emergency medical technician skills check list · pdf fileemergency medical technician ....

FALL 2012

Students Name: _____________________________ Lead Instructor: ___________________________

Skills Date Instructor's

Completed Initials

1.01.0 Vital Sign - PULSE 1.02.0 Vital Sign - RESPIRATION 1.03.0 Vital Sign - LUNG SOUNDS 1.04.0 Vital Sign - BLOOD PRESSURE 1.05.0 Vital Sign - PULSE OXIMETRY 1.06.0 Basic Airway - OROPHARYNGEAL AIRWAY (OPA) 1.07.0 Basic Airway - NASOPHARYNGEAL AIRWAY (NPA) 1.08.0 Basic Airway - ORAL SUCTIONING 1.09.0 Basic Airway - BAG VALVE MASK 1.10.0 Basic Airway - OXYGEN ADMINISTRATION 1.11.0 Advanced Airway - MULTI-LUMEN AIRWAY (COMBI-TUBE) 1.12.0 Patient Assessment - TRAUMA 1.12.1 Patient Assessment - MEDICAL 1.13.0 Bleeding Control/Shock Management 1.14.0 PNEUMATIC ANTI SHOCK GARMENT (MAST) 1.15.0 Spinal Immobilization - B/B (SUPINE PT.) 1.16.0 Spinal Immobilization - KED (SEATED PT.) 1.17.0 Helmet Removal - FOOTBALL 1.18.0 Helmet Removal - MOTORCYCLE 1.19.0 Splinting - LONG BONE 1.20.0 Splinting - BIPOLAR TRACTION (HARE) 1.21.0 Splinting - UNIPOLAR TRACTION (SAGER) 1.22.0 Scoop Stretcher 1.23.0 BLS/ALS - Cardiac Arrest Management (AED) 1.24.0 BLS/ALS - Nitroglycerin Administration (NTG) 1.25.0 BLS/ALS - Epinephrine Administration (EPI)CPR - ADULT / CHILD / INFANTFBAO - ADULT / CHILD / INFANT

***ALL SKILLS MUST BE COMPLETED PRIOR TO FINAL SKILLS EXAM

Emergency Medical Technician Skills Check List

FALL 2012

1.01.0 SKILL: VITAL SIGNS - PULSE ASSESSMENT

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Assess patient's heart rate *The student will describe the indication for the equipment/procedure 1. All Patients * 2. Every 5 minutes for Unstable patients * 3. Every 15 minutes for Stable patients *The student will describe the contraindications for the equipment/procedure 1. None *The student will describe the possible side effects to the use of the equipment/procedure 1. None *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions P F P F Explains the procedure to the patient P F P F 1. Locate patient's pulse P F P F 2. Count the number of beats in 30 or 60 seconds (explain alternate methods) P F P F a. Locate the patient's CAROTID pulse P F P F b. Locate the patient's BRACHIAL pulse P F P F c. Locate the patient's RADIAL pulse P F P F d. Locate the patient's FEMORAL pulse P F P F e. Locate the patient's DORSALIS PEDIS or POSTERIOR TIBIAL pulse P F P F 3. Note patient's pulse quality and regularity P F P F

***Critical Criteria****Failure to verbalize BSI

INSTRUCTOR INITIALS ________ 1st attempt PASS_____ FAIL_____

INSTRUCTOR SIGNATURE ________________________ 2nd attempt PASS_____ FAIL_____

FALL 2012

1.02.0 SKILL: VITAL SIGNS - RESPIRATION ASSESSMENT

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Assess patient's breathing rate *The student will describe the indication for the equipment/procedure 1. All Patients * 2. Every 5 minutes for Unstable patients * 3. Every 15 minutes for Stable patients *The student will describe the contraindications for the equipment/procedure 1. None *The student will describe the possible side effects to the use of the equipment/procedure 1. None *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions P F P F 1. Locate patient's chest/torso P F P F 2. Count the number of breaths in 30 seconds and multiply by 2 P F P F a. Visually observe chest rise and fall P F P F b. Place hand on chest to count rise and fall P F P F c. Use a stethoscope to auscultate breathing P F P F 3. Note patient's breathing quality and regularity P F P F




FALL 2012

1.03.0 SKILL: VITAL SIGNS - LUNG SOUND ASSESSMENT

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Assess patient's breathing rate and quality *The student will describe the indication for the equipment/procedure 1. All Patients *The student will describe the contraindications for the equipment/procedure 1. None *The student will describe the possible side effects to the use of the equipment/procedure 1. None *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions P F P F Explains the procedure to the patient and remind them not to move or talk without instruction P F P FMEDICAL PATIENTS 1. Expose patient's chest/torso P F P F 2. Place stethoscope on chest or back and auscultate inspiratory and expiratory sounds P F P F

Move the stethoscope across and down the anterior chest at the follow 4 positions: *Right and Left Apexes - Between 2nd & 3rd intercostal space/midclavicular line P F P F *Right and Left Bases - 4th or 5th intercostal space, midclavicular line P F P F

Move the stethoscope across the lateral chest at the following 2 positions: *Right and Left midaxillary line - 4th or 5th intercostal space, on the lateral P F P F aspect of the chest 3. Correctly identify and note any abnormal respiratory deficiencies and note: P F P F (When, Where & What you heard) TRAUMA PATIENTS RAPID TRAUMA SURVEY 1. Expose the patient's torso and back P F P F 2. Listen with the stethoscope bell over the anterior chest, between 2nd & 3rd intercostal P F P F space/midclavicular line and over the lateral chest midaxillary near 4th or 5th intercostal space on each side 3. Simply note if breath sounds are present and equal bilaterally P F P F


*Failure to properly place and auscultate lung sounds on a medical patient*Failure to properly place and auscultate lung sounds on a trauma patient

*Failure to correctly identify and note any abnormal respiratory deficiencies



FALL 2012

1.04.0 SKILL: VITAL SIGNS - BLOOD PRESSURE

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Assess patient's Blood Pressure *The student will describe the indication for the equipment/procedure 1. All Patients * 2. Every 5 minutes for Unstable patients * 3. Every 15 minutes for Stable patients *The student will describe the contraindications for the equipment/procedure 1. Mastectomy (B/P) * 2. Dialysis Shunts (B/P) * 3. Affected Side (Stroke) (Relative) *The student will describe the possible side effects to the use of the equipment/procedure 1. None *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions P F P F Explains the procedure to the patient and remind them not to move without instruction P F P F 1. Blood Pressure via Auscultation a. Choose the appropriate size cuff P F P F b. Apply the cuff to the patient's arm with the lower end of the cuff positioned P F P F 1 to 2 inches above the antecubital space c. Locate/Palpate brachial pulse P F P F d. Position the stethoscope over the brachial artery within the Antecubital Space P F P F where the pulse was palpated e. The cuff is inflated to a point approximately 30mm Hg above where the P F P F brachial pulse can no longer be auscultated f. The cuff is slowly deflated at a rate of 2 to 3 mm Hg per second P F P F g. As the pressure falls observe the gauge and note where the first sound or P F P F pulsation is heard (systolic pressure) h. As the pressure falls observe the gauge and note the point where the sounds P F P F change in quality or become muffled (diastolic pressure) Ex. 120/80 If sound is heard all the way down to 0 then write it as such, systolic/0 2. Blood Pressure via Palpation a. Choose the appropriate size cuff P F P F b. Apply the cuff to the patient's arm with the lower end of the cuff positioned P F P F 1 to 2 inches above the antecubital space c. Locate/Palpate radial pulse P F P F d. The cuff is inflated to a point where the pulse can no longer be felt P F P F (Maintain finger contact at the pulse location as the cuff is deflated) e. When the pulse becomes palpable, the gauge reading is noted (systolic P F P F pressure) Ex. 120/P f. Record readings in even numbers P F P F




FALL 2012

1.05.0 SKILL: VITAL SIGNS - PULSE OXIMETRY

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Used to monitor changes in oxygen saturation of patients *The student will describe the indication for the equipment/procedure 1. All Patients with any respiratory difficulty or distress * 2. May be taken with vitals on all patients *The student will describe the contraindications for the equipment/procedure 1. Nail polish (relative) * Readings may be inaccurate under the following conditions: 1. Carbon monoxide toxicity * 2. Patients in shock with Hypotension, Hypovolemia, or Hypothermia * 3. Patients with poor distal circulation *The student will describe the possible side effects to the use of the equipment/procedure None *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions P F P F Explains the procedure to the patient P F P F Prepare equipment and assemble appropriate probe (re-usable finger or single use P F P F tape-on) ***Place probe on any appropriate place using proper orientation (i.e.: finger, toe, earlobe) P F P F Record readings for assessment and watch for trend comparison P F P FThe student will identify state of distress based on SpO2 reading 1. Normal SpO2 = 100 to 97 P F P F 2. <96 may indicate hypoxia P F P F 3. <90 indicates severe hypoxia P F P F


