Key Takeaways
- Patient education should be provided at the patient's level of understanding using clear, non-technical language
- The teach-back method (asking patients to repeat instructions in their own words) confirms understanding
- CPR for adults: 30 compressions to 2 breaths at a rate of 100-120 compressions per minute, depth of at least 2 inches
- AED should be applied as soon as available; follow voice prompts for analysis and shock delivery
- Signs of shock include pale/cool/clammy skin, rapid weak pulse, low blood pressure, altered mental status, and rapid shallow breathing
- Choking (conscious adult): perform abdominal thrusts (Heimlich maneuver) until object is expelled or patient becomes unconscious
- Burns are classified as superficial (1st degree), partial-thickness (2nd degree), and full-thickness (3rd degree)
- Bleeding control: apply direct pressure with sterile gauze, elevate the extremity, and apply a pressure bandage if needed
- Anaphylaxis requires immediate epinephrine (EpiPen) administration and activation of EMS
- Nutrition counseling includes the MyPlate guidelines, macronutrients (carbs, proteins, fats), and micronutrients (vitamins, minerals)
Patient Education, First Aid & Emergency Procedures
Medical assistants serve as patient educators and must be prepared to respond to office emergencies. Both patient education techniques and emergency response procedures are tested on the RMA exam.
Patient Education Principles
Effective Education Techniques
| Technique | Description |
|---|---|
| Teach-back method | Ask the patient to repeat instructions in their own words to confirm understanding |
| Demonstration / return demonstration | Show the patient how to perform a task, then have them demonstrate it back |
| Written instructions | Provide take-home materials at the patient's reading level |
| Visual aids | Use diagrams, models, and videos to supplement verbal instructions |
| Cultural sensitivity | Respect cultural beliefs, use interpreters when needed |
| Plain language | Avoid medical jargon; use simple, clear terms |
Health Literacy Considerations
- Nearly 36% of adults have limited health literacy
- Use materials written at a 5th-6th grade reading level
- Ask permission to educate: "Would it be helpful if I explained...?"
- Allow time for questions
- Provide instructions in the patient's primary language when possible
- Use pictorial aids for patients with low literacy
Nutrition Education
MyPlate Guidelines (USDA):
| Food Group | Recommendation | Key Nutrients |
|---|---|---|
| Fruits | 1.5-2 cups/day | Vitamins A, C, potassium, fiber |
| Vegetables | 2-3 cups/day | Vitamins A, C, K, folate, fiber, potassium |
| Grains | 5-8 oz/day (at least half whole grains) | B vitamins, iron, fiber |
| Protein | 5-6.5 oz/day | Iron, zinc, B vitamins |
| Dairy | 3 cups/day | Calcium, vitamin D, potassium |
Macronutrients
| Nutrient | Calories/gram | Function | Sources |
|---|---|---|---|
| Carbohydrates | 4 cal/g | Primary energy source | Grains, fruits, vegetables, legumes |
| Proteins | 4 cal/g | Growth, repair, immune function | Meat, fish, eggs, dairy, legumes |
| Fats | 9 cal/g | Energy storage, insulation, vitamin absorption | Oils, butter, nuts, avocado |
Emergency Procedures
CPR (Adult) -- Current AHA Guidelines
| Component | Adult | Child (1-puberty) | Infant (<1 year) |
|---|---|---|---|
| Compression depth | At least 2 inches (5 cm) | About 2 inches (5 cm) | About 1.5 inches (4 cm) |
| Compression rate | 100-120/min | 100-120/min | 100-120/min |
| Compression:breath ratio | 30:2 (1 or 2 rescuers) | 30:2 (1 rescuer), 15:2 (2 rescuers) | 30:2 (1 rescuer), 15:2 (2 rescuers) |
| Hand position | Center of chest, lower half of sternum | Center of chest, lower half of sternum | Just below nipple line |
| Compression method | Two hands, heel of hand | One or two hands | Two fingers (1 rescuer) or two thumb-encircling (2 rescuers) |
