by Dr Michael A. Prytula ND

Emergency Procedures Course Objectives:

-To educate and prepare Doctors and Medical staff for the worst case IV and injection situation so that in all other IV and injection situations the doctor and staff will have the utmost confidence in dealing with them.

-To develop confidence in doing IV and injection therapies.

-To educate and role play IV and injection worst case scenarios in an IV and injection room setting.

-Emergency supplies- what you absolutely need and where to get it, plus familiarization and application.

-The emergency chart (for your crash cart): familiarization and application.

Format:

The course is taught with the intention of maximizing learning by first using Lecture Format with audio visual aids and then Behavior Modeling, Case Studies with discussions, Role Playing and Action Learning. In every course we emphasize hands on learning and try to maximize the attendees time with the therapies. We provide quick reference charts to make Dr’s more efficient and effective in their IV and injection suite. I don’t just want knowledgeable Doctors, I want effective, efficient, safe, and successful Doctors.

Lecture:

 including the use of overhead and projector with powerpoint presentations.

Learning Aids:

 The Emergency Procedures Chart (double sided and laminated with emergency conditions in red and non-life threatening situations in orange).

Action Learning and Role Playing Practicum: Role Playing (hands on with emergency equipment).

Discussion and questions.

NaturoMedic’s courses are all designed to give maximum amount of information in a most effective way and to get the practitioner safely using the information with hands on experience as soon as possible.

Textbooks:

Comprehensive class notes.

The Program:

Emergency Procedures Course, Day 1 is spent discussing the emergency crash cart; the contents of the crash cart are placed at each table allowing each attendee to get hands on experience. We then review the Emergency Procedures Chart (11X17” double sided laminated chart), which is to be attached to the Emergency Crash Cart. All attendees get their own copy of the Emergency Procedures Chart. All tables have oxygen tanks with appropriate regulators, IV poles with normal saline bags and tubing, and each attendee has their own oxygen mask. We start role playing after we go over the “golden rules”. An IV line with a plastic bag is attached (no IV access) to the patient’s arm, then each attendee takes turns applying the golden rules by maintaining the IV flow, taking vitals, Trendelenburg position, applying oxygen by mask and more. Attendees are also expected to ask questions while taking vitals. Exposure to defibrillation equipment is also provided.

Remainder of Day 1 is spent on going through the IV Rules for patients in regards to acute conditions, emphasizing signs and symptoms, immediate actions, rationale and then possible nursing/doctor action for long term workup if necessary.

Day 2 finishes the section on acute conditions, followed by work on medications and their contraindications. Role playing is assigned for the rest of the afternoon with one doctor being the patient, another being the Dr and others just watching. We have forty plus worst case scenarios that attendees can work through. Health Canada’s definition of drug and how that pertains to the Doctor as well as NAPRAs drug regulation standards are also reviewed. Day two’s afternoon is finished with more role playing, followed by a survey.

New additions to the course include: AED useage, 
pulse oximeter useage, injection therapies situations (prolotherapy, neural, trigger point and mesotherapy) also picc and port access problems.

Day 1

9:00-9:30 Introductions and Seminar Purpose

9:30-9:45 Why IV protocols and How We Learn!

9:45-10:00 Golden Rules and some IV rules.

10:00-10:30 Practicum #1: Practice golden rules by taking and recording vitals, questioning patient, placing patient in Trendelenburg position, Administer O2 with mask or nasal cannula (must turn on O2 tank and administer oxygen at designated flow rate), hang piggy back 500ml D5W. Defibrillation equipment explanation and useage.

10:30-10:45 Review IV rules for patients, as the Best Prevention is a good education.

For all disorders we will cover: signs and symptoms, actions immediate, rationale, and actions long term.

10:45-12:00 Hypoglycemia and Insulin shock, Hypocalcemia, Seizures, Allergy, Nephrotoxicity, renal toxic reaction and Renal Failure.

12:00- 12:30 Practicum #2: Emergency crash carts (contents) familiarization (hands on open up contents and see how they work) and contraindications.

12:30-1:00 Practicum #3: Role Playing (1 moderator, 1 actor, 1 doctor) with all emergency equipment.

Moderator tells patient (actor) what symptoms to act out from the NaturoMedic master role playing program and tells the doctor what they are finding when they go to investigate. Moderator tells the actor what symptoms to act out to simulate deteriorating scenario. All patients have an IV bag and are taped like they are connected up but really are not.

1:00-2:00 Lunch

2:00-4:00 Hypotension, Congestive Heart Failure, Arrhythmia, Angina, Heart Attack and Asystole, Stroke, Shock, Choking, and CPR reminder.

4:00-5:00 Practicum#4: Role Playing (as above)

5:00-5:30 Discussion #1

Day 2

9:00-9:15 Discussion #2Review and discuss previous day

9:15-9:30 contraindications to the application of emergency crash cart contents

9:30-11:00 Catheter embolism, air embolism, speed shock, circulatory overload and pulmonary edema, pneumothorax and lung puncture, Septicemia, Vasovagal. DDX for symptoms of chest pain, tachycardia, shortness of breath, and altered mental status.

11:00-12:30 Practicum#5: Role Playing (as above).

12:30-1:00 Discussion #3Emergency protocol for dealing with emergencies.

1:00-2:00 Lunch

2:00-3:00 Anticoagulants, Bleeding disorders, Epistaxis, Local Irritation, Infiltration, Extravasation, Thrombophlebitis, Asthma.

3:00-3:30 Practicum #6: RolePlaying (as above)

3:30-4:00 Eczema and Joint pain/ fever, Headaches/ Nausea, Excessive fatigue/ weakness,Haematuria, Dehyration, overmedicated, overdoseage.

4:00-5:00 Practicum #7: Role Playing (as above)

5:00-5:30 Discussion #4: Incident report and interactions with 911 personnel

Course Evaluation

Exam: None at this point