Introduction This is the Great Lakes EMS Academy / Davenport University Consortium Paramedic ALS Psychomotor Skills Manual. This manual is part of the student’s permanent record. The student will have possession of this book throughout the Paramedic course. The student should try to bring this to class every day and also with them to their various clinical experiences. In 2016, the Great Lakes EMS Academy has changed some of the methods in training, evaluation and documentation of skills training. These changes have occurred to make sure that we are in compliance with the NREMT Paramedic Psychomotor Competencies Portfolio (PPCP). This new portfolio structure will necessitate very involved documentation by the student. Psychomotor skills are an important component of safe and effective out-of-hospital care. Delivery of care, at its most fundamental level, is when and where the importance of EMS is demonstrated to the public. Compassionate care using the complete affective skill set can result in a positive image of EMS and lead to medical and public support for the profession. Psychomotor Skills include the skills lab and scenario lab components. Psychomotor education begins in the skills lab component, where psychomotor learning takes place. The skills lab component is the setting for educational imprinting, cognitive integration, frequent drilling and autonomic development of psychomotor skills. The scenario lab component provides students a contextual opportunity to demonstrate what they have learned in a simulated environment based upon the psychomotor skills established in the skills lab. Once students have demonstrated skill competence in the simulated environment, they progress to assessing and treating real patients in the clinical phase with adequate supervision. The clinical phase in a student’s education includes “planned, scheduled, educational student experience with patient contact activities in settings, such as hospitals, clinics, free-standing emergency centers, and the ambulance. ” Generally speaking, we try to teach skills within the first days of class. We follow short discussion on skills with demonstration and then practice…practice…practice. During practice time the students are expected to participate in learner-lead skills practice. Following practice, the student will go through skills evaluation. During evaluation a passing score is determined by how many points the student receives from the skill sheet. The minimal score for successful completion is found on the bottom of each of the skill sheets. Next, we will put the student into scenario-based training at the earliest time possible. Only after the completion of scenario-based training may a student practice that skill in the clinical environment. So, for example, students will learn how to start an IV in the second week of class. They will be practicing the skill on a manikin arm, which is setting on a table. The next week will already be “testing” for that skill. Scenario-based training will be the next step. The student will then be “signed off” in their clinical manual. At that time, the student will be able to start IVs in the clinical environment. Paramedic students are required to successfully test out several times for each of the skills. The opportunity to test will begin within the first few weeks of class. As adult learners we all need to be challenged and see progress. As we are taught and then practice skills, our abilities and confidence increases with experience. Students who fail skills testing will have an opportunity to retest. Students may need to complete remedial training outside of the regularly scheduled time frames for class. At the end of each module, the faculty will be reviewing the student’s practical skill sheets to assure that the student has passed all of the required skills testing. If there is a problem with the student’s doc umentation for skills evaluation, the student will be required to show competency in that skill (pass a skill station).
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GLEMSA/DU Skill Sheet Name ______________________
Introduction This is the Great Lakes EMS Academy / Davenport University Consortium Paramedic ALS Psychomotor Skills
Manual. This manual is part of the student’s permanent record. The student will have possession of this book
throughout the Paramedic course. The student should try to bring this to class every day and also with them to their
various clinical experiences.
In 2016, the Great Lakes EMS Academy has changed some of the methods in training, evaluation and
documentation of skills training. These changes have occurred to make sure that we are in compliance with the
NREMT Paramedic Psychomotor Competencies Portfolio (PPCP). This new portfolio structure will necessitate
very involved documentation by the student.
Psychomotor skills are an important component of safe and effective out-of-hospital care. Delivery of care, at its
most fundamental level, is when and where the importance of EMS is demonstrated to the public. Compassionate
care using the complete affective skill set can result in a positive image of EMS and lead to medical and public
support for the profession. Psychomotor Skills include the skills lab and scenario lab components. Psychomotor
education begins in the skills lab component, where psychomotor learning takes place. The skills lab component is
the setting for educational imprinting, cognitive integration, frequent drilling and autonomic development of
psychomotor skills. The scenario lab component provides students a contextual opportunity to demonstrate what
they have learned in a simulated environment based upon the psychomotor skills established in the skills lab. Once
students have demonstrated skill competence in the simulated environment, they progress to assessing and treating
real patients in the clinical phase with adequate supervision.
The clinical phase in a student’s education includes “planned, scheduled, educational student experience with patient
contact activities in settings, such as hospitals, clinics, free-standing emergency centers, and the ambulance.”
Generally speaking, we try to teach skills within the first days of class. We follow short discussion on skills with
demonstration and then practice…practice…practice. During practice time the students are expected to participate
in learner-lead skills practice. Following practice, the student will go through skills evaluation. During evaluation a
passing score is determined by how many points the student receives from the skill sheet. The minimal score for
successful completion is found on the bottom of each of the skill sheets. Next, we will put the student into
scenario-based training at the earliest time possible. Only after the completion of scenario-based training may a
student practice that skill in the clinical environment. So, for example, students will learn how to start an IV in the
second week of class. They will be practicing the skill on a manikin arm, which is setting on a table. The next week
will already be “testing” for that skill. Scenario-based training will be the next step. The student will then be
“signed off” in their clinical manual. At that time, the student will be able to start IVs in the clinical environment.
