIC or CLI is not available, the agency training officer can conduct the training with approval from the agencies Medical Director. When an agency conducts this in-service training there must be documentation kept on- file at the agency. This documentation must include, but not limited to:
• Sign-in and sign-out attendance records. • Copies of all educational materials used for the purpose of this
• Copies of all evaluation tools used for each provider who completed
the training. Evaluation tools must be approved by the agency Medical Director before they are used.
Training – The updated NYS EMT-B curriculum module, NYS BLS Protocol and a practical skills evaluation form have been provided for your convenience and to assure uniformity in training across the state. Please assure that all copies of the EMT-B curriculum and protocol are replaced with these updated versions. Once a provider has received this training they must be evaluated for both written and skill comprehension. Training should include all objectives from EMT-B module 4-3. This will include an overall review of unchanged objectives/content and a complete thorough instruction of the new objectives/content. NEW YORK STATE DEPARTMENT OF HEALTH Practical Bureau of Emergency Medical Services Evaluation ASPIRIN ADMINISTRATION INSTRUCTIONS TO THE STUDENT/INSTRUCTOR
This station is designed to test the student’s ability to manage a prehospital patient complaining of chest pain who requires administration of aspirin. As you arrive on the scene, you encounter a patient who is complaining of chest pain/discomfort. You have completed your initial assessment as well as obtained a complete set of vital signs. You may use any of the supplies available in this room. You have 3 minutes to complete this skill station. Do you have any questions?
Bureau of Emergency Medical Services Practical Skills Evaluation – Emergency Medical Technician - Basic Emergency Medical Technician - Basic NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Emergency Medical Services Skill Assessment Administration Comments Verbalizes indications and contraindications for use of aspirin Takes or verbalizes, body substance isolation precautions
Properly explains to patient the need for the medication and obtains patient’s
States the correct milligrams per tablet
States correct dosage for patient
Verifies patient will be able to safely ingest the medication
Explains medication administration procedure to the patient
Gives medication to patient and instructs patient to chew the medication
Re-assess patient for any changes & assures no immediate adverse reactions
Verbalizes documentation procedure including time of administration
Candidate completed station within 3 minute time limit Note: Candidate must complete all critical criteria and receive at least 6 points to pass this station. Total to pass: 6 COMMENTS:
Bureau of Emergency Medical Services Practical Skills Evaluation – Emergency Medical Technician - Basic Adult Cardiac Related Problem Request Advanced Life Support if available. Do not delay transport to the appropriate hospital. Be prepared to deal with respiratory and/or cardiac arrest!
Assure that the patient’s airway is open and that breathing and circulation are adequate.
Place the patient in a position of comfort, while reassuring the patient and loosening tight or restrictive clothing.
Ongoing assessment. Obtain and record the patient’s vital signs, repeat enroute as often as the situation indicates.
If patient has not taken aspirin and has no history of aspirin allergy and no evidence of recent gastrointestinal bleeding, administer nonenteric chewable aspirin (160 to 325 mg).
VII. If chest pain is present and if the patient possesses nitroglycerin prescribed by his/her physician and has a systolic blood pressure of 120mm Hg or greater, the EMT-B may assist the patient in self-administration of the patient’s prescribed sublingual nitroglycerin as indicated on the medicine container.
A. In the absence of standing orders for nitroglycerin, contact medical control
for authorization to administer the nitroglycerin.
B. Confirm the systolic blood pressure is 120mm Hg or greater.
C. Question patient on last dose administration of nitroglycerin, effects, and
assure understanding of route and administration.
D. Administer one (1) metered dose of nitroglycerin spray or one (1)
nitroglycerin tablet under the patient’s tongue without swallowing and record the time of the administration.
NYS EMT-B Basic Life Support Protocols UPDATED 1/18/07 M – 5 Page
E. Recheck blood pressure within two (2) minutes of administration and
record any changes in the patient’s condition.
Record all patient care information, including the patient’s medical history and all
treatment provided, on a Prehospital Care Report (PCR).
NYS EMT-B Basic Life Support Protocols UPDATED 1/18/07 M – 5 Page Adult Cardiac Related Problem, continued NYS EMT-B Basic Life Support Protocols UPDATED 1/18/07 M – 5
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