Emt Skill Sheets

Emergency Medical Technician
Skills Check List

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 / INFANT
FBAO - ADULT / CHILD / INFANT
***ALL SKILLS MUST BE COMPLETED PRIOR TO FINAL SKILLS EXAM
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 _________________

1. Assess patient's breathing rate *
1. All Patients *
1. None *
1. None *
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 _________________

1. Assess patient's breathing rate and quality *
1. All Patients *
1. None *
1. None *
Explains the procedure to the patient and remind them not to move or talk without instruction P F P F
MEDICAL 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 _________________

1. Assess patient's Blood Pressure *
1. All Patients *
1. Mastectomy (B/P) *
2. Dialysis Shunts (B/P) *
3. Affected Side (Stroke) (Relative) *
1. None *
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 _________________

1. Used to monitor changes in oxygen saturation of patients *
1. All Patients with any respiratory difficulty or distress *
2. May be taken with vitals on all patients *
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 *
None *
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 F
The 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 _________________

1. Improve airway patency *
1. Any unconscious patient without a gag reflex requiring ventilatory assistance *
1. Patients with an intact gag reflex *
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 *
*** 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
*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 _________________

1. Improve airway patency *
1. Any conscious or unconscious patient requiring ventilatory assistance and where the *
use of oropharyngeal airway is not tolerated or contraindicated
1. Basilar skull fractures, periorbital and/or nasal fractures, or any suspected head *
trauma
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 *
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 _________________

1. Remove mucus, vomitus, secretions, and sputum from the hypopharynx *
1. Any patient's airway or breathing that is compromised by fluid obstruction *
1. None *
1. Hypoxia *
2. Reflex Bradycardia *
3. Damage to the oropharyngeal tissue *
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 _________________

1. Manually operated ventilation device that achieves approximately 100% oxygen delivery *
1. Any patient that requires ventilation assistance affecting rate or depth *
2. Patient's with pulmonary edema (rales) *
1. None *
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 *
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 _________________

1. Provide supplemental oxygen therapy to diminish respiratory distress, & tissue/organ hypoxia *
1. To meet the increased oxygen demand for any injured or ill patients *
1. None, if the patient is showing signs of hypoxia *
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 *

*** 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 _________________

1. To establish a patent and protected airway *
1. Any unresponsive patient without a gag reflex not likely to regain consciousness *
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.) *
1. Stimulation of the gag reflex and vomiting *
2. Soft tissue trauma *
3. Reflex bradycardia and hypoxia *
*** 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
*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 _________________
1. To identify all possible signs and symptoms relating to the illness or injury *
1. All patients *
1. Lack of patient consent *
2. Patient or scene presents an immediate physical threat to the rescuer *
1. Possible delay in care or transport time *
***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)
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 deformity and stability (if c/o pain, crepitus, or obvious deformity - DO NOT palpate) P F P F
Extremities - Legs and Arms
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 _________________
1. To identify all possible signs and symptoms relating to the illness or injury *
1. All patients *
1. Lack of patient consent *
2. Patient or scene presents an immediate physical threat to the rescuer *
1. Possible delay in care or transport time *
***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?
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)
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 softness, rigidity, distention, and tenderness P F P F
Pelvis
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 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
*** Based on the Chief Complaint Perform a Focused Physical Exam***
(Palpation,Inspection,Questioning)
***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
FALL 2012
1.13.0 SKILL: BLEEDING CONTROL / TOURNIQUET
EMT SKILLS TESTING
NAME _________________________ DATE _________________

1. Control hemorrhage *
2. Prevent contamination of soft tissue injury *
1. Any open soft tissue injury *
1. None *
1. Possible additional contamination *
2. Soft tissue damage if a tourniquet is applied *
*** 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
*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 _________________
1. Increase peripheral vascular resistance by pressurizing lower abdomen & extremities *
2. Immobilize the lower extremities and the pelvic region *
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 *
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) *
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 *
*** 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
FALL 2012
1.15.0 SKILL: SPINAL IMMOBILIZATION (Supine)
EMT SKILLS TESTING
NAME _________________________ DATE _________________