Paramedic students are required to successfully test out several times for each of the skills. The opportunity to test
will begin within the first few weeks of class. As adult learners we all need to be challenged and see progress. As
we are taught and then practice skills, our abilities and confidence increases with experience.
Students who fail skills testing will have an opportunity to retest. Students may need to complete remedial training
outside of the regularly scheduled time frames for class.
At the end of each module, the faculty will be reviewing the student’s practical skill sheets to assure that the student
has passed all of the required skills testing. If there is a problem with the student’s documentation for skills
evaluation, the student will be required to show competency in that skill (pass a skill station).
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To be Successful To pass each practical skill, the student must obtain a score that is at least as high as the minimum score designated
at the bottom of the skill sheet and must not violate any of the critical criteria (auto fail).
The student must physically go through all of the steps on each practical skill in order to sufficiently learn
it. Simply repeating what is printed on the practical skill sheet is not sufficient, and the student will fail the
examination if he or she does that. The student must demonstrate that he or she is capable of physically performing
the practical skill, not simply repeating printed lines of text.
Each skill must be practiced several times in order to sufficiently learn it. Simply watching an instructor
demonstrate the skill or watching other students practice the skill is not sufficient. The student must physically
practice the skill themselves several times in order to sufficiently learn it.
“Standard Precautions” is the first step on each practical skill, and failure to take appropriate standard precautions is
a critical failure on many practical skills. Therefore, the student should form the habit of always taking standard
precautions before every practical skill.
Many steps must be performed in a specific manner in order to obtain the corresponding point or to avoid violating
critical criteria. Alternatively, many steps can be successfully completed in a variety of manners, and instructors
practice different styles of demonstrating these steps. Students are responsible for understanding what constitutes
critical criteria and which procedures are open to personal variation in style.
Some steps must be performed at specific points during the practical skills while others can be performed at points
other than the ones printed on the practical skill sheets. Students are responsible for knowing which procedures
must be performed at specific points in the practical skills.
The most common reason that the student fails a practical skill is because of anxiety. Stay calm and go through the
practical skill at a comfortable pace. If the student forgets what to do next, he or she should remain calm and
mentally repeat the steps that he or she has already completed. If the student wishes, he or she is also allowed to
physically repeat any steps that he or she has already completed.
A huge part of skills training at the Academy is the documentation of that skills training. Pretty much, everything
you do during the practical aspect of class needs to be documented on paper and on FISDAP. People do not fail
paramedic class because they are not able to start an IV or intubate a manikin. They fail because they are not able to
document their performance in the Lab and clinical environment.
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Skill Sheets This manual is full of skill sheets that we will be using throughout the time that we are training together. We will
often use these skill sheets throughout the module and then at the end switch to a NREMT skill sheet. It is important
for students to learn the skill sheets. However, when it comes to doing the skill in the field in a dynamic setting with
extra pressure, students need to know why they are doing things and be comfortable with the procedure as a whole.
Routinely we teach the student a skill then we practice that skill for a week. The following week, we try to test that
skill. Then later we incorporate the skill into scenarios and we use an abridge version of the skill sheet to “test”
students while they are doing the skill during a scenario. Students should always try to perform skills as though they
are being tested at the NREMT.
