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Back to EMT-B

 No matter how many points you get, you will fail the station if you forget just one critical step.

Steps must be completed in this order. Skipping around will cause you to loose points.

Put your gloves on in the beginning and leave them on!

Patient Assessment / Management Trauma   (Must receive a minimum of 23 points to pass this station 33 total)
Category Steps Points
SCENE SIZE-UP Takes, or verbalizes, body substance isolation precautions C
Determines the Scene is safe C
Determine the Mechanism of injury / nature of illness (MOI / NOI) 1
Considers stabilization of the spine C
INITIAL ASSESSMENT Verbalizes general impression of the patient 1
Determines Responsiveness/level of Consciousness (AVPU) 1
Determines chief complaint/apparent life threats 1
Airway and Breathing Assesses and maintains airway C
Initiates appropriate oxygen therapy C
Assures adequate ventilation C
Manages life threats to airway/breathing C
Circulation Assesses/controls major bleeding C
Assesses pulse (Existing or not) C
Assesses skin (color, temperature and condition) C
Assesses airway, breathing and circulation prior to detailed physical exam C
Identifies priority patients/ makes transport decision C
Utilized CUPS status 1
HISTORY/ PHYSICAL EXAM/ RAPID ASSESSMENT Selects appropriate assessment (focused or rapid assessment) 1
Obtains baseline vital signs Pulse              Determines rate and quality (+-10) C
Respirations   Determines rate and quality (+-4) C
Blood Pressure systolic and diastolic (+-10) C
Obtains SAMPLE history 1
DETAILED PHYSICAL EXAM Assesses the head Inspects and palpates the scalp and ears 1
Assess the eyes 1
Assesses the facial area including oral and nasal areas 1
Assesses the neck Inspects and palpates the neck 1
Assesses for JVD 1
Assesses for tracheal deviation 1
Assesses the chest Inspects  1
Palpates (looking for flail chest etc.) 1
Auscultates  1
Assesses the abdomen/pelvis Assesses the abdomen (palpate all 4 quadrants) 1
Assesses the pelvis (push in on side, push down on points) 1
Verbalize assessment of genitalia/perineum as needed 1
Assesses the extremities Inspects and palpates all 4 extremities   (1pt each) 4
Check motor, sensory, distal circulation  (PMS)   (1 pt each)  4
Assesses the posterior Assesses thorax 1
Assesses lumbar 1
Manages secondary injuries and wounds appropriately 1
ONGOING ASSESSMENT (VERBALIZED) Repeats initial assessment 1
Retreats vital signs 1
Repeats focused assessment 1
Candidate completed station within 15 minute time limit C
TOP OF THIS ASSESSMENT                         

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Patient Assessment / Management Medical   (Must receive a minimum of 13 points to pass this station 19 total)

Category

Steps

Points

SCENE SIZE-UP Takes, or verbalizes, body substance isolation precautions C
Determines the Scene is safe C
Determine the Mechanism of injury / nature of illness (MOI / NOI) 1
Considers stabilization of the spine if indicated 1
INITIAL ASSESSMENT Verbalizes general impression of the patient 1
Determines responsiveness/level of consciousness (AVPU) 1
Determines chief complaint/apparent life threats 1
Airway and breathing Assesses and maintains airway C
Initiates appropriate oxygen therapy C
Assures adequate ventilation C
Circulation Assesses/ controls major bleeding C
Assesses pulse (Existing or not) C
Assesses skin (color, temperature and condition) C
Assesses airway breathing and circulation prior to focused history/physical exam C
Identifies priority patients/makes transport decision C
Utilizes CUPS status determination 1
Assesses history of present illness - ask required number of questions C

FOCUSED HISTORY AND 
PHYSICAL EXAM

Respiratory         Cardiac            Altered Mental                  Allergic                        Poisoning/
                                                         Status                          Reaction                       Overdose


OPQRSTI           OPQRSTI           - Description of            - History of                    - Substance
     (5)                      (5)                    the episode                   allergies?                    - When did you
                                                      - Onset                        - What were you               ingest/exposed?
                                                      - Duration                       exposed to?                - How much did
                                                      - Associated                 - How were you               you ingest?
                                                        Symptoms                     exposed?                     - Over what time
                                                      - Evidence of                 - Effects                           period
                                                         trauma?                      - Progression                 - Interventions
                                                      - Interventions              - Interventions              - Estimated weight
                                                      - Seizures                             (4)                                   (5)
                                                      - Fever
                                                             (6)