1. Provide immobilization of suspected neck and back injuries *
2. Provide full body support for CPR, movement of patient, or splinting of injuries *
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 injury
1. (Relative) Patients with spinal deformities that require alternative packaging *
1. Injury can result from movement necessary to place patient onto backboard *
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
*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 _________________
1. Immobilize spine for transfer from a seated position to a backboard with minimal movement *
2. Immobilizes / Stabilizes hip fractures *
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.
1. Any patient meeting "Load & Go" or National Trauma Triage Criteria for immediate transport. *
1. Delay in transport time *
2. Respiratory difficulty due to over-tightening the chest straps *
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
*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

FALL 2012
1.17.0 SKILL: HELMET REMOVAL (FOOTBALL)
EMT SKILLS TESTING
NAME _________________________ DATE _________________

1. To remove a football helmet without doing any further injury to the spine *
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 *
1. None *
1. Improper helmet removal can cause additional injury to the patient *
**Student Must be proficient and/or perform either rescuer role (instr. Option )**
***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
*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 201 2
1.18.0 SKILL: HELMET REMOVAL (MOTORCYCLE)
EMT SKILLS TESTING
NAME _________________________ DATE _________________

1. To remove a motorcycle helmet without doing any further injury to the spine *
1. Any victim of trauma with a full face motorcycle style helmet requiring immobilization *
1. None *
1. Helmet removal can cause additional injury to the patient *
**Student Must be proficient and/or perform either rescuer role (instr. Option )** 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 _________________

1. Reduce pain, prevent further injury, and help control hemorrhage *
1. Any suspected fracture or dislocation of an extremity *
1. None *
1. Possibility of neurovascular injury *
2. Possible retraction of bone ends into the wound during splinting of open fracture *
***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
*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 _________________

1. Device for splinting and reducing pain associated with qualifying femur fractures *
1. Patient with suspected mid-shaft or proximal third femoral fractures *
1. An associated fracture of the: pelvis, hip, knee, tibia/fibula, ankle, or foot *
2. Suspected fracture within 3 inches of any joint *
1. Possibility of neurovascular injury consistent with manipulation of fractured limb *
***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
*Failure to stabilize the injury & assess for DCAPBTLS from the pelvis down
*Failure to apply the ischial strap as directed
FALL 2012
1.21.0 SKILL: UNIPOLAR TRACTION SPLINT (SAGER)
EMT SKILLS TESTING
NAME _________________________ DATE _________________

1. Device for splinting and reducing pain associated with qualifying femur fractures *
1. Patient with suspected mid-shaft or proximal third femoral fractures *
1. An associated fracture of the: pelvis, hip, knee, tibia/fibula, ankle, or foot *
2. Suspected fracture within 3 inches of any joint *
1. Possibility of neurovascular injury consistent with manipulation of fractured limb *
***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
*Failure to stabilize the injury & assess for DCAPBTLS from the pelvis down
*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 _________________

1. Facilitates the lifting/moving of patients in limited access areas *
1. Facilitates the lifting/moving of patients where minimal patient movement is desired *
1. Cannot immobilize a spinal injured patient with the scoop stretcher *
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 *
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
*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 _________________

1. Helps restore normal cardiac function in patients requiring defibrillation by terminating V-Fib *
1. All patients who are unresponsive, apneic/gasping breath only, and pulseless *
2. Victims of drowning or electrocution *
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) *
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 *
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 _________________
1. Dilates blood vessels, increasing blood flow to the heart *
2. Decreases the workload of the heart *
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) *
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 *
1. Headache *
2. Drop in blood pressure with an increase in heart rate to compensate *
***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
*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**
FALL 2012
1.25.0 SKILL: BLS - EPINEPHRINE ADMINISTRATION
EMT SKILLS TESTING
NAME _________________________ DATE _________________

1. Relieves severe allergic reactions *
2. Constricts blood vessels and dilates bronchioles *
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) *
1. No contraindications when used in a life threatening situation *
1. Tachycardia and excitability *
2. Chest pain and/or headache *
3. Dizziness and/or pallor *
4. Nausea and/or vomiting *
***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
*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
SKILL: Adult One person CPR (C-A-B)
EMT SKILLS SHEET
Student Name Date
Information 1st attempt 2nd attempt