Preparatory Module We include all of the skill sheets that we will start with during the Preparatory module. During this module we will
be teaching you several ALS SKILLS:
1. Intravenous (IV) therapy,
2. Establishing an intraosseous (IO) line
3. IM and SQ injections
4. IV Drug Administration
5. Use of A nebulizer for medication administration
6. Use of Nasal Mucosal Atomizer Device (MAD) for Medication administration
7. Use of a glucometer
8. Supraglottic Airways
We have several SCENARIO skill sheets that we use during this module. They consist of:
1. Cardiac Chest Pain
2. Shortness of Breath
3. Stroke
4. Altered Mental Status (AMS)
5. Acute Abdomen
6. Normal Childbirth
7. Abnormal Childbirth
8. General Medical Complaint
9. Hemorrhage control and shock Management
10. Splinting
11. Trauma Patient Management
At the end of this module, students are TESTED on the following skills using the NREMT Skill Sheets:
1. Intravenous (IV) therapy,
2. Establishing an intraosseous (IO) line
3. IM and SQ injections
4. IV Drug Administration
5. Supraglottic Airways
6. Pediatric Airway Compromise
7. Medical Emergency Scenario
8. Traumatic Emergency Scenario
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Cardiology Module During the second module (Cardiology), we will give the students several more SKILL SHEETS. They include:
1. Adult Oral-tracheal Intubation
2. Pediatric Oral-tracheal Intubation
3. Task analysis for defibrillation
4. Task analysis for cardioversion
5. Task analysis for pacing
6. 12-Lead ECG
7. IV Drip Skill Sheet
8. NREMT Dynamic Cardiology
9. NREMT Static Cardiology
We have several SCENARIO skill sheets that we use during this module. They consist of:
1. Cardiac Chest Pain
2. Shortness of Breath
3. ACLS – Bradycardia
4. ACLS – Tachycardia
5. ACLS – Cardiac Arrest – VF/VT
At the end of this module, students are TESTED on the following skills using the NREMT Skill Sheets:
1. Ventilatory Management – Adult
2. Ventilatory Management - Pediatrics
3. NREMT Dynamic Cardiology
4. NREMT Static Cardiology
Medical Emergencies I
During the third module (MEI), we will give the students more SKILL SHEETS. They include:
1. Comprehensive History
2. Comprehensive Physical Exam
We have several SCENARIO skill sheets that we use during this module. At this time, we will continue to do many
advanced cardiac life support (ACLS) scenarios. The medical scenarios will include:
1. Cardiac Chest Pain
2. Shortness of Breath
3. Stroke
4. AMS
5. Anaphylaxis
6. Acute Abdomen
At the end of this module, students are TESTED on the following skills using the NREMT Skill Sheets:
1. NREMT Dynamic Cardiology
2. NREMT Static Cardiology
3. Ventilatory Management – Adult
4. IV start and Medication Administration
5. Medical Emergencies Scenario
5
Medical Emergencies II
During the fourth module (ME II), the students does not receive any new SKILL SHEETS.
We have several SCENARIO skill sheets that we use during this module. At this time, we will continue to do many
advanced cardiac life support (ACLS) scenarios. The medical scenarios will include:
1. Normal Childbirth
2. Abnormal Childbirth
3. General Medical Complaint
4. Comprehensive Pediatric Physical Exam
5. Toxicology (poisons)
6. Toxicology (medications)
7. Toxicology (illegal drugs)
8. Acute Abdomen
9. Psychiatric Emergencies
10. General Medical
At the end of this module, students are TESTED on the following skills using the NREMT Skill Sheets:
1. NREMT Dynamic Cardiology
2. NREMT Static Cardiology
3. Ventilatory Management – Pediatric
4. IO start and Medication Administration
5. Medical Emergencies Scenario
Trauma Module
During trauma the students will receive the following SKILL SHEETS again (we will use these in Preparatory).
1. Bleeding and shock
2. KED AND Backboarding
3. Orthopedic Injuries (Splinting and Traction Splinting)
4. Trauma Management
5. Surgical and Needle Cricothyrotomy
6. Needle Decompression
We have several SCENARIO skill sheets that we use during this module. The trauma scenarios will include:
1. Blunt Trauma
2. Penetrating trauma
3. Burns
4. Hemorrhagic Shock
At the end of this module, students are TESTED on the following skills using the NREMT Skill Sheets:
1. IO start and Fluid Administration
2. Traumatic Patient Management
3. Random Basic Skill (KED, Splinting, Bleeding control)
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Operations and Review
During Operations and Review the student will be tested one final time on the skills listed below:
Scoring Skill Sheets While participating in skills training at the Academy we will usually be using standard GLEMSA / DU skills sheets
or the NREMT skill sheets. When using these skill sheets the participant will earn a score on 0, 1 or 2 for each line
item. The explanation of how to score the line item can be found below:
0 = Unsuccessful; required critical or excessive prompting; inconsistent; not yet competent. This would be when
the student completely skips a step in the skill. For some items there is no way to gently prompt the student.
At other times, the instructor may give clues to help the students obtain a “1”.
1 = Not yet competent, marginal or inconsistent, this includes partial attempts. A “1” is given when the student
needed a little help in remembering the step. When a student performs the step, but there is a problem with
that performance, the student would score a “1”
2 = Successful; competent; no prompting necessary. To score a “2”, there is not much room for improvement.
The student has “mastered” that aspect of the skill.
Auto-Fail - When there is an “AF” included at the end of the line item the student has to score a 1 or a 2 for that line
item. These auto-fails are sometime regraded as critical criteria. Failing to complete that step can have a major
impact on the patient or the success of the skill.
Critical Criteria – Towards the bottom of the skill sheets you may find a list of critical criteria. These are easily
noticed by the presence of a small check box located in the scoring column. If the student obtains a check here, it is
the same as an auto-fail. The skill attempt is recognized as a fail.
Level of Competence When we evaluate students as they complete skill, instructors will not only give the student a Pass / Fail mark. We
will also describe the competency level while performing that skill. The expectation is that the student will progress
from manipulation to naturalization. To graduate from the Academy, student need only be at the precision level.
Manipulation (M) = Student completed the skills evaluation with some problems or hesitations during the
procedure. The instructor had to give hints or noted flaws in the performance of the skill.