*Failure to identify at least 2 out of 3 locations for probe placement



FALL 2012

1.06.0 SKILL: OROPHARYNGEAL AIRWAY

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Improve airway patency *The student will describe the indication for the equipment/procedure 1. Any unconscious patient without a gag reflex requiring ventilatory assistance *The student will describe the contraindications for the equipment/procedure 1. Patients with an intact gag reflex *The student will describe the possible side effects to the use of the equipment/procedure 1. Obstruction of the airway (usually from improper sizing) * 2. Localized soft tissue, mucosal, or dental damage * 3. Retching/Vomiting caused by an intact gag reflex *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes BSI - Universal Precautions - INCLUDING FACE & EYE PROTECTION P F P F Select appropriate size Oropharyngeal airway - measure from the corner of the P F P F mouth to the earlobe Maintain manual C-Spine immobilization throughout procedure (if C-Spine injury is suspected) P F P F Open patients mouth using the cross-finger technique P F P F Insert tip TOWARD roof of mouth - rotate 180° when the tip reaches the soft palate P F P F Alternate: Use tongue blade eliminating the need to rotate (only method in pediatrics) P F P F Advance the OPA until the flange rests on the TEETH P F P F If the patient begins to retch or gag, REMOVE DEVICE IMMEDIATELY P F P F Assess airway patency for improvement in: chest rise, lung sounds, & pulse oximetry P F P F

***Critical Criteria****Failure to verbalize BSI - UNIVERSAL PRECAUTIONS

*Failure to properly size the device*Failure to demonstrate BOTH proper insertion techniques



FALL 2012

1.07.0 SKILL: NASOPHARYNGEAL AIRWAY

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Improve airway patency *The student will describe the indication for the equipment/procedure 1. Any conscious or unconscious patient requiring ventilatory assistance and where the * use of oropharyngeal airway is not tolerated or contraindicatedThe student will describe the contraindications for the equipment/procedure 1. Basilar skull fractures, periorbital and/or nasal fractures, or any suspected head * traumaThe student will describe the possible side effects to the use of the equipment/procedure 1. Obstruction of the airway (usually from improper sizing) * 2. Localized soft tissue, mucosal damage, or bleeding * 3. Intracranial insertion with rupture of the cribiform plate *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes BSI - Universal Precautions - INCLUDING FACE & EYE PROTECTION P F P F Maintain manual C-Spine immobilization throughout procedure (if C-Spine injury is suspected) P F P F Determine larger of the patient's nare P F P F Select and measure appropriate size Nasopharyngeal airway - measure from the tip of the P F P F nose to the earlobe Lubricate with a water soluble lubricant P F P F If resistance is met, rotate gently from side to side, if NPA still will not advance, attempt P F P F other side *** For right nare insertion, bevel toward septum P F P F *** For left nare insertion, bevel toward septum & gently rotate 180 ° during insertion P F P F Insert slowly until flange rests against nostril P F P F Assess airway patency for improvement in: chest rise, lung sounds, & pulse oximetry P F P F


*Failure to properly size the device*Failure to demonstrate BOTH proper insertion techniques



FALL 2012

1.08.0 SKILL: SUCTION

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Remove mucus, vomitus, secretions, and sputum from the hypopharynx *The student will describe the indication for the equipment/procedure 1. Any patient's airway or breathing that is compromised by fluid obstruction *The student will describe the contraindications for the equipment/procedure 1. None *The student will describe the possible side effects to the use of the equipment/procedure 1. Hypoxia * 2. Reflex Bradycardia * 3. Damage to the oropharyngeal tissue *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes BSI - Universal Precautions - INCLUDING FACE & EYE PROTECTION P F P F Test/Set unit to confirm vacuum reading > 300 mmHg P F P F Select and measure appropriate size suction catheter - measure from the corner of the P F P F mouth to the angle of the jaw Open patient's mouth using cross finger technique P F P F Insert suction catheter the proper depth into pharynx and cover hole to create suction P F P F Suction pharynx and hypopharyngeal area (no more than 15 seconds - adult; 10 seconds - child; P F P F 5 seconds - infants Re-oxygenate patient and reassess for the need of additional suction P F P F


*Must test and confirm vacuum/suction present*Failure to identify proper depth and cover hole on catheter

*Exceeding the allowable suction time - 15 seconds-adult, 10 seconds child, 5 seconds-infants*Failure to re-oxygenate and reassess patient



FALL 2012

1.09.0 SKILL: BASIC AIRWAY - BAG VALVE MASK

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Manually operated ventilation device that achieves approximately 100% oxygen delivery *The student will describe the indication for the equipment/procedure 1. Any patient that requires ventilation assistance affecting rate or depth * 2. Patient's with pulmonary edema (rales) *The student will describe the contraindications for the equipment/procedure 1. None *The student will describe the possible side effects to the use of the equipment/procedure 1. Can result in gastric distention (especially in children) * 2. Inconsistent or Inadequate tidal volumes * 3. Insufficient face seal can result in poor ventilation and oxygenation *

*** DESIGN REQUIREMENTS *** Self refilling bag without foam rubber * Non-jam, non-rebreathing valve system calibrated at 15 lpm * Transparent face mask with air filled or contoured resilient cuff * No "pop-off" valves - if present, they must have the option to be disabled * Standard 15mm/22mm fittings * Must be able to operate in hot/cold weather * Must have an oxygen reservoir *

PROCEDUREThe student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes BSI - Universal Precautions P F P F Select appropriate Bag Valve Mask - Check/Inflate mask if applicable P F P F Insert appropriate airway adjunct P F P F Apply mask with apex over the bridge of patient's nose and align base between lower lip and chin P F P F Achieve proper mask seal using approved method (i.e.: OK, EC, C3) P F P F Compress bag smoothly delivering adequate volume at the rate of 10-12/min P F P F Successfully ventilate mannequin 10 times P F P F Observe patient's chest rise and fall P F P F


*Failure to properly utilize appropriate airway adjunct*Failure to use an appropriate mask seal method

*Failure to properly ventilate mannequin at least 8 out of 10 breaths



FALL 2012

1.10.0 SKILL: BASIC AIRWAY - OXYGEN ADMINSTRATION

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Provide supplemental oxygen therapy to diminish respiratory distress, & tissue/organ hypoxia *The student will describe the indication for the equipment/procedure 1. To meet the increased oxygen demand for any injured or ill patients *The student will describe the contraindications for the equipment/procedure 1. None, if the patient is showing signs of hypoxia *The student will describe the possible side effects to the use of the equipment/procedure 1. May result in respiratory depression or arrest in patients breathing on "Hypoxic Drive" * 2. Oxygen Toxicity may result after several days of >50% oxygen concentration delivery *

*** OXYGEN SAFETY PRECAUTIONS *** Cylinders that are positioned upright MUST BE secured to prevent tipping or falling over * DO NOT handle or allow petroleum based products to make contact with tank or regulator parts * DO NOT allow smoking in vicinity when oxygen is in use * DO NOT use regulators with missing or modified pins * Keep all valves closed when not in use even when tank is empty * Keep oxygen cylinders horizontal and secured from rolling *

The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes BSI - Universal Precautions P F P F Visually inspects oxygen regulator and bottle (pins, o-ring, damage, hydro-date) P F P F Properly attaches the regulator to the tank -- Check regulator for leaks P F P F Verify adequate tank pressure P F P F Attach a NASAL CANNULA at set proper flow rate (1 - 6 lpm), 24% - 44% P F P F Attach a NON-REBREATHER and set proper flow rate (10 - 15 lpm), max - 90% P F P F


*Failure to properly place NC on patient or set wrong flow rate*Failure to properly place NRB on patient or set wrong flow rate

*Failure to properly assemble an oxygen delivery system*Failure to properly inspect, assemble regulator to tank, or check pressure



FALL 2012

1.11.0 SKILL: ADV. AIRWAY - MULTI LUMEN COMBI-TUBE

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. To establish a patent and protected airway *The student will describe the indication for the equipment/procedure 1. Any unresponsive patient without a gag reflex not likely to regain consciousness *The student will describe the contraindications for the equipment/procedure 1. Patients with an intact gag reflex * 2. Patients younger than 14 years old * 3. Patients less than 5 feet tall * 4. Patients with esophageal disease or varicies * 5. Patients who have ingested a caustic substance (Bleach, Acid, Etc.) *The student will describe the possible side effects to the use of the equipment/procedure 1. Stimulation of the gag reflex and vomiting * 2. Soft tissue trauma * 3. Reflex bradycardia and hypoxia *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions - INCLUDING FACE AND EYE PROTECTION P F P F Pre-oxygenate patient with 100% oxygen using a Bag Valve Mask P F P F Assemble and check equipment P F P F Place patient's head in a neutral or slightly flexed position unless contraindicated , then P F P F perform a tongue-jaw-lift and insert the device until front teeth are between black rings on tube Inflate the BLUE pharyngeal cuff to 100 cc of air P F P F Inflate the WHITE distal cuff with 10-15 cc of air P F P F Ventilate BLUE tube marked #1 and observe for chest rise; listen for gastric first, followed P F P F by lung sounds