1 Takes/ Verbalizes Universal Precautions (BSI) * P F P F
Check for unresponsiveness (Verbal & Painful stimulation) & briefly check for breathing
2 P F P F
(If not breathing or only gasping breath move to step 3)*
3 Call for help and get a AED or call for ALS backup P F P F
Circulation : Check a Carotid or Femoral pulse If no pulse start chest compressions
4 P F P F
(within 10 seconds) *
5 Expose the patient P F P F
6 Find land mark between nipple line P F P F
7 Place 2 hands between the nipple line * P F P F
8 Start 30 chest compressions * P F P F
9 Open airway (Head tilt-chin lift or jaw thrust) & Give 2 breaths over a sec * P F P F
Critical Criteria
Failure to verbalize BSI
Failure to check for unresponsiveness & breathing
Failure to check carotid or femoral pulse
Failure to place hands between nipple line
Failure to do cycles of 30 compressions and give 2 breath
Instructor Print 1st attempt Pass Fail

2nd attempt Pass Fail
Instructor Signature
Reference: American Heart Association 2010 CPR Guidelines Revision Date: Feb 2012
FALL 2012
SKILL: Child One person CPR (C-A-B)
EMT SKILLS SHEET
Student Name Date

2 P F P F
Circulation : Check a Carotid or Femoral pulse No pulse or pulse less then 60bpm
4 P F P F
with inadequate signs of perfusion (10 seconds) -> move to step 5
7 Place1 hand between the nipple line * P F P F
*Critical Criteria*
Failure to check carotid or femoral pulse
Instructor Printed 1st attempt Pass Fail

FALL 2012
SKILL: Infant One person CPR (C-A-B)
EMT SKILLS SHEET
Student Name Date

2 P F P F
Circulation: Check a Brachial or Femoral pulse No pulse or pulse less then 60bpm
4 P F P F
with inadequate signs of perfusion (10 seconds) -> move to step 5
7 Place 2 fingers, one finger width below nipple line* P F P F
*Critical Criteria*
Failure to check brachial or femoral pulse
Failure to place 2 fingers, one finger width below nipple line
Instructor Printed 1st attempt Pass Fail

FALL 2012
SKILL: Adult Abdominal Thrust (Choking)
Responsive & Unresponsive

EMT SKILLS SHEET
NAME Date

2 Look for the universal sign of choking P F P F
3 Ask the patient are you choking/ Ask the patient can I help P F P F
4 Position yourself behind the patient P F P F
5 Place one leg in between the patients leg P F P F
6 Locate the belly button (Umbilicus) with one finger P F P F
Make a fist with your other hand and place it above the belly button, thumb side towards
7 P F P F
the abdomen
8 Use a up and in technique to press on the abdomen area P F P F
9 Continue abdominal thrust until (object comes out or patient passes out) P F P F
10 If patient pass out/ goes unresponsive, Lay patient on the floor P F P F
11 Activate the EMS system P F P F
16 Open airway, look in side the mouth/ (DO NOT perform a blind finger sweep) P F P F
17 Give one breath looking for chest rise. P F P F
18 If no chest rise, realign the airway and give second breath looking for chest rise P F P F
19 Repeat steps 13-18 until object comes out or breath go in P F P F
Critical Criteria
Failure to identify patient choking
Failure to do perform the Abdominal Thrust correctly
Failure to Open the Airway
Failure to give 1 breaths
Failure to give 2nd breath
Instructor Initials 1st attempt Pass Fail

FALL 2012
SKILL: Child Abdominal Thrust (Choking)
EMT SKILLS SHEET
NAME Date

2 Look for the universal sign of choking P F P F
3 Ask the patient are you choking/ Ask the patient can I help P F P F
4 Position yourself behind the patient, kneel to patients level P F P F
5 Place one leg in between the patients leg P F P F
6 Locate the belly button (Umbilicus) with one finger P F P F
Make a fist with your other hand and place it above the belly button, thumb side
7 P F P F
towards the abdomen
8 Use a up and in technique to press on the abdomen area P F P F
9 Continue abdominal thrust until object comes out or patient passes out P F P F
10 If patient pass out/ goes unresponsive, Lay patient on the floor P F P F
Critical Criteria
Failure to do perform the Abdominal Thrust correctly