Precision (P) = Instructor was quiet during the skills evaluation and simply allowed the student to go through the
skills with no interruptions. The student completed skill with no mistakes.
Articulation (A) = Student completed the task with no mistakes. The instructor asked questions about the
procedure, like: “why are we doing this”, “tell me about capnography for monitoring placement”, “what would you
do if….”
Naturalization (N) = Student completed the task with no mistakes. The instructor distracts the learner with
conversation about something not related to the skill or has students prepping the patient/working a scenario. The
student would be able to troubleshoot problems and have confidence while completing the skill.
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Skills Tested at the NREMT Psychomotor Evaluation
1. Patient Assessment-Trauma You will be required to perform a "hands-on," head-to-toe, physical assessment and voice treatment of a
simulated patient for a given scenario, including: Scene Size-Up
Initial Assessment/Resuscitation
Focused History and Physical Examination - Rapid Trauma Assessment
Detailed Physical Examination
2. Patient Assessment-Medical You will be required to perform a "hands-on," head-to-toe, physical assessment and voice treatment of a
simulated patient for a given scenario, including:
Scene Size-Up
Initial Assessment/Resuscitation
Focused History and Physical Examination - Rapid Trauma Assessment
On-Going Assessment
3. Apneic Adult (supraglottic airway) Given a scenario of having just found an apneic adult patient with a palpable carotid pulse, you must
demonstrate immediate management of the patient using simple airway maneuvers and adjuncts, bag-valve-
mask device, and supplemental oxygen. You will then complete the adult presentation by placing a supraglottic
airway device.
4. Pediatric Respiratory Compromise You will be given a scenario of having just found an infant in respiratory distress and must demonstrate
immediate management of the patient using simple airway maneuvers, adjuncts, and supplemental oxygen. You
will then be required to demonstrate bag-valve-mask ventilation as the patient progresses from respiratory
distress to respiratory failure.
5. Cardiac Arrest Management/AED You will be evaluated on your ability to manage a cardiac arrest situation, including 1-rescuer CPR and usage
of the AED given a cardiac arrest scenario where no bystanders are present.
6. IV and Medication Skills
Intravenous Therapy - You will be required to establish a patent IV in a mannequin arm in accordance
with a given scenario.
Intravenous Bolus Medications - after establishing a patient IV line, you will be required to administer
an IV bolus of medication in accordance with a given scenario.
8. Pediatric Intraosseous Infusion Skills You will be required to establish an intraosseous line in a pediatric IO mannequin. Either manual insertion using
Jamshidi® needles or electric, drill-type devices are permitted to establish intraosseous access.
9. Spinal Immobilization (Supine Patient) You will be required to immobilize an adult patient who is found supine with a suspected unstable spine using a
long spine immobilization device. An EMT Assistant will be provided and you are also responsible for the
direction and subsequent actions of the EMT Assistant.
10. Random EMT Skills You will be evaluated over one (1) of the following EMT skills tested at random. All instruments for these
skills will adhere to the National Registry EMT Users Guide material: Spinal Immobilization (Seated Patient)
Long Bone Immobilization
Joint Immobilization
Bleeding Control/Shock Management
9
GLEMSA/DU Skill Sheet Name ______________________
Supraglottic Airway – King LTd Date Date
1. “Scene is safe and standard precautions” and checks ABCs (AF)
2. Uses a manual airway and BVM to ventilate patient within 30 seconds (AF)
3. Ventilates at a rate of 10 /min. Squeeze BVM for 1 second. (AF)
4. Attaches BVM to O2 and has O2 set at 12 to 15 liters/minute (AF)
5. Checks no gag reflex and properly inserts basic airway
6. Check lungs sounds and place patient on pulse oximetry
Ventilate the patient for 30 to 60 seconds at a proper rate and tidal volume. “Lung sounds are clear and equal. Pulse oximetry is at 88%. It is time to place an supraglottic airway.”
7. Student should direct the evaluator or helper to ventilate patient
8. Checks/prepares the airway device (chooses correct size)
9. Lubricates the distal tip of the device (AF)
10. Positions the head (sniffing position)
11. Performs a tongue-jaw lift and inserts device to the appropriate depth
12. Inflates the balloon(s) appropriately and removes the syringe(s) (AF)
13. Attaches BVM appropriately and ventilates patient
14. Confirms placement /ventilation observing chest rise, and auscultating over the
epigastrium and bilaterally over each lung
15. Adjusts airway to allow for maximum ventilation (possibly pull back)
16. Uses secondary device/method to monitor the placement of the tube:
capnography, ETCO2 detector, watch patient color and SaO2
17. Secures device or confirms that the device remains properly secured
Did not take, or verbalize, body substance isolation precautions
Did not ventilate properly (rate, tidal volume, no interruptions)
Did not pre-oxygenate the patient prior to placement
Did not confirm placement properly/timely
Inserted any adjunct in a manner that was dangerous to the patient
1. “Scene is safe and standard precautions” and ABCs
2. Uses a manual airway maneuver and BVM to ventilate patient
3. Ventilates at a rate of 10 /min. Squeeze BVM for 1 second.
4. Attaches BVM to O2 and has O2 set at 12 to 15 liters/minute
5. Checks no gag reflex and properly inserts basic airway
6. Check lungs sounds and place patient on pulse oximetry
Ventilate the patient for 30 to 60 seconds at a proper rate and tidal volume. “Lung sounds are clear and equal. Pulse oximetry is at 88%. It is time to place an supraglottic airway.”