IF NO CHEST RISE IS NOTED AND NO LUNG SOUNDS AUDIBLE: P F P F Ventilate WHITE tube marked #2 and observe for chest rise; listen for gastric/lung sounds P F P F After confirming proper placement - record depth, secure the tube, and apply a C-Collar P F P F Continue ventilating patient through appropriate tube at the proper rate P F P F Monitor patient and record any changes in patient condition P F P F

***Critical Criteria****Failure to take/verbalize Universal Precautions

*Failure to pre-oxygenate patient*Failure to confirm placement & select proper ventilation port (blue or white)

*Failure to inflate both cuffs before ventilating



FALL 2012

1.12.0 SKILL: PATIENT ASSESSMENT - TRAUMA

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. To identify all possible signs and symptoms relating to the illness or injury *The student will describe the indication for the equipment/procedure 1. All patients *The student will describe the contraindications for the equipment/procedure 1. Lack of patient consent * 2. Patient or scene presents an immediate physical threat to the rescuer *The student will describe the possible side effects to the use of the equipment/procedure 1. Possible delay in care or transport time *The student will demonstrate the use of the equipment/procedure

***SCENE SIZE UP*** Park vehicle in a safe and convenient location P F P F ***Takes/Verbalizes Universal Precautions P F P F ***Evaluate Scene Safety for personnel, patient, and bystanders P F P F Consider possible etiology of problem (If TRAUMA, establish Mechanism of Injury. If MEDICAL, P F P F establish Nature of Illness) Establish the number of patients P F P F Evaluate the need for additional resources: personnel, equipment, and special equipment P F P F

***PRIMARY ASSESSMENT*** ***General Impression of the patient (begin to establish priorities) P F P F ***If patient is unconscious or spinal injury is suspected, maintain manual immobilization of C-Spine P F P F ***If patient is conscious: perform introductions, gain consent, and obtain chief complaint P F P F ***Establish Level of Consciousness (AVPU) - Alert x 4 - person, place, time, and event P F P F ***Airway - Is the airway open? Will the airway stay open? Does anything endanger the airway? P F P F Ensure patient has a patent airway P F P F Consider an Airway Adjunct and the possible need for Suction P F P F ***Breathing - Is the patient breathing? Is the patient having trouble breathing? Are the rate and P F P F depth adequate? Does anything endanger the patient's breathing? Rate (Absent, Fast, Slow, Normal) P F P F Depth (Shallow, Deep, Normal) P F P F Quality (Labored, Normal) P F P F ***Initiate appropriate O2 therapy P F P F ***Circulation - Does the patient have a pulse and where is it located? P F P F (If Carotid is present, BP is at least 60 mmHg Systolic) Rate (Absent, Fast, Slow, Normal) P F P F Rhythm (Regular, Irregular) P F P F Quality (Normal, Weak-thready, Strong-bounding) P F P F Skin: Color, Temperature, Condition P F P F Bleeding - Check and Control any life threatening bleeding P F P F ***Expose/Protect and Perform a Rapid Scan (60-90 sec. Identify and Correct All Life P F P F Threats)

FALL 2012

***RAPID SCAN*** ***Assess for DCAPBTLS (Explain, Inspect, Palpate) Head and Neck Check for obvious wounds of the head, face, and neck P F P F Check eyes, ears, nose, and mouth (pupils (PEARRL), bleeding, foreign objects, etc.) P F P F Check neck for tracheal deviation, tugging, or JVD P F P F Check for deformity or tenderness of the neck P F P F Measure and apply a C-Collar P F P F Chest Check for symmetry, paradoxical movement, or flail segments P F P F Check for open sucking wounds P F P F Auscultate for equal and present breath sounds in four fields P F P F Abdomen Check for obvious wounds P F P F Check for softness, rigidity, distention, and tenderness P F P F Pelvis Check for obvious wounds P F P F Check for deformity and stability (if c/o pain, crepitus, or obvious deformity - DO NOT palpate) P F P F Extremities - Legs and Arms Check for obvious wounds P F P F Check for distal circulation, motor, and sensation P F P F Posterior (done during transfer to backboard) Check the head, thorax, pelvis, and back of the legs P F P F*** Determine Transport Priority (Load and Go vs. Stay and Play) P F P F Ensure pt is packaged properly and ready for transport P F P F

***History Taking*** ***Investigate the Patient's Chief Complaint P F P F ***OBTAIN SAMPLE HISTORY*** (When applicable include--OPQRST) ***Medical History - question bystanders, family, caretaker for further information S - Signs or Symptoms P F P F A - Allergies (medication or foods) P F P F M - Medications (prescribed or over the counter - OTC) P F P F P - Past medical history (or surgeries) - pertinent to C/C P F P F L - Last oral intake P F P F E - Events leading to C/C P F P F For Pt's experiencing any associated pain. Use the following mnemonic O - Onset/Origin of symptoms or pain P F P F P - Provocation of symptoms or pain P F P F Q - Quality of symptoms or pain P F P F R - Region/Radiation of symptoms or pain P F P F S - Severity of symptoms or pain P F P F T - Time of onset of symptoms or pain P F P F I - Interventions done PTA

FALL 2012

***SECONDARY ASSESSMENT*** ***Baseline Vital Signs - Assess/Record a complete set of vital signs Respirations P F P F Pulse P F P F Blood Pressure P F P F Lung Sounds P F P F Skin condition / Color / Temperature (capillary refill in children < 6 y/o) P F P F Pupils P F P F Pulse Oximetry and Glucose (if available) P F P F *** Repeat a Full Body Scan(Detailed Physical Exam if time allows) or Focused Physical Exam (if

isolated to certain areas ) Use Mneumonic DCAPBTLS Mental Status Reassess the Level of Consciousness x 4 (person, place, time, and event) P F P F Record Glasgow Coma Scale (Is the patient better or worse) P F P F Head/Scalp Check for position P F P F Check for DCAPBTLS (occipital, parietal, frontal, and temporal areas) P F P F Face Check zygomatic arch, maxilla, mandible, and TMJ P F P F Eyes Check pupils - PEARL P F P F Check for hyphema, foreign bodies, and periorbital ecchymosis P F P F Ears Check for blood, CSF or other fluids, and battle signs P F P F Nose Check for blood, CSF or other fluids, and crepitus P F P F Mouth Check for blood, CSF, foreign bodies, teeth, dentures, fluid, tissue damage, odors, & discoloration P F P F Neck Check for JVD, tracheal deviation, and medical alert tag P F P F Suprasternal/Clavicular Check for subcutaneous emphysema P F P F Check for NTG or other medication patches, pacemaker, and crepitus P F P F Chest Palpate sternum for crepitus, symmetry, and paradoxical motion P F P F Auscultate for present and equal breath sounds (check 6 fields) P F P F Abdomen Palpate all four quadrants for softness, rigidity, distention, tenderness, and guarding P F P F Palpate for pulsating masses P F P F Pelvis Palpate the integrity of the pelvic girdle & pubis symphysis (careful of crepitus or instability) P F P F Check for incontinence and priapism P F P F Legs Check for position and length P F P F Palpate femoral and dorsalis pedis pulses, motor (ROM), and sensation P F P F Arms Check for position and length P F P F Palpate brachial and radial pulses, motor (ROM), sensation, grip strength, and medical alert tag P F P F Posterior

FALL 2012

Assess head, thorax, pelvis, and back of legs (if not already done) P F P F

***REASSESSMENT*** ***Repeat Primary Assessment (Mental Status, A,B,C's) P F P F ***Repeat Vitals Signs (Unstable - every 5 min. / Stable - every 15 min.) P F P F ***Reassess Chief Complaint P F P F ***Check Interventions P F P F ***Record any changes in the patients condition P F P F


*Failure to perform critical interventions from information found during the Primary Assessment, Rapid Scan, Secondary Assessment, or Reassessment

*Failure to identify "Load and Go" criteria patients*Failure to follow a systematic approach/Physical Exam

*Determine Transport Priority (Appropriate Medical Facility) from Assessment Findings



FALL 2012

1.12.1 SKILL: PATIENT ASSESSMENT - Medical

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. To identify all possible signs and symptoms relating to the illness or injury *The student will describe the indication for the equipment/procedure 1. All patients *The student will describe the contraindications for the equipment/procedure 1. Lack of patient consent * 2. Patient or scene presents an immediate physical threat to the rescuer *The student will describe the possible side effects to the use of the equipment/procedure 1. Possible delay in care or transport time *The student will demonstrate the use of the equipment/procedure

***SCENE SIZE UP*** Park vehicle in a safe and convenient location P F P F ***Takes/Verbalizes Universal Precautions P F P F ***Evaluate Scene Safety for personnel, patient, and bystanders P F P F Consider possible etiology of problem (If TRAUMA, establish Mechanism of Injury. If MEDICAL, P F P F establish Nature of Illness) Establish the number of patients P F P F Evaluate the need for additional resources: personnel, equipment, and special equipment P F P F