FALL 2012
SKILL: Infant Back Slaps/Chest Trust (Choking)
EMT SKILLS SHEET
NAME Date
1 Takes/Verbalizes Universal Precautions (BSI) * P F P F

2 Check to see if the Infant is choking P F P F
3 Support the child head in your hand laying face down, legs between your arm P F P F
4 Locate the shoulder blades P F P F
5 Perform 5 Back Slaps P F P F
6 Flip the Infant over now supporting the back of the head P F P F
7 Find land mark: One finger width below nipple line P F P F
8 Place 2 fingers below nipple line P F P F
9 Perform 5 Chest Trust P F P F
10 Continue Back Slaps & Chest Thrust until object comes out or Infant passes out P F P F
11 If Infant pass out/ goes unresponsive, lay patient on a flat surface P F P F
Critical Criteria
Failure to do perform the Back Blows & Chest Thrust

FALL 2012

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Emergency Medical Technician

Skills Check List

Skills Date Instructor's

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

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure

INSTRUCTOR INITIALS ________ 1st attempt PASS_____ FAIL_____

INSTRUCTOR SIGNATURE ________________________ 2nd attempt PASS_____ FAIL_____

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure

INSTRUCTOR INITIALS ________ 1st attempt PASS_____ FAIL_____

INSTRUCTOR SIGNATURE ________________________ 2nd attempt PASS_____ FAIL_____

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure

INSTRUCTOR INITIALS ________ 1st attempt PASS_____ FAIL_____

INSTRUCTOR SIGNATURE ________________________ 2nd attempt PASS_____ FAIL_____

The student will describe the therapeutic effects of the equipment/procedure

INSTRUCTOR INITIALS ________ 1st attempt PASS_____ FAIL_____

INSTRUCTOR SIGNATURE ________________________ 2nd attempt PASS_____ FAIL_____

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure

INSTRUCTOR INITIALS ________ 1st attempt PASS_____ FAIL_____

INSTRUCTOR SIGNATURE ________________________ 2nd attempt PASS_____ FAIL_____

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure

INSTRUCTOR INITIALS ________ 1st attempt PASS_____ FAIL_____

INSTRUCTOR SIGNATURE ________________________ 2nd attempt PASS_____ FAIL_____

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure

INSTRUCTOR INITIALS ________ 1st attempt PASS_____ FAIL_____

INSTRUCTOR SIGNATURE ________________________ 2nd attempt PASS_____ FAIL_____

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure

INSTRUCTOR INITIALS ________ 1st attempt PASS_____ FAIL_____

INSTRUCTOR SIGNATURE ________________________ 2nd attempt PASS_____ FAIL_____

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure

*** DESIGN REQUIREMENTS ***

INSTRUCTOR INITIALS ________ 1st attempt PASS_____ FAIL_____

INSTRUCTOR SIGNATURE ________________________ 2nd attempt PASS_____ FAIL_____

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure

*** OXYGEN SAFETY PRECAUTIONS ***

The student will demonstrate the use of the equipment/procedure

INSTRUCTOR INITIALS ________ 1st attempt PASS_____ FAIL_____

INSTRUCTOR SIGNATURE ________________________ 2nd attempt PASS_____ FAIL_____

EMT SKILLS TESTING

NAME _________________________ DATE _________________

The student will describe the therapeutic effects of the equipment/procedure

INSTRUCTOR INITIALS ________ 1st attempt PASS_____ FAIL_____

INSTRUCTOR SIGNATURE ________________________ 2nd attempt PASS_____ FAIL_____

EMT SKILLS TESTING

EMT SKILLS TESTING

EMT SKILLS TESTING

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

* DESIGN REQUIREMENTS *

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

* OXYGEN SAFETY PRECAUTIONS *

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

NAME _________ DATE _

INSTRUCTOR INITIALS ______ 1st attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___

INSTRUCTOR SIGNATURE ______________________ 2nd attempt PASS_ FAIL___