1. Student should direct the evaluator or helper to ventilate patient
2. Checks/prepares the airway device (chooses correct size)
3. Lubricates the distal tip of the device
4. Positions the head (neutral position)
5. Performs a tongue-jaw lift and inserts device to the appropriate depth
6. (front teeth between black lines)
7. Inflates the balloon(s) appropriately and removes the syringe(s)
8. Attaches BVM appropriately and ventilates patient
9. Confirms placement /ventilation observing chest rise, and auscultating over the
epigastrium and bilaterally over each lung
10. Adjusts ventilation as necessary (if no lung sounds move to tube #2)
11. Uses secondary device/method to monitor the placement of the tube:
capnography, colorametric ETCO2 watch patient color and SaO2
12. Secures device or confirms that the device remains properly secured
Did not take, or verbalize, body substance isolation precautions
Did not ventilate properly (rate, tidal volume, no interruptions)
Did not pre-oxygenate the patient prior to placement
Did not confirm placement properly/timely
Inserted any adjunct in a manner that was dangerous to the patient
16. Extremities Legs – DCAP, BTLS, TIC, Check PMS)
Arms – DCAP, BTLS, TIC, Check PMS)
17. Vital signs: Pulse Blood Pressure Resp.
18. A.M.P.L.E. Allergies Medications History Last meal
Management
19. Manages primary and secondary njuries appropriately (AF)
20. Radio Report: MOI Assessment Treatment Clear and Concise
35 points needed to pass skill evaluation Points: ____/40 ____/40
AF= Auto Fail or Critical Criteria Pass / Fail:
Initials:
GLEMSA/DU Skill Sheet Name ______________________
32
Preparatory Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
33
Preparatory Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
34
Preparatory Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
35
Preparatory Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
36
Preparatory Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
37
Preparatory Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
38
Preparatory Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
39
Preparatory Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
40
Preparatory Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
41
Preparatory Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
42
Preparatory Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
43
Preparatory Module Affective Evaluation
Demographics
Name Class Date
Evaluation Statements
1. Professionalism in the classroom Competent Not yet competent
Showing consideration to fellow students and the instructor by being quiet and participating in discussion at the
appropriate times. Responding appropriately to questions. Does not have a problem turning pagers or phones off prior
to class. Seems eager to learn.
Comments:
2. Self-Motivation Competent Not yet competent Taking initiative to complete assignments; taking initiative to improve and/or correct behavior; taking on and following
through on tasks without constant supervision; showing enthusiasm for learning and improvement; consistently striving
for excellence; accepting constructive feedback in a positive manner; taking advantage of learning opportunities
Comments:
3. Appearance and Personal Hygiene Competent Not yet competent Clothing and uniform is appropriate, neat, clean and well maintained; good personal hygiene and grooming.
Comments:
4. Self-Confidence and Communication Competent Not yet competent Able to communicate thoughts, feelings, and rationale when questioned by the instructor or other students. Uses proper
tone and volume of speech when discussing material. Speaks clearly; writing legibly; listening actively; adjusting
communication strategies to various situations
Comments:
5. Time Management Competent Not yet competent Consistent punctuality; completing tasks and assignments on time. Absenteeism and Tardiness
Comments:
6. Respect Competent Not yet competent Being polite to others; not using derogatory or demeaning terms; behaving in a manner that brings credit to the
profession.
Comments:
Student’s Comments
Signature of Student
Date
Signature of Primary Instructor Date
GLEMSA/DU Skill Sheet Name ______________________
44
Cardiology Module Skills and Scenarios
GLEMSA/DU Skill Sheet Name ______________________
45
Laryngoscopic Intubation – Adult Date Date
1. Takes Standard Precautions (AF) (gloves and face shield or goggles)
2. Begins with Manual airway and BVM ventilations (AF)
8. Provides Basic Airway that evolves to an adjunct and Advanced Airway
9. Starts an IV / IO and gives appropriate fluid bolus
10. Patient History from bystanders/family. What happened and down time.
Possibly SAMPLE
AC
LS
Ca
re
11. Defibrillation appropriate level every 2 minutes (if appropriate)
12. Epinephrine 1.0 mg every 3-5 minutes IVP (if appropriate)
13. Ventricular antidysrhythmic (if appropriate)
Amiodarone 300 mg. followed by 150 mg
Lidocaine 1.0 – 1.5 mf/kg followed by ½ dose
Procainamide 100 mg every 5 minutes
14. Considers H’s and T’s
15. Switches out person doing compressions every 2-4 minutes
16. Used capnography to maintain ALS airway and look for ROSC
17. Provides proper post arrest care (IV fluids, ventilation, possible drugs)
18. Moved Patient appropriately
19. Provided effective radio report to hospital
1. Failure to deliver shock in a timely and safe manner.
2. Failure to order start or resume of CPR when appropriate.
3. Failure to order correct management of airway and oxygenation
4. Orders administration of an inappropriate drug or dosage.
5. Misinterpretation of the rhythm.
6. Does not appear confident or hesitates too often.
_____
_____
Student need 32 points to pass Points: ___/38 ___/38
Pass/Fail:
Initials:
GLEMSA/DU Skill Sheet Name ______________________
57
12-Lead ECG Date
Date
Date
1. Explains procedure to patient
2. Prepares the patient (shaving and cleansing as needed)
3. Places limb leads on the limbs
4. Places precordial leads at their appropriate locations:
5. Ensures the patient is sitting or lying still, breathing normally and not
talking
6. Obtains 12-lead ECG recording
7. Examines tracing for acceptable quality
8. Interprets 12-lead ECG to local standard and reports findings as needed
9. Voices repeating 12-lead ECG every 5 – 10 minutes in high risk patients
and post- treatment
10. Addresses modesty/privacy of the patient by keeping them covered
where appropriate
Passing score is = 13 Total ___ /20 ___ /20 ___ /20
Pass / Fail
Skill Level (If this was learner-led, mark “S” for student)
Initials of Evaluator
GLEMSA/DU Skill Sheet Name ______________________
58
Shortness of Breath Leader
Team
First 60 seconds
1. Assess the scene and take deliberate actions to stay safe. Standard precautions (gloves) (AF)
2. As I approach the patient, what do I see (stable/unstable, age, anxiety, position) (AF)
3. Initial Assessment (quick assessment of ABCs and AVPU, and ABCs) (AF)
4. Good Introduction
Basic History
5. History Allergies, Medical Hx, Medications (AF)
6. Onset: “what were you doing when it started?”
7. Provocation/palliation: “does anything make it better or worse?”
8. Time: “When did it start and has it been constant?”
9. Follow up questions: “What do you think it is?” “Been short of breath like this before?”
Differential Diagnosis
10. Organized and thorough assessment and integrated findings to expand the assessment
Chest pain?
Nausea or have you vomited?
Trauma to the chest?
Productive cough?
Risk factors for P.E.
Have you been sick lately? Running a fever?
Smoker? COPD?
Anxiety problems? [This area is worth a total of 5 pts]
Alcohol or illicit drugs?”?”
“Any history of surgeries?”
Physical Exam
11. Lung sounds. (AF)
12. Palpate abdomen.
13. Distal extremities for edema and JVD.
14. EKG, Pulse Oximetry, and capnography and 12-lead (as appropriate). (AF)
Management
15. Position, Oxygen and IV(AF)
16. Proper fluid and/or drug administration. The drug and drug dose has to be appropriate and the
standard questioning / assessment needs to occur prior to administration(AF)
17. Moved patient appropriately
18. Provided effective radio report to hospital(AF)
Affective
19. Uses proper non-verbal communication(AF)
20. Uses patient’s name and gives Empathy statements(AF)
21. Communicated thoughts/rationale of clinical impression and treatment plan to patient
22. Looks confident, makes the patient feel at ease. (AF)
Total needed to pass: 38 Total ____ / 44
Instructors name (printed) Pass / Fail
Initials
Comments:
GLEMSA/DU Skill Sheet Name ______________________
59
Chest pain Leader Team
First 60 seconds
1. Assess the scene and take deliberate actions to stay safe. Standard precautions (gloves)
2. As I approach the patient, what do I see (stable/unstable, age, anxiety, position)
3. Initial Assessment (quick assessment of ABCs and AVPU, and ABCs)
4. Good Introduction
Basic History
5. History Allergies, Medical Hx, Medications
6. Onset: “what were you doing when it started?”
7. Provocation/palliation: “does anything make it better or worse?”
8. Quality: “Can you describe the pain?”
9. Region/radiation: “Can you point to the pain and does it go anywhere?”
10. Severity: “can you put it on a scale from 1 – 10?”
11. Time: “When did it start and has it been constant?”
12. Follow up questions: “What do you think it is?” “Have you ever had pain like this before?”
Differential Diagnosis
13. Organized and thorough assessment and integrated findings to expand the assessment
Short of breath?”
Nausea / Vomiting
Trauma to the chest?”
Risk factors for cardiac
History of GERD or GI problems
Sick lately? Running a fever?
Have you had any problems with your bowel/Stools?”