***PRIMARY ASSESSMENT*** ***General Impression of the patient (begin to establish priorities) P F P F ***If patient is unconscious or spinal injury is suspected, maintain manual immobilization of C-Spine P F P F ***If patient is conscious: perform introductions, gain consent, and obtain chief complaint P F P F ***Establish Level of Consciousness (AVPU) - Alert x 4 - person, place, time, and event P F P F ***Airway - Is the airway open? Will the airway stay open? Does anything endanger the airway? P F P F Ensure patient has a patent airway P F P F Consider an Airway Adjunct and the possible need for Suction P F P F ***Breathing - Is the patient breathing? Is the patient having trouble breathing? Are the rate and P F P F depth adequate? Does anything endanger the patient's breathing? Rate (Absent, Fast, Slow, Normal) P F P F Depth (Shallow, Deep, Normal) P F P F Quality (Labored, Normal) P F P F ***Initiate appropriate O2 therapy P F P F ***Circulation - Does the patient have a pulse and where is it located? P F P F (If Carotid is present, BP is at least 60 mmHg Systolic) Rate (Absent, Fast, Slow, Normal) P F P F Rhythm (Regular, Irregular) P F P F Quality (Normal, Weak-thready, Strong-bounding) P F P F Skin: Color, Temperature, Condition P F P F Bleeding - Check and Control any life threatening bleeding P F P F ***Expose/Protect and Perform a Rapid Scan (60-90 sec. Identify and Correct All Life P F P F Threats)

FALL 2012

***RAPID SCAN*** ***Assess for DCAPBTLS (Explain, Inspect, Palpate) Head and Neck Check for obvious wounds of the head, face, and neck P F P F Check eyes, ears, nose, and mouth (pupils(PEARRL), bleeding, foreign objects, etc.) P F P F Check neck for tracheal deviation, tugging, or JVD P F P F Check for deformity or tenderness of the neck P F P F Measure and apply a C-Collar P F P F Chest Check for symmetry, paradoxical movement, or flail segments P F P F Check for open sucking wounds P F P F Auscultate for equal and present breath sounds in four fields P F P F Abdomen Check for obvious wounds P F P F Check for softness, rigidity, distention, and tenderness P F P F Pelvis Check for obvious wounds P F P F Check for deformity and stability (if c/o pain, crepitus, or obvious deformity - DO NOT palpate) P F P F Extremities - Legs and Arms Check for obvious wounds P F P F Check for distal circulation, motor, and sensation P F P F Posterior (done during transfer to backboard) Check the head, thorax, pelvis, and back of the legs P F P F*** Determine Transport Priority (Load and Go vs. Stay and Play) P F P F Ensure pt is packaged properly and ready for transport P F P F

***History Taking*** ***Investigate the Patient's Chief Complaint P F P F ***OBTAIN SAMPLE HISTORY*** (When applicable include--OPQRST) ***Medical History - question bystanders, family, caretaker for further information S - Signs or Symptoms P F P F A - Allergies (medication or foods) P F P F M - Medications (prescribed or over the counter - OTC) P F P F P - Past medical history (or surgeries) - pertinent to C/C P F P F L - Last oral intake P F P F E - Events leading to C/C P F P F For Pt's experiencing any associated pain. Use the following mnemonic O - Onset/Origin of symptoms or pain P F P F P - Provocation of symptoms or pain P F P F Q - Quality of symptoms or pain P F P F R - Region/Radiation of symptoms or pain P F P F S - Severity of symptoms or pain P F P F T - Time of onset of symptoms or pain P F P F I- Interventions done PTA P F P F

FALL 2012

( Determine Pertinent Positives or Negatives with associated Signs/Symptoms) Cardiac: Onset, Provocation, Quality, Radiation, Severity, Time, Interventions Stroke Onset, Describe episode, Duration, Neuro exam, (facial droop, arm drift, speech) Altered Mental: Describe episode, Duration, Onset, Symptoms, Seizures, Fever, Trauma, Interventions Allergic Reactions: Hx. of allergies, Exposed to what, How exposed, Effects, Progression, Interventions Syncope: LOC duration, Position, Hx, Incontinence, Hx. of blood in vomit or stool, Ortho V/S, Trauma Poisoning/OD: Substance, When, Amount, How, Time Period, Patient's estimated weight, Interventions Acute Abdomen: Location of pain, Bleeding/Discharge, Last Menses, Blood in vomit/stool, Ortho V/S, Trauma OB/GYN: Pregnant, Due Date, Last menses, Para/Gravida, Pain/Contractions, Bleeding/Discharge, Urine changes

***SECONDARY ASSESSMENT*** ***Baseline Vital Signs - Assess/Record a complete set of vital signs Respirations P F P F Pulse P F P F Blood Pressure P F P F Lung Sounds P F P F Skin condition / Color / Temperature (capillary refill in children < 6 y/o) P F P F Pupils P F P F Pulse Oximetry and Glucose (if available) P F P F ***Record all Pt's reaction to Medication Given (when applicable) P F P F

***Starting with Mental Status through Posterior***

***REASSESSMENT*** ***Repeat Primary Assessment (Mental Status, A,B,C's) P F P F ***Repeat Vitals Signs (Unstable - every 5 min. / Stable - every 15 min.) P F P F ***Reassess Chief Complaint P F P F ***Check Interventions P F P F ***Record any changes in the patients condition P F P F


*Failure to perform critical interventions from information found during the Primary Assessment, Rapid Scan, Secondary Assessment, or Reassessment

*Failure to identify "Load and Go" criteria patients*Failure to follow a systematic approach/Physical Exam

*Determine Transport Priority (Appropriate Medical Facility) from Assessment Findings



*** Based on the Chief Complaint Perform a Focused Physical Exam*** (Palpation,Inspection,Questioning)

FALL 2012

1.13.0 SKILL: BLEEDING CONTROL / TOURNIQUET

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Control hemorrhage * 2. Prevent contamination of soft tissue injury *The student will describe the indication for the equipment/procedure 1. Any open soft tissue injury *The student will describe the contraindications for the equipment/procedure 1. None *The student will describe the possible side effects to the use of the equipment/procedure 1. Possible additional contamination *

2. Soft tissue damage if a tourniquet is applied *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions - including face and eye protection P F P F Explains the procedure to the patient and expose the wound P F P F ***Assess circulation, motor, and sensation before dressing and bandage P F P F *** Apply and maintain direct pressure using gloved hand first, then sterile pressure dressing P F P F ***Elevate the extremity above the level of the heart at least 6" unless suspected fracture P F P F is present (Splint prior to elevation) and apply bandage *** If bleeding persists, apply additional pressure and dressing over the dressings already applied P F P F and wrap with another tighter bandage Once hemorrhage is controlled, apply bandage using proper technique P F P F Monitor patient for recurring hemorrhage. P F P F ***Assess circulation, motor, and sensation after dressing and bandage P F P F

If unable to control hemorrhage, use tourniquet P F P F ***Apply tourniquet correctly using a 4" wide multi layered bandage, BP cuff or commercial device P F P F Tighten tourniquet until hemorrhage ceases, then properly secure in place (never remove in the field) P F P F ***Document the time applied on either the tourniquet or patient's forehead (TK-00:00) P F P F Maintain tourniquet in open view and monitor for recurrent hemorrhage P F P F ***Assess patient - obtain vital signs and treat for shock if necessary P F P F ***High flow oxygen and prevent loss of body heat P F P F

***Critical Criteria****Failure to take/verbalize Universal Precautions - including face and eye protection

*Failure to properly apply and maintain direct pressure*Failure to elevate the extremity

*Failure to assess CMS before & after dressing and bandage*Failure to properly apply tourniquet and monitor

*Failure to assess patient - obtain vital signs and treat for shock if necessary



FALL 2012

1.14.0 SKILL: PNEUMATIC ANTI-SHOCK GARMENT / MAST

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Increase peripheral vascular resistance by pressurizing lower abdomen & extremities * 2. Immobilize the lower extremities and the pelvic region *The student will describe the indication for the equipment/procedure 1. Pelvic fractures and instability with hypotension (Inflate to air-splint pressures only) * 2. Neurogenic Shock without evidence of other internal injuries * 3. Patients in sever hypovolemic shock due to CONTROLLED hemorrhage *The student will describe the contraindications for the equipment/procedure

ABSOLUTE CONTRAINDICATIONS: 1. Penetrating thoracic & abdominal trauma * 2. Pulmonary Edema *