AED (Automated External Defibrillator) Use
- Turn on the AED and follow voice prompts
- Attach pads: One pad on the upper right chest, one on the lower left side
- Clear the patient: Ensure no one is touching the patient during analysis
- Deliver shock if advised by the AED
- Resume CPR immediately after the shock for 2 minutes
- Follow AED prompts for re-analysis
Choking (Foreign Body Airway Obstruction)
Conscious Adult/Child:
- Ask "Are you choking?" -- if patient cannot speak, cough, or breathe, intervene
- Perform abdominal thrusts (Heimlich maneuver): Stand behind patient, fist above navel, quick upward thrusts
- Continue until object is expelled or patient becomes unconscious
- If unconscious: lower to ground, call 911, begin CPR (check mouth for object before breaths)
Conscious Infant:
- Place infant face-down on your forearm (head lower than body)
- Give 5 back blows between shoulder blades with heel of hand
- Turn infant face-up, give 5 chest thrusts with 2 fingers on sternum
- Alternate until object is expelled or infant becomes unconscious
Bleeding Control
| Severity | Action |
|---|---|
| Minor | Clean wound, apply antibiotic ointment, bandage |
| Moderate | Apply direct pressure with sterile gauze, elevate extremity above heart |
| Severe | Apply direct firm pressure, apply pressure bandage, call EMS; apply tourniquet only as last resort for life-threatening bleeding |
Burns
| Classification | Depth | Appearance | Sensation |
|---|---|---|---|
| Superficial (1st degree) | Epidermis only | Red, dry, no blisters | Painful |
| Partial-thickness (2nd degree) | Epidermis + dermis | Red, moist, blisters | Very painful |
| Full-thickness (3rd degree) | All skin layers + deeper | White, charred, leathery | Little/no pain (nerve damage) |
Burn first aid:
- Remove the source of the burn
- Cool with cool (not ice cold) running water for at least 10 minutes
- Cover with sterile, non-adherent dressing
- Do NOT apply butter, ice, or home remedies
- Do NOT break blisters
- Call EMS for large burns, facial burns, or full-thickness burns
Shock (Hypoperfusion)
Signs and symptoms:
- Pale, cool, clammy (diaphoretic) skin
- Rapid, weak (thready) pulse
- Low blood pressure (hypotension)
- Altered mental status (confusion, anxiety, unresponsiveness)
- Rapid, shallow breathing
- Nausea, thirst
Treatment:
- Call EMS
- Position patient in Trendelenburg (elevate feet) or flat if spinal injury suspected
- Maintain body temperature (cover with blanket)
- Do NOT give food or fluids
- Monitor vital signs continuously
Anaphylaxis
Signs: Urticaria (hives), angioedema (facial/throat swelling), wheezing, dyspnea, hypotension, tachycardia, GI symptoms
Treatment:
- Epinephrine (EpiPen) -- administer IM in the lateral thigh immediately
- Call 911 / EMS
- Position patient supine with legs elevated (unless breathing difficulty)
- Monitor airway and breathing
- Prepare for possible CPR
Syncope (Fainting)
Treatment:
- Lower patient to the floor or lay flat
- Elevate legs above heart level
- Loosen tight clothing
- Apply cool cloth to forehead
- Check vital signs
- If patient does not regain consciousness quickly, call EMS
According to current AHA guidelines, the correct rate for chest compressions during adult CPR is:
A patient in the medical office develops hives, facial swelling, and difficulty breathing after receiving a medication. The medical assistant should FIRST:
The teach-back method in patient education involves:
A patient with a 2nd-degree (partial-thickness) burn to the forearm should receive which first aid treatment?
Signs and symptoms of shock include all of the following EXCEPT:
For adult CPR, the compression-to-breath ratio is ___:2.
Type your answer below
Arrange the steps of the AED procedure in the correct order.
Arrange the items in the correct order
Which of the following are signs of anaphylaxis? (Select all that apply)
Select all that apply