Any history of surgeries
Changes in your diet [This area is worth a total of 5 pts]
Risk factors for P.E
Physical Exam
14. Lung sounds.
15. Palpate abdomen.
16. Distal extremities for edema and JVD.
17. Compare pulses in both radials to assess for thoracic aneurysm.
18. EKG, Pulse Oximetry, and capnography (as appropriate). 12 lead or 15 lead if appropriate.
Management
19. Position, Oxygen and IV
20. Aspirin, confirms no problem with aspirin and that there is no risk for internal bleeding
21. Nitroglycerine, confirms no ED meds and advises patient how the SL route works
22. Morphine, “sells” the medication to the patient.
23. Provided effective radio report to hospital
Affective
24. Uses proper non-verbal communication. Uses patient’s name and gives Empathy statements
25. Communicated thoughts/rationale of clinical impression and treatment plan to patient
Total needed to pass: 42 Total ____ / 50
50Instructors name (printed) Pass / Fail
Initials
Comments:
GLEMSA/DU Skill Sheet Name ______________________
60
Cardiology Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
61
Cardiology Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
62
Cardiology Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
63
Cardiology Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
64
Cardiology Module Affective Evaluation
Demographics
Name Class Date
Evaluation Statements
1. Professionalism in the classroom Competent Not yet competent
Showing consideration to fellow students and the instructor by being quiet and participating in discussion at the
appropriate times. Responding appropriately to questions. Does not have a problem turning pagers or phones off prior
to class. Seems eager to learn.
Comments:
2. Self-Motivation Competent Not yet competent Taking initiative to complete assignments; taking initiative to improve and/or correct behavior; taking on and following
through on tasks without constant supervision; showing enthusiasm for learning and improvement; consistently striving
for excellence; accepting constructive feedback in a positive manner; taking advantage of learning opportunities
Comments:
3. Appearance and Personal Hygiene Competent Not yet competent Clothing and uniform is appropriate, neat, clean and well maintained; good personal hygiene and grooming.
Comments:
4. Self-Confidence and Communication Competent Not yet competent Able to communicate thoughts, feelings, and rationale when questioned by the instructor or other students. Uses proper
tone and volume of speech when discussing material. Speaks clearly; writing legibly; listening actively; adjusting
communication strategies to various situations
Comments:
5. Time Management Competent Not yet competent Consistent punctuality; completing tasks and assignments on time. Absenteeism and Tardiness
Comments:
6. Respect Competent Not yet competent Being polite to others; not using derogatory or demeaning terms; behaving in a manner that brings credit to the
profession.
Comments:
Student’s Comments
Signature of Student
Date
Signature of Primary Instructor Date
GLEMSA/DU Skill Sheet Name ______________________
65
Medical Emergencies I Skills and Scenarios
GLEMSA/DU Skill Sheet Name ______________________
66
During this exercise the student should visualize the scene as a clinic or for a home health care setting. The student
will be completing a thorough patient physical exam in order to relay that information to a provider. Completing a
thorough patient physical exam such as this should take 15 to 20 minutes. The patient will most likely have a
general illness of some sort and not require immediate intervention/ transportation. Track the time!
Comprehensive Adult Physical Exam Date Date Date
Initial General Impression
Appearance
1. Speaks when approached
2. Facial expression / Anxiety
3. Skin color
4. Eye contact
5. Weight-estimated/translated to kg
6. Work of breathing
7. Posture, ease of movement
Level of Consciousness/Mental Status
8. Person Place and Time
Speech
9. Rate and Volume
10. Articulation and Fluency
Memory
11. Short term (give the patient 3-4 objects to remember)
12. Long term (ask about something in the past)
Vital signs
13. Blood pressure, Pulse, Respirations, Temperature, and Pulse Oximetry
Secondary physical examination
Skin / Integumentary
14. Colors-flushed, jaundiced, pallor, cyanotic
15. Moisture-dryness, sweating, oiliness
16. Temperature-hot or cool to touch -Take a temperature
33. Sensory feels touch in each extremity (eyes closed)
34. Coordination (finger to nose and heel to shin)
Differential Diagnosis
35. Organized and thorough assessment and integrated findings to expand the assessment
Been sick lately?
Risk factors for cerebral embolism
Risk factors for aneurysm (HTN)
Hx of seizures?
Any complaint of a headache or stiff neck
Running a fever? Feeling run down / tired?
Nausea or have you vomited
Trauma to the head? [This area is worth a total of 5 pts]
Medication, alcohol or illicit drugs
Physical Exam
36. Check blood sugar
37. EKG, Pulse Oximetry, and capnography (as appropriate). 12 lead or 15 lead if appropriate.
38. Repeat Cincinnati Stroke Scale
Management
39. Position, Oxygen and IV
40. Proper IV fluid and/or drug administration
41. Moved Patient appropriately
42. Provided effective radio report to hospital
Affective
43. Uses proper non-verbal communication. Uses patient’s name and gives Empathy statements
44. Communicated thoughts/rationale of clinical impression and treatment plan to patient
Total needed to pass: 38 Total ____ / 44
Instructors name (printed) Pass / Fail
Initials
Comment
GLEMSA/DU Skill Sheet Name ______________________
76
Altered Mental Status Leader Team
First 60 seconds
20. Assess the scene and take deliberate actions to stay safe. Standard precautions (gloves)
21. As I approach the patient, what do I see (stable/unstable, age, anxiety, position)
22. Initial Assessment (quick assessment of ABCs and AVPU, and ABCs)
23. Rapids Medical Assessment (quick head to toe looking for life threats) Pupils, JVD, Lung Sounds,
Palpate Abdomen, Any Signs of Trauma (with a Good Introduction)
Basic History
24. History Allergies, Medical Hx, Medications
25. Onset: “what were you doing when it started?”
26. Time: “When were they last seen normal?”
Differential Diagnosis
27. Organized and thorough assessment and integrated findings to expand the assessment
Been sick lately?