RELATIVE CONTRAINDICATIONS: 1. Penetrating object * 2. Pregnancy beyond the second trimester - (Inflate the LEGS ONLY) *The student will describe the possible side effects to the use of the equipment/procedure 1. Increase the rate of hemorrhage from damaged blood vessels outside are of device * 2. Compartment Syndrome * 3. Dyspnea due to increase in diaphragmatic pressure *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions ***Record baseline vitals and pulse, motor, & sensation in all extremities Explains the procedure to the patient & removes patient's clothing prior to application of PASG/MAST P F P F ***Complete a DETAILED assessment on ALL areas that will be covered by the PASG/MAST P F P F PLACE PASG/MAST ON BACKBOARD BEFORE LOG-ROLL & PLACING PATIENT ON BACKBOARD P F P F IF ALREADY ON BACKBOARD, CAREFULLY SLIDE PASG/MAST UNDERNEATH PATIENT P F P F IF USING WITH A HARE OR SAGER SPLINT, THEN APPLY SPLINT FIRST AS DIRECTED P F P F ***The TOP of the PASG/MAST should lie just below the level of the lowest ribs P F P F ***Examine areas that will be wrapped for bulky or sharp objects (i.e.: broken glass, knives, etc.) P F P F Wrap the legs being careful not to have excessive folds or creases & secure Velcro straps P F P F Wrap the abdomen being careful not to have excessive folds or creases (*If not contraindicated) P F P F Connect all tubes to the pump - OPEN both leg valves and CLOSE the abdominal valve P F P F ***Auscultate lung sounds assuring lungs sounds are clear bilaterally P F P F Inflate leg portions slowly until the Velcro crackles (approx. 106 mmHg) P F P F ***Assess vital signs and lung sounds between the inflation of the leg and abdominal compartments P F P F If using abdominal section, CLOSE both leg valves and OPEN abdominal section P F P F Inflate abdominal section (if used) slowly until the Velcro crackles (approx. 106 mmHg) P F P F When inflation of abdominal section (if used) is complete, CLOSE all valves P F P F ***Assess vital signs and lung sounds when inflation of all compartment is complete P F P F ***Reassess pulse, motor, and sensation in all extremities P F P F Continue assessment of pressure in all compartments P F P F Monitor patient and record any changes in patient condition P F P F

***Critical Criteria***INSTRUCTOR INITIALS ________ 1st attempt PASS_____ FAIL_____INSTRUCTOR SIGNATURE ________________________ 2nd attempt PASS_____ FAIL_____

FALL 2012

1.15.0 SKILL: SPINAL IMMOBILIZATION (Supine)

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Provide immobilization of suspected neck and back injuries * 2. Provide full body support for CPR, movement of patient, or splinting of injuries *The student will describe the indication for the equipment/procedure 1. Any unconscious trauma patient * 2. Any cardiac arrest patient * 3. Any drowning patient * 4. Any patient complaining of neck or back pain resulting from trauma 5. Any patient complaining of a head injury sufficient enough to suspect C-SPINE injuryThe student will describe the contraindications for the equipment/procedure 1. (Relative) Patients with spinal deformities that require alternative packaging *The student will describe the possible side effects to the use of the equipment/procedure 1. Injury can result from movement necessary to place patient onto backboard *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions P F P F Explains the procedure to the patient and remind them not to move without instruction P F P F Direct a rescuer to establish manual immobilization of C-Spine P F P F ***Evaluate/Record baseline circulation, motor, and sensation in all extremities P F P F Perform a neck survey and apply a C-Collar P F P F Place backboard next to patient (along affected side if possible) P F P F Position the top of the backboard approximately 12" above the patient's head P F P F ***Log roll patient, assess posterior, place patient onto backboard P F P F Adjust patient position on backboard using the "45° slide" P F P F Correctly position and secure the chest straps P F P F Correctly position and secure the waist/pelvis strap P F P F Correctly position and secure the leg straps P F P F Secure patient's head to the board in a neutral position (use padding under head if needed) P F P F ***Straps must capture the patient's shoulder and pelvic girdles to prevent motion when turned P F P F ***Reassess circulation, motor, and sensation in all extremities P F P F Monitor patient and record any changes in patient condition P F P F


*Failure to maintain immobilization until head is secured*Failure to assess CMS in all extremities before and after placing patient on backboard

*Failure to assess posterior prior to placing patient on backboard*Failure to apply straps in the correct order

*Failure if arms are secured WITHIN the chest straps*Failure if there is dangerous or excessive movement of patient during procedure



FALL 2012

1.16.0 SKILL: SPINAL IMMOBILIZATION - KED (Seated) EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Immobilize spine for transfer from a seated position to a backboard with minimal movement * 2. Immobilizes / Stabilizes hip fractures *The student will describe the indication for the equipment/procedure 1. Any patient found in a seated position with neck pain, back pain, or neurological deficit * to the extremities secondary to trauma that requires immobilization to a backboard. 2. Any patient found in a seated position with head trauma sufficient to cause spinal injury * that requires immobilization to a backboard.The student will describe the contraindications for the equipment/procedure 1. Any patient meeting "Load & Go" or National Trauma Triage Criteria for immediate transport. *The student will describe the possible side effects to the use of the equipment/procedure 1. Delay in transport time * 2. Respiratory difficulty due to over-tightening the chest straps *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions P F P F Explain the procedure to the patient and remind them not to move without instruction P F P F ***Direct a rescuer to establish manual immobilization of C-Spine and place head in a neutral position P F P F ***Evaluate/Record baseline circulation, motor, and sensation in all extremities P F P F Perform a neck survey and apply a C-Collar P F P F Direct a second rescuer to tilt the patient forward as a unit utilizing the c-clamp method P F P F ***Assess posterior P F P F Carefully slide KED behind the patient with the smooth side toward the patient P F P F Undo Velcro of LEG straps, pull each strap down and to side of the patient P F P F Pull the device upwards so the sides of the device are fitted snugly under the armpits P F P F Ask patient to inhale deeply, then firmly snug the TOP strap using the push/pull method P F P F Firmly snug the MIDDLE strap using push/pull method (time with patient's inspiration) P F P F Firmly snug the BOTTOM strap using push/pull method (time with patient's inspiration) P F P F Loop the LEG straps around same side leg and attach them to the buckles on the same side P F P F ***Use padding to fill any voids between the patient's head and the device P F P F Ensure that the KED is snug under the patient's armpits, then tighten and secure all straps P F P F Apply and secure the CHIN and HEAD straps P F P F Have patient hold hands together or tie thumbs/wrists together P F P F Swivel the patient to facilitate extrication and slide the patient onto backboard P F P F IF KED HAS HANDLES ON SIDES, THEY ARE USED TO EASE MOVEMENT. THEY ARE NOT RATED FOR LIFTING AFTER PLACING PATIENT HORIZONTALLY ONTO A BACKBOARD. Carefully release BOTH of the LEG straps and extend the patients hips and knees P F P F Secure the patient to the backboard leaving the KED attached to the patient P F P F ***Reassess the patient's circulation, motor, and sensation in all extremities P F P F Monitor patient and record any changes in patient condition P F P F


*Failure to assess posterior*Failure to assess CMS before and after applying KED

*Failure if there is dangerous or excessive movement of patient during procedure*Failure if over-tightening of chest straps causes breathing difficulty in the patient

INSTRUCTOR INITIALS ________ 1st attempt PASS_____ FAIL_____INSTRUCTOR SIGNATURE ________________________ 2nd attempt PASS_____ FAIL_____

FALL 201 2

1.17.0 SKILL: HELMET REMOVAL (FOOTBALL)

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. To remove a football helmet without doing any further injury to the spine *The student will describe the indication for the equipment/procedure 1. Patient with any bleeding originating from inside the helmet * 2. Patient who's football helmet is found to be loose or poorly fitting * 3. Patient requiring immobilization wearing a helmet but NOT wearing shoulder pads * 4. Football helmet has lost its integrity due to damage or cannot be secure to backboard * 5. Football helmet interferes with ability to do a NEEDED complete physical assessment *The student will describe the contraindications for the equipment/procedure 1. None *The student will describe the possible side effects to the use of the equipment/procedure 1. Improper helmet removal can cause additional injury to the patient *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions P F P F**Student Must be proficient and/or perform either rescuer role (instr. Option )** Explains the procedure to the patient and remind them not to move without instruction P F P F ***First rescuer positions him/herself above and behind the patient P F P F First rescuer places hands on each side of helmet with fingers stabilizing the mandible P F P F Second rescuer removes face mask, ear pads, and chin strap P F P F ***The second rescuer then places one hand under the neck and the other hand on the P F P F anterior neck cupping the mandible with the forefinger and thumb First rescuer releases stabilization, looks for obstructions, and deflates bladder(s) (if equipped) P F P F First rescuer now removes the helmet by pulling out laterally on each side to clear the P F P F ears tilting forward and then upward, pulling slowly to remove it ***The second rescuer maintains immobilization during procedure by sliding their posterior P F P F hand with the helmet until reaching the occiput to prevent the head from dropping After removal of the helmet, the first rescuer takes over manual C-Spine immobilization P F P F ***A neck survey is performed and a C-Collar is sized and applied P F P F ***Patient's head is then brought back to a neutral inline position or supported with pads P F P F Monitor patient and record any changes in patient condition P F P F


*Any action or inaction which causes excessive movement of the head*Failure to identify all 5 criteria for football helmet removal

*Failure to bring head into a neutral inline position or provide support*Failure to perform a neck survey prior to applying a C-Collar