Environmental                       Obstetrics                                 Behavioral
Emergency

- Source                          - Are you pregnant?                    - How do you feel?
- Environment                - How long have you                    - Determine suicide
- Duration                        been pregnant?                            tendencies
- Loss of                         - Pain or contractions?                 - Is the patient a threat
  consciousness              - Bleeding or discharge                 to self or others?
- Effects of                      - Has water broke?                      - Is there a medical problem?
  general or local            - Do you feel the need                - Interventions
       (4)                              to push?                                                 (4)
                                      - Last menstrual period?
                                                     (5)

see list
Signs / symptoms 1
Allergies 1
Medications 1
Past pertinent history 1
Last oral intake 1
Event leading to present illness (rule out trauma) 1
Performs focused physical exam.  (consistent with scenario) 1

Vitals (obtains baseline vital signs)

Pulse                       Determines Rate and Quality (+-10) C
Respirations            Determines Rate and Quality (+-4) C
Blood Pressure        Determines systolic and Diastolic (+-10) C
TREATMENTS  / INTERVENTIONS (Consistent with NYS and Regional Protocols) 1
Did not administer a dangerous or inappropriate intervention C
Transport (Re-evaluates the transport decision) 1
Verbalize the consideration of completing a detailed physical examination 1

ONGOING ASSESSMENT (VERBALIZE)

Repeats initial assessment 1
Repeats vital signs 1
Repeats focused assessment regarding patient complaint or injuries 1
Candidate completed station within the 15 minute time limit C
TOP OF THIS ASSESSMENT                         

BACK TO TIPS

Cardiac Arrest Management / AED   (Must receive a minimum of 13 points to pass this station 19 total)

Category

Steps

Points

ASSESSMENT Takes, or verbalizes, body substance isolation precautions C
Briefly questions the rescuer about arrest events 1
Directs rescuer to stop CPR 1
Verifies absence of spontaneous pulse (skill station examiner states "no pulse") C
Directs resumption of CPR 1
Turns on defibrillator power 1
Attaches automated defibrillator to the patient 1
Directs rescuer to stop CPR 1
Ensures all individuals are clear of the patient 1
Initiates analysis of the rhythm 1
Delivers shock (up to three successive shocks) C
Verifies absence of spontaneous pulse (skill station examiner states "no pulse") 1
TRANSITION Directs resumption of CPR 1
Gathers additional information about arrest event 1
Verifies effectiveness of CPR (ventilation and compression) 1
INTEGRATION Verbalizes insertion of a simple airway adjunct (oral/nasal airway) 1
Ventilates the patient 1
Assures high concentration of oxygen is delivered to the patient 1
CPR continues without unnecessary/prolonged interruption 1
Re-evaluates patient in approximately one minute 1
Candidate verbalizes defibrillation sequence protocol 1

Transportation

Verbalizes transportation of patient 1
Candidate initiated first shock within 1 minute of arrival C
Assured all individuals were clear of the patient before delivering each shock C
Directed initiation/resumption of ventilation/compressions at appropriate times C
Candidate completed station within 15 minute time limit

C

TOP OF THIS ASSESSMENT                         

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Bag-Valve-Mask / Apneic Patient   (Must receive a minimum of 6 points to pass this station 9 total)

Steps

Points
Takes, or verbalizes, body substance isolation precautions C
Opens the airway 1
Inserts an airway adjunct 1
Selects an appropriately sized mask 1
Creates proper mask-to-face seal 1
Ventilates patient at no less then 800 ml volume  (the examiner must witness for at least 30 seconds) C
Candidate ventilated patient prior to connecting supplemental oxygen C
Connects reservoir and oxygen 1
Adjusts liter flow to 15 liters/minute or greater C
The Examiner indicates arrival of a second EMT
The second EMT is instructed to ventilate the patient while the candidate controls the mask and the airway
1
Reopens the airway 1
Creates a proper mask-to-face seal 1
Instructs assistant to resume ventilation at proper volume per breath  (The examiner must witness for at least 30 seconds) 1
Did not interrupt ventilation for more then 20 seconds C
Allows for adequate exhalation C
Candidate must complete the station within the 5 minute time mark C
TOP OF THIS ASSESSMENT                         

