| 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
BACK TO TIPS
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
BACK TO TIPS
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
BACK TO TIPS
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
BACK TO TIPS
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
BACK TO TIPS
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
BACK TO TIPS
Supplemental Oxygen
Administration (Must receive a minimum of
8 points to pass this station 11 total) |
|
|
| TOP OF THIS
ASSESSMENT
BACK TO TIPS
|