FALL 2012

1.18.0 SKILL: HELMET REMOVAL (MOTORCYCLE)

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. To remove a motorcycle helmet without doing any further injury to the spine *The student will describe the indication for the equipment/procedure 1. Any victim of trauma with a full face motorcycle style helmet requiring immobilization *The student will describe the contraindications for the equipment/procedure 1. None *The student will describe the possible side effects to the use of the equipment/procedure 1. Helmet removal can cause additional injury to the patient *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions P F P F**Student Must be proficient and/or perform either rescuer role (instr. Option )** P F P F Explains the procedure to the patient and remind them not to move without instruction P F P F ***First rescuer positions him/herself above and behind the patient P F P F First rescuer places hands on each side of helmet with fingers stabilizing the mandible P F P F Second rescuer opens visor, removes glasses, and cuts or unstraps chinstrap P F P F ***The second rescuer then places one hand under the neck and the other hand on the anterior neck cupping the mandible with the forefinger and thumb P F P F First rescuer releases stabilization, looks for obstructions, and deflates bladder(s) (if equipped) P F P F First rescuer now removes the helmet by pulling out laterally on each side to clear the ears tilting forward and then upward, pulling slowly to remove it P F P F ***The second rescuer maintains immobilization during procedure by sliding their posterior hand with the helmet until reaching the occiput to prevent the head from dropping P F P F After removal of the helmet, the first rescuer takes over manual C-Spine immobilization P F P F ***A neck survey is performed and a C-Collar is sized and applied P F P F ***Patient's head is then brought back to a neutral inline position or supported with pads P F P F Monitor patient and record any changes in patient condition


*Any action or inaction which causes excessive movement of the head*Failure to bring head into a neutral inline position or provide support

*Failure to perform a neck survey prior to applying a C-Collar



FALL 2012

1.19.0 SKILL: SPLINTING LONG BONE

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Reduce pain, prevent further injury, and help control hemorrhage *The student will describe the indication for the equipment/procedure 1. Any suspected fracture or dislocation of an extremity *The student will describe the contraindications for the equipment/procedure 1. None *The student will describe the possible side effects to the use of the equipment/procedure 1. Possibility of neurovascular injury * 2. Possible retraction of bone ends into the wound during splinting of open fracture *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions P F P F Explain the procedure to the patient and remind them not to move without instruction P F P F ***Instruct partner to stabilize the injury P F P F Expose injury (If injury is below the waist, expose bi-laterally) - Perform DCAPBTLS P F P F ***Assess/Record baseline circulation, motor, sensation - distal to the injury (Control any P F P F bleeding of present) Splint fracture in position found - unless extremity is pulseless, cyanotic, or severely P F P F deformed. If any of those are found, atttempt to re-align extremity once into normal anatomical position using gentle traction. If resistance to limb alignment is felt, splint in deformed position. If an open wound is present, apply and secure a sterile dressing to the wound P F P F Select the appropriate splint, padding the splint if necessary P F P F Gently lift the injury while providing support and place the splint P F P F Immobilize the extremity in the position of function if possible P F P F ***When immobilizing a bone, splint joint to joint - When immobilizing a joint, splint bone to bone P F P F If possible, raise a lower extremity injury 6" and apply cold packs to reduce swelling P F P F Secure the splint P F P F ***Reassess/Record circulation, motor, and sensation - distal to the injury P F P F Monitor patient and record any changes in patient condition P F P F


*Failure to stabilize the injury*Failure to assess CMS before and after applying splint

*Failure to follow general rules of splinting bone/joint injuries*Excessive movement of the patient's extremity during procedure



FALL 2012

1.20.0 SKILL: BIPOLAR TRACTION SPLINT (HARE)

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Device for splinting and reducing pain associated with qualifying femur fractures *The student will describe the indication for the equipment/procedure 1. Patient with suspected mid-shaft or proximal third femoral fractures *The student will describe the contraindications for the equipment/procedure 1. An associated fracture of the: pelvis, hip, knee, tibia/fibula, ankle, or foot * 2. Suspected fracture within 3 inches of any joint *The student will describe the possible side effects to the use of the equipment/procedure 1. Possibility of neurovascular injury consistent with manipulation of fractured limb *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions P F P F Explains the procedure to the patient and remind them not to move without instruction P F P F ***Stabilize leg, Expose both legs, Assess both legs for DCAPBTLS from the pelvis down P F P F ***Assess/Record baseline circulation, motor, and sensation - distal to the injury P F P F ***Carefully bring angulated leg to an inline normal anatomical position P F P F IF RESISTANCE IS FELT DURING REALIGNMENT, STOP AND SPLINT LEG IN POSITION FOUND P F P F Secure ankle hitch to patient's injured limb P F P F Have 2nd rescuer apply manual traction P F P F Adjust the splint for proper length, using the uninjured leg as a guide (approx. 12") P F P F Position the splint under the injured leg until the ischial pad rests against the bony P F P F prominence of the buttocks. Once the splint is in position, raise the heel stand ***Attach the ischial strap over the groin and thigh - must be firmly secured P F P F Secure ankle hitch ring to the hook on winding strap P F P F Apply mechanical traction until manual traction is relieved, pain and muscle spasms are reduced, P F P F or in the unconscious patient - until the injured leg is of equal length to the uninjured leg Apply Velcro straps and reevaluate the ischial strap and ankle hitch P F P F ***Reassess/Record circulation, motor, and sensation - distal to the injury P F P F Monitor patient and record any changes in patient condition P F P F


*Failure to stabilize the injury & assess for DCAPBTLS from the pelvis down*Failure to assess CMS before and after applying splint

*Failure to apply the ischial strap as directed



FALL 2012

1.21.0 SKILL: UNIPOLAR TRACTION SPLINT (SAGER)

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Device for splinting and reducing pain associated with qualifying femur fractures *The student will describe the indication for the equipment/procedure 1. Patient with suspected mid-shaft or proximal third femoral fractures *The student will describe the contraindications for the equipment/procedure 1. An associated fracture of the: pelvis, hip, knee, tibia/fibula, ankle, or foot * 2. Suspected fracture within 3 inches of any joint *The student will describe the possible side effects to the use of the equipment/procedure 1. Possibility of neurovascular injury consistent with manipulation of fractured limb *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions P F P F Explain the procedure to the patient and remind them not to move without instruction P F P F ***Stabilize leg, Expose both legs, Assess both legs for DCAPBTLS from the pelvis down P F P F ***Assess/Record baseline circulation, motor, and sensation - distal to the injury P F P F ***Carefully bring angulated leg to an inline normal anatomical position P F P F IF RESISTANCE IS FELT DURING REALIGNMENT, STOP AND SPLINT LEG IN POSITION FOUND P F P F Place the splint along the medial aspect of the uninjured leg - adjust it so that it is level P F P F with the heel - BE MINDFUL OF PATIENT'S GENITAL AREA ***Attach the top strap over the upper thigh - tighten in a cephelad (toward the head) P F P F direction - Strap must be firmly secured Secure both ankle hitches to patient and attach only injured leg to the end of the inner shaft P F P F ***Stabilize upper-shaft with one hand & extend the lower until: P F P F 1. The device reads 10% of the patient's weight or 15 lbs max pull for 1 injured leg 2. The device reads 20% of the patient's weight or 30 lbs max pull for 2 injured legs Apply Velcro straps and reevaluate the thigh strap and ankle hitch P F P F Secure feet in a normal anatomical position using a pedal pinion strap or comparable replacement P F P F ***Reassess/Record circulation, motor, and sensation - distal to the injury P F P F Monitor patient and record any changes in patient condition P F P F


*Failure to stabilize the injury & assess for DCAPBTLS from the pelvis down*Failure to assess CMS before and after applying splint

*Failure to apply the ischial strap as directed*Failure to pull traction to the specified percentage or weight



FALL 2012

1.22.0 SKILL: SCOOP STRETCHER

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Facilitates the lifting/moving of patients in limited access areas *The student will describe the indication for the equipment/procedure 1. Facilitates the lifting/moving of patients where minimal patient movement is desired *The student will describe the contraindications for the equipment/procedure 1. Cannot immobilize a spinal injured patient with the scoop stretcher *The student will describe the possible side effects to the use of the equipment/procedure 1. Patients can be pinched during application of scoop stretcher * 2. Cannot x-ray through scoop stretcher * 3. Scoop stretcher is often cold and uncomfortable *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions P F P F Explains the procedure to the patient and remind them not to move without instruction P F P F Place scoop stretcher along uninjured side of patient P F P F Align headrest with occipital area of patient's head P F P F Open locks and extend leg rails to nearest appropriate length P F P F ***Visually ensure locks have seated in rail holes and that leg sections are secure P F P F Open both ends of scoop and place half on each side of the patient P F P F Carefully place one half as far as possible under patient P F P F Connect the other half of the scoop stretcher carefully at the HEAD P F P F Slowly and carefully close the remaining half together until locking at the FEET P F P F Move patient to the desired location and remove device P F P F Monitor patient and record any changes in patient condition P F P F


*Separating the halves before measuring and extending the lower section*Failure to ensure locking pins are set