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Spinal Immobilization / Seated Patient   (Must receive a minimum of 6 points to pass this station 8 total)

Steps

Points

Takes, or verbalizes, body substance isolation precautions C
Directs assistant to place and maintain head in the neutral in-line position C
Reassesses motor, sensory and circulation function in each extremity 1
Applies appropriate sized extrication collar 1
Positions the immobilization device behind the patient 1
Secures the device to the patient's torso 1
Evaluates torso fixation and adjusts as necessary 1
Evaluates and pads the patients head as necessary 1
Secures the patients head to device 1
Verbalizes moving patient o a long board 1
Reassesses motor, sensory and circulatory function in each extremity C
Did not release or order release of manual immobilization before it was maintained mechanically C
Patient was not manipulated or moved excessively, to cause potential spinal compromise C
Did not move devise excessively up, down, left, right on the patients torso C
Head immobilization does not allow for excessive movement C
Torso fixation does not inhibit chest rise, resulting in respiratory compromise C
Upon completion of immobilization, head is in the neutral position C
Immobilized torso before the head C
Candidate completed station within 10 minute time limit C
TOP OF THIS ASSESSMENT                         

BACK TO TIPS

Spinal Immobilization / Supine Patient   (Must receive a minimum of 6 points to pass this station 8 total)

Steps

Points

Takes, or verbalizes, body substance isolation precautions C
Directs assistant to place and maintain head in the neutral in-line position C
Reassesses motor, sensory and circulation function in each extremity 1
Applies appropriate sized extrication collar 1
Positions the immobilization device appropriately 1
Directs movement of the patient onto the device without compromising the integrity of the spine C
Applies padding to voids between the torso and the board as necessary 1
Secures patient's torso to the device 1
Secures the patient's legs to the device 1
Secures the patients Head to the device 1
Secures the patients arms to the device 1
Reassesses motor, sensory and circulation function in each extremity C
Did not release or order release of manual immobilization before it was maintained mechanically C
Patient was not manipulated or moved excessively, to cause potential spinal compromise C
Did not move devise excessively up, down, left, right on the patients torso C
Head immobilization does not allow for excessive movement C
Upon completion of immobilization, head is in the neutral position C
Immobilized torso before the head C
Candidate completed station within 10 minute time limit C
TOP OF THIS ASSESSMENT                         

BACK TO TIPS

Immobilization Skills / Long Bone Injury   (Must receive a minimum of 4 points to pass this station 5 total)

Steps

Points

Takes, or verbalizes, body substance isolation precautions C
Directs application of manual stabilization of the injury 1
Assesses motor, sensory, and circulatory function in the injured extremity C
Note: the examiner acknowledges "motor, sensory and circulatory function are present and normal"
Measure the splint 1
Applies the splint 1
Immobilizes the joint above the injury site C
Immobilizes the joint below the injury site C
Secures the entire injured extremity 1
Immobilizes the hand/foot in the position of function 1
Reassesses motor, sensory, and circulatory function in the injured extremity C
Note: The examiner acknowledges "motor, sensory and circulatory function are present and normal"
Candidate did not grossly move the injured extremity C
Candidate must complete station within 10 minute time limit C
TOP OF THIS ASSESSMENT                         

BACK TO TIPS

Immobilization Skills / Joint Injury   (Must receive a minimum of 2 points to pass this station 3 total)

Steps

Points

Takes, or verbalizes, body substance isolation precautions C
Directs application of manual stabilization of the shoulder injury 1
Assesses motor, sensory, and circulatory function in the injured extremity C
Note: the examiner acknowledges "motor, sensory and circulatory function are present and normal"
Selects the proper splinting material 1
Immobilizes the site of the injury 1
Immobilizes the bone above the injured joint C
Immobilizes the bone below the injured joint C
Reassesses motor, sensory, and circulatory function in the injured extremity C
Note: The examiner acknowledges "motor, sensory and circulatory function are present and normal"
Joint is supported so that the joint does not bear distal weight C
Candidate must complete station within 5 minute time limit C
TOP OF THIS ASSESSMENT                         