FALL 2012

1.23.0 SKILL: BLS-CARDIAC ARREST MANAGEMENT/AED

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Helps restore normal cardiac function in patients requiring defibrillation by terminating V-Fib *The student will describe the indication for the equipment/procedure 1. All patients who are unresponsive, apneic/gasping breath only, and pulseless * 2. Victims of drowning or electrocution *The student will describe the contraindications for the equipment/procedure 1. Unconscious patients with agonal respirations and/or pulses * 2. Pediatric patients less that 1 y/o (use appropriate defib pads with patients 1 to 8 y/o) * 3. Cardiac arrest secondary to trauma (exception: drowning and electrocution) *The student will describe the possible side effects to the use of the equipment/procedure 1. Patient contact or movement during the analyze mode can interfere with the AED analysis * 2. Some electrical appliances and radio frequencies can interfere with the AED analysis * 3. Failure to remove trans-dermal patches before shock delivery can result in injury *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions P F P F Forms a general impression P F P F Briefly questions rescuers or witness(s) about cardiac arrest events: P F P F Witnessed arrest? Estimated down time? Bystander CPR initiated? P F P F ***Follow AHA guidelines to determine if the patient is: unconscious, apneic, and pulseless (A, B, C's) P F P F ***Instructs assistant(s) to begin CPR according to AHA guidelines Verbalizes "push hard, push fast, allow for full chest recoil" P F P F Verbalizes CPR is to be performed for 2 minutes (5 cycles 30:2 ratio) before the AED is P F P F utilized, unless know down time of less than 4 to 5 minutes Positions AED next to patient and turns the power on P F P F Connects Electrodes P F P F Prior to applying pads to the patient, the rescuer MUST verbalize the following: P F P F Medication patches and necessary chest hair removed / pads are away from pacemakers AED can be used for any age. They recommend child size pads and joules reduction machine. P F P F If they are not available you can shock them with an adult AED. Directs rescuer to stop CPR and makes sure the patient is not being touched P F P F Initiates analysis of the patient's rhythm, waits for AED to analyze P F P F If shock is indicated, states "stand clear" and ensures that the area around the patient P F P F clear before delivery of shock Immediately directs CPR to begin without interruption (NO PULSE CHECK AT THIS TIME) P F P F Verbalizes insertion of an airway adjunct (OPA or NPA as appropriate) P F P F Assures high concentration of O2 is delivered & observes adequate ventilation with BVM P F P F After approximately 2 minutes of CPR (5 cycles of 30:2), re-evaluate patient's pulse - P F P F pause no longer than 10 seconds for pulse check If no pulse is present, re-analyze rhythm, if indicated - deliver shock P F P F After delivering second shock or "no shock advised", resume CPR & transport patient (no pulse check) P F P F If pulse returns, obtain vital signs - Respirations, Pulse, and Blood Pressure P F P F Gathers additional information on cardiac arrest from family or witnesses P F P F Verbalizes transport of patient P F P F

FALL 2012

Leaves defibrillator pads attached to patient for monitoring during transport P F P F


*Failure to follow a systematic approach*Failure to direct initiation/resumption of ventilation/compressions at appropriate times and ratios

*Failure to initiate 1st shock - if known downtime is less than 4 to 5 minutes*Failure to assure that all individuals were clear of patient before delivering each shock

*Failure if CPR is interrupted for longer for 10 seconds



FALL 2012

1.24.0 SKILL: BLS - NITROGLYCERIN ADMINISTRATION

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Dilates blood vessels, increasing blood flow to the heart * 2. Decreases the workload of the heart *The student will describe the indication for the equipment/procedure 1. Patients who exhibit signs and symptoms of chest pain * 2. Medication is prescribed for this patient * 3. Medical direction authorizes use (on or off line) *The student will describe the contraindications for the equipment/procedure 1. Patient's blood pressure is below 100 mmHg systolic or a 30mmHg drop from baseline. * 2. Ingestion of sexually enhancing drugs in the past 24 hrs (Viagra, Cialis, Levitra) * 3. The patient has a suspected head injury * 4. The patient has already taken a total of 3 doses *The student will describe the possible side effects to the use of the equipment/procedure 1. Headache * 2. Drop in blood pressure with an increase in heart rate to compensate *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions P F P F ***Perform your Primary Assessment (including O2 administration), Rapid Scan P F P F Investigate Pt's Chief Complaint P F P F***Must obtain/record SAMPLE and OPQRSTI P F P F***Obtain/Record complete set of vitals P F P F***Perform a Focused Physical Exam (DCAPBTLS) on areas based on chief complaint Determine that the patient has their own nitroglycerin and protocols allow administration P F P F Check "Five Rights" - Right Patient, Right Medication, Right Route, Right Dose, Right Date P F P F ***Confirm blood pressure is > 100 mmHg systolic P F P F ***Confirm the patient's level of consciousness (must be alert and oriented) P F P F ***Confirm the patient HAS NOT ingested any sexually enhancing drugs in the past 24 hrs. P F P F ***Confirm dose of NTG as 0.3mg or 0.4mg tablet or sublingual spray P F P F Assist patient - placing one tablet or delivering one metered dose spray under tongue - P F P F Instruct patient to close mouth and do not swallow ***After 5 minutes - reassess/record patient's: medical condition and vital signs P F P F If pain persists, continue with NTG administration according to the protocol - up to 3 doses P F P F ***Document - Medication: dosage, actions, route, time, (DART) and patient's response (+/-) P F P F If condition WORSENS: Obtain medical direction (on/off line) for an additional dose P F P F If condition IMPROVES: Continue oxygen, monitoring of patient vitals, and transport P F P F

***Critical Criteria****Failure to take/verbalize Universal Precautions//Failure to check all five rights*Failure to confirm no sexually enhancing drugs within 24 hours//Vital signs ensuring systolic >100mmHg*Failure to reassess vitals post medication administration *Failure to document - Medication: dosage, actions, route, time, and patient's response (+/-)***Failure to perform a Focused Physical Exam of Chest, Abdomen, and Lung Sounds**INSTRUCTOR INITIALS ________ 1st attempt PASS_____ FAIL_____


FALL 2012

1.25.0 SKILL: BLS - EPINEPHRINE ADMINISTRATION

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure 1. Relieves severe allergic reactions * 2. Constricts blood vessels and dilates bronchioles *The student will describe the indication for the equipment/procedure 1. Patients exhibiting S/S of a severe allergic reaction (Uticaria, Respiratory Distress, Hypotension) * 2. Medication is prescribed for this patient * 3. Medical direction authorizes use (on or off line) *The student will describe the contraindications for the equipment/procedure 1. No contraindications when used in a life threatening situation *The student will describe the possible side effects to the use of the equipment/procedure 1. Tachycardia and excitability * 2. Chest pain and/or headache * 3. Dizziness and/or pallor * 4. Nausea and/or vomiting *The student will demonstrate the use of the equipment/procedure *** Takes/Verbalizes Universal Precautions P F P F ***Perform your Primary Assessment (including O2 administration), Rapid Scan P F P F Investigate Pt's Chief Complaint P F P F***Must obtain/record SAMPLE and OPQRSTI P F P F***Obtain/Record complete set of vitals P F P F***Perform a Focused Physical Exam (DCAPBTLS) on areas based on chief complaint P F P F Determine that the patient has their own auto-injector and protocols allow administration P F P F Check "Five Rights" - Right Patient, Right Medication, Right Route, Right Dose, Right Date P F P F Explain the procedure to the patient and instruct them not to move without instruction P F P F Remove the safety cap from the auto-injector and hold correctly(90* angle to lateral thigh) P F P F Place the tip of auto-injector against the patient's thigh - laterally & mid-shaft P F P F Push the auto-injector firmly until the injector activates - holding firmly until it discharges P F P F completely (at least 10 seconds) P F P F ***Discard auto-injector in SHARPS container P F P F ***After 5 minutes - reassess patient's: medical condition and vital signs P F P F ***Document - Medication: dosage, actions, route, time, (DART) and patient's response (+/-) P F P F If condition WORSENS: Obtain medical direction (on/off line) for an additional dose, treat for shock If condition IMPROVES: Continue oxygen, monitoring of patient vitals, and transport

***Critical Criteria****Failure to take/verbalize Universal Precautions//*Check the Five Rights***

*Failure to discard auto-injector in SHARPS container// *Proper Location and Time*Failure to obtain vitals - pre/post administration//*Physical Exam of any kind

*Failure to document - Medication: dosage, actions, route, time, and patient's response (+/-)

INSTRUCTOR INITIALS _____________________ 1st attempt PASS_____ FAIL_____


FALL 2012

EMT SKILLS SHEET

Date

1 P F P F

3 P F P F

5 P F P F6 P F P F7 P F P F8 P F P F9 P F P F

10 P F P F11 P F P F12 P F P F13 P F P F14 P F P F15 P F P F16 P F P F17 P F P F

Pass FailPass Fail

Reference:

SKILL: Adult One person CPR (C-A-B)