BACK TO TIPS

Immobilization Skills / Traction Splinting   (Must receive a minimum of 7 points to pass this station 11 total)

Steps

Points
Takes, or verbalizes, body substance isolation precautions C
Directs application of manual stabilization of the injured leg 1
Candidate Assesses motor, sensory, and circulatory function in the injured extremity C
Note: The examiner acknowledges "motor, sensory and circulatory function are present and normal"
Directs application of manual traction 1
Prepares/adjusts splint to the proper length 1
Applies the splint to the injured leg 1
Applies the proximal security device (e.g.... ischial strap) 1
Applies the distal securing device (e.g.... ankle hitch) 1
Applies mechanical traction 1
Positions/secures the support straps 1
Re-evaluates the proximal/distal security devices 1
Candidate reassesses motor, sensory, and circulatory function in the injured extremity C
Note: The examiner acknowledges "motor, sensory and circulatory function are present and normal"
Note: The examiner must ask the candidate how he/she would prepare the patient for transportation
Verbalizes securing the torso to the long board to immobilize the hip 1
Verbalizes securing the splint to the long board to prevent movement of the splint 1
Traction is maintained throughout application of splint C
the foot was not excessively rotated or extended after the splint was applied C
Secured the ischial strap before applying mechanical traction C
Final immobilization supported the femur and prevented rotation of the injured leg C
Applied mechanical traction before securing the leg to the splint C
Candidate completed the station within 10 minute time limit C
TOP OF THIS ASSESSMENT                         

BACK TO TIPS

Bleeding Control / Shock Management   (Must receive a minimum of 5 points to pass this station 7 total)

Steps Points
Takes, or verbalizes, body substance isolation precautions C
Applies direct pressure to the wound 1
Evaluates extremity 1
Note: The examiner must now inform the candidate that the wound continues to bleed
Applies an additional dressing to the wound 1
Note: The examiner must now inform the candidate that the wound still continues to bleed. The second dressing does not control the bleeding.
Locates and applies pressure to appropriate arterial pressure point 1
Note: The examiner must now inform the candidate that the bleeding is controlled
Bandages the wound 1
Candidate controlled hemorrhage appropriately C
Note: The examiner must now inform the candidate that the patient is now showing signs and symptoms indicative of hypoperfusion
Properly positions the patient 1
Applies high concentrated oxygen C
Initiates steps to prevent heat loss from the patient 1
Indicates the need for immediate transportation C
Candidate did not apply a tourniquet before attempting other methods of bleeding control C
Candidate completed the station within 5 minute time limit C
TOP OF THIS ASSESSMENT                         

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Upper Airway Adjuncts and Suction   (Must receive a minimum of 8 points to pass this station 12 total)

OROPHARYNGEAL AIRWAY

Steps

Points
Takes, or verbalizes, body substance isolation precautions C
Selects appropriately sized airway 1
Measures airway 1
Inserts airway without pushing the tongue posteriorly 1
Note: The examiner must advise the candidate that the patient is gagging and becoming conscious
Removes the oropharyngeal airway 1

SUCTION

Steps

Points
Note: The examiner must advise the candidate to suction the patients airway
Turns on/prepares suction device 1
Assures presence of mechanical suction 1
Inserts the suction tip without suction 1
applies suction to the oropharynx/nasopharynx 1
Candidate demonstrated acceptable suction technique C

NASOPHARYNGEAL AIRWAY

Steps

Points
Note: The examiner must advise the candidate to insert a nasopharyngeal airway
Selects appropriately sized airway 1
Measures airway 1
Verbalizes lubrication of the nasal airway 1
fully inserts airway with the bevel facing toward the septum 1
Candidate did not insert any adjunct in a manner dangerous to the patient C
Candidate completed the station within 5 minute limit C
TOP OF THIS ASSESSMENT                         

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Mouth-To-Mask / Supplemental Oxygen   (Must receive a minimum of 4 points to pass this station 6 total)

Steps

Points
Takes, or verbalizes, body substance isolation precautions C
   
   
   
   
   
   
   
   
   
   
   
   
   
TOP OF THIS ASSESSMENT                         

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Supplemental Oxygen Administration   (Must receive a minimum of 8 points to pass this station 11 total)

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