Student Name

Open airway (Head tilt-chin lift or jaw thrust) & Give 2 breaths over a sec *Start 30 chest compressions *Open airway (Head tilt-chin lift or jaw thrust) & Give 2 breaths over a sec *Start 30 chest compressions *

1st attempt 2nd attemptInformation

Call for help and get a AED or call for ALS backup

Find land mark between nipple line

F

Start 30 chest compressions *Open airway (Head tilt-chin lift or jaw thrust) & Give 2 breaths over a sec *

Start 30 chest compressions *


→ Failure to verbalize BSICritical Criteria

American Heart Association 2010 CPR Guidelines Revision Date: Feb 2012

→ Failure to check carotid or femoral pulse

Place 2 hands between the nipple line *

4

Open airway (Head tilt-chin lift or jaw thrust) & Give 2 breaths over a sec *

→ Failure to place hands between nipple line

Circulation : Check a Carotid or Femoral pulse →If no pulse → start chest compressions (within 10 seconds) *

→ Failure to check for unresponsiveness & breathing

P F

Expose the patient

P


→ Failure to do cycles of 30 compressions and give 2 breath

Instructor Print 1st attempt2nd attempt

Instructor Signature

P F P F2

Takes/ Verbalizes Universal Precautions (BSI) *Check for unresponsiveness (Verbal & Painful stimulation) & briefly check for breathing (If not breathing or only gasping breath move to step 3)*

FALL 2012

EMT SKILLS SHEET

Date

1 P F P F

3 P F P F



Pass FailPass Fail

Reference:

SKILL: Child One person CPR (C-A-B)

Student Name

*Critical Criteria*→ Failure to verbalize BSI

Start 30 chest compressions *Open airway (Head tilt-chin lift or jaw thrust) & Give 2 breaths over a sec *Start 30 chest compressions *Open airway (Head tilt-chin lift or jaw thrust) & Give 2 breaths over a sec *Start 30 chest compressions *

Circulation : Check a Carotid or Femoral pulse →No pulse or pulse less then 60bpm with inadequate signs of perfusion (10 seconds) -> move to step 5

Start 30 chest compressions *Open airway (Head tilt-chin lift or jaw thrust) & Give 2 breaths over a sec *Start 30 chest compressions *Open airway (Head tilt-chin lift or jaw thrust) & Give 2 breaths over a sec *

Takes/ Verbalizes Universal Precautions (BSI) *

4

Expose the patient


Information 1st attempt 2nd attempt

2Check for unresponsiveness (Verbal & Painful stimulation) & briefly check for breathing (If not breathing or only gasping breath move to step 3)*

F P F

P F P F

P



Find land mark between nipple linePlace1 hand between the nipple line *

→ Failure to check carotid or femoral pulse → Failure to place hands between nipple line



2nd attemptInstructor Signature

Instructor Printed 1st attempt

FALL 2012

EMT SKILLS SHEET

Date

1 P F P F

3 P F P F



Pass FailPass Fail

Reference:

SKILL: Infant One person CPR (C-A-B)

Student Name

Information 1st attempt


2nd attempt

Open airway (Head tilt-chin lift or jaw thrust) & Give 2 breaths over a sec *Start 30 chest compressions *Open airway (Head tilt-chin lift or jaw thrust) & Give 2 breaths over a sec *Start 30 chest compressions *




→ Failure to check brachial or femoral pulse → Failure to place 2 fingers, one finger width below nipple line

F

2 P FCheck for unresponsiveness (Verbal & Painful stimulation) & briefly check for breathing (If not breathing or only gasping breath move to step 3)*

Takes/ Verbalizes Universal Precautions (BSI) *

2nd attempt


P

4Circulation: Check a Brachial or Femoral pulse →No pulse or pulse less then 60bpm with inadequate signs of perfusion (10 seconds) -> move to step 5

P F P


Expose the patient

Start 30 chest compressions *Open airway (Head tilt-chin lift or jaw thrust) & Give 2 breaths over a sec *Start 30 chest compressions *

Find land mark between nipple linePlace 2 fingers, one finger width below nipple line*

1st attempt


*Critical Criteria*→ Failure to verbalize BSI


Instructor Printed

F

FALL 2012

EMT SKILLS SHEET

NAME Date

1 P F P F2 P F P F3 P F P F4 P F P F5 P F P F6 P F P F

8 P F P F9 P F P F

10 P F P F11 P F P F12 P F P F13 P F P F14 P F P F15 P F P F16 P F P F17 P F P F18 P F P F19 P F P F

Pass FailPass Fail

Reference:



Instructor Initials 1st attempt

If no chest rise, realign the airway and give second breath looking for chest riseRepeat steps 13-18 until object comes out or breath go in

Critical Criteria→ Failure to verbalize BSI

→ Failure to identify patient choking→ Failure to do perform the Abdominal Thrust correctly

→ Failure to place hands between nipple line→ Failure to do cycles of 30 compressions and give 2 breath

→ Failure to Open the Airway→ Failure to give 1 breaths

→ Failure to give 2nd breath

Give one breath looking for chest rise.

P F

Use a up and in technique to press on the abdomen areaContinue abdominal thrust until (object comes out or patient passes out)If patient pass out/ goes unresponsive, Lay patient on the floorActivate the EMS system

F

Expose the patientFind land mark between nipple linePlace 2 hands between the nipple line *Start 30 chest compressions *Open airway, look in side the mouth/ (DO NOT perform a blind finger sweep)

Place one leg in between the patients legLocate the belly button (Umbilicus) with one finger

7Make a fist with your other hand and place it above the belly button, thumb side towards the abdomen

P

Position yourself behind the patient

SKILL: Adult Abdominal Thrust (Choking)

Responsive & Unresponsive

Takes/ Verbalizes Universal Precautions (BSI) *Look for the universal sign of choking Ask the patient are you choking/ Ask the patient can I help

FALL 2012

EMT SKILLS SHEET

NAME Date

1 P F P F2 P F P F3 P F P F4 P F P F5 P F P F6 P F P F

8 P F P F9 P F P F

10 P F P F11 P F P F12 P F P F13 P F P F14 P F P F15 P F P F16 P F P F17 P F P F18 P F P F19 P F P F

Pass FailPass Fail

Reference: Revision Date: Feb 2012


American Heart Association 2010 CPR Guidelines


→ Failure to Open the Airway→ Failure to give 1 breaths


Instructor Initials 1st attempt

→ Failure to do perform the Abdominal Thrust correctly

Expose the patientFind land mark between nipple linePlace 2 hands between the nipple line *Start 30 chest compressions *Open airway, look in side the mouth/ (DO NOT perform a blind finger sweep)Give one breath looking for chest rise. If no chest rise, realign the airway and give second breath looking for chest riseRepeat steps 13-18 until object comes out or breath go in

Critical Criteria→ Failure to verbalize BSI

→ Failure to identify patient choking

P F

Use a up and in technique to press on the abdomen areaContinue abdominal thrust until object comes out or patient passes outIf patient pass out/ goes unresponsive, Lay patient on the floor

P F

Activate the EMS system

Place one leg in between the patients legLocate the belly button (Umbilicus) with one finger

7Make a fist with your other hand and place it above the belly button, thumb side towards the abdomen

Position yourself behind the patient, kneel to patients level

SKILL: Child Abdominal Thrust (Choking)Responsive & Unresponsive

Takes/ Verbalizes Universal Precautions (BSI) *Look for the universal sign of chokingAsk the patient are you choking/ Ask the patient can I help

FALL 2012

NAME Date

1 P F P F2 P F P F3 P F P F4 P F P F5 P F P F6 P F P F7 P F P F8 P F P F9 P F P F

10 P F P F11 P F P F12 P F P F13 P F P F14 P F P F15 P F P F16 P F P F17 P F P F18 P F P F19 P F P F20 P F P F

Pass FailPass Fail

Reference: Revision Date: Feb 2012

→ Failure to give 1 breaths

American Heart Association 2010 CPR Guidelines


Instructor Initials 1st attempt2nd attempt


→ Failure to identify patient choking→ Failure to do perform the Back Blows & Chest Thrust


→ Failure to Open the Airway

→ Failure to verbalize BSI

If Infant pass out/ goes unresponsive, lay patient on a flat surfaceActivate the EMS systemExpose the patientFind land mark between nipple linePlace 2 hands between the nipple line *Start 30 chest compressions *Open airway, look in side the mouth/ (DO NOT perform a blind finger sweep)Give one breath looking for chest rise. If no chest rise, realign the airway and give second breath looking for chest riseRepeat steps 14-19 until object comes out or breath go in

Critical Criteria

Continue Back Slaps & Chest Thrust until object comes out or Infant passes out

SKILL: Infant Back Slaps/Chest Trust (Choking)

Takes/Verbalizes Universal Precautions (BSI) *Check to see if the Infant is chokingSupport the child head in your hand laying face down, legs between your armLocate the shoulder blades

Responsive & UnresponsiveEMT SKILLS SHEET

Perform 5 Back SlapsFlip the Infant over now supporting the back of the headFind land mark: One finger width below nipple linePlace 2 fingers below nipple linePerform 5 Chest Trust

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