Risk factors for cerebral embolism
Risk factors for aneurysm (HTN)
Trauma?
Hx of seizures?
Problems with bowel or bladder?
Any complaint of a headache or stiff neck
Running a fever? Feeling run down / tired?
Nausea or have you vomited
Trauma to the head? [This area is worth a total of 5 pts]
Medication, alcohol or illicit drugs
Depression or Psychiatric Hx
Physical Exam
28. Lung sounds
29. Inspect and Palpate Abdomen
30. Check blood sugar
31. EKG, Pulse Oximetry, and capnography (as appropriate). 12 lead or 15 lead if appropriate.
Management
32. Position, Manage ABCs
33. Oxygen and IV
34. Proper IV fluid and/or drug administration
35. Moved Patient appropriately
36. Provided effective radio report to hospital
Affective
37. Uses proper non-verbal communication. Uses patient’s name and gives Empathy statements
38. Communicated thoughts/rationale of clinical impression and treatment plan to patient
Total needed to pass: 32 Total ____ / 38
Instructors name (printed) Pass / Fail
Initials
Comment
GLEMSA/DU Skill Sheet Name ______________________
77
Abdominal Pain Leader Team
First 60 seconds
25. Assess the scene and take deliberate actions to stay safe. Standard precautions (gloves)
26. As I approach the patient, what do I see (stable/unstable, age, anxiety, position)
27. Initial Assessment (quick assessment of ABCs and AVPU, and ABCs)
28. Good Introduction
Basic History
29. History Allergies, Medical Hx, Medications
30. Onset: “what were you doing when it started?”
31. Provocation/palliation: “does anything make it better or worse?”
32. Quality: “Can you describe the pain?”
33. Region/radiation: “Can you point to the pain and does it go anywhere?”
34. Severity: “can you put it on a scale from 1 – 10?”
35. Time: “When did it start and has it been constant?”
36. Follow up questions: “What do you think it is?” “Have you ever had pain like this before?”
Differential Diagnosis
37. Organized and thorough assessment and integrated findings to expand the assessment
Short of breath?”
Nausea / Vomiting
Trauma to the Abdomen?”
Risk factors for cardiac
History of GERD or GI problems
Sick lately? Running a fever?
Have you had any problems with your Bowel/Stools?”
Any history of surgeries
Changes in your diet [This area is worth a total of 5 pts]
Risk of pregnancy and the menstrual cycle
Physical Exam
38. Lung sounds.
39. Inspect and Palpate abdomen.
40. Distal extremities for edema and JVD.
41. Compare pulses in both Feet to assess for aortic aneurysm.
42. EKG, Pulse Oximetry, and capnography (as appropriate). 12 lead or 15 lead if appropriate.
Management
43. Position, Oxygen and IV
44. Proper fluid and/or drug administration
45. Moved patient appropriately
46. Provided effective radio report to hospital
Affective
47. Uses proper non-verbal communication. Uses patient’s name and gives Empathy statements
48. Communicated thoughts/rationale of clinical impression and treatment plan to patient
Total needed to pass: 40 Total ____ / 48
Instructors name (printed) Pass / Fail
Initials
Comments:
GLEMSA/DU Skill Sheet Name ______________________
78
Anaphylaxis Leader
Team
First 60 seconds
1. Assess the scene and take deliberate actions to stay safe. Standard precautions (gloves) (AF)
2. As I approach the patient, what do I see (stable/unstable, age, anxiety, position) (AF)
3. Initial Assessment (quick assessment of ABCs and AVPU, and ABCs) (AF)
4. Good Introduction
Basic History
5. History Allergies, Medical Hx, Medications (AF)
6. Onset: “what were you doing when it started?”
7. Provocation/palliation: “does anything make it better or worse?”
8. Time: “When did it start and has it been constant?”
Differential Diagnosis
9. Organized and thorough assessment and integrated findings to expand the assessment
Nausea or have you vomited?
Recent Trauma?
Sickness? Fever? Productive cough?
Risk factors for P.E.
Anxiety/psychiatric problems?
Alcohol or illicit drugs?
Physical Exam
10. Lung sounds. (AF)
11. Check trunk for Urticaria
12. Blood sugar check
13. Any problems with upper airway (hoarseness, difficulty in swallowing)
14. Distal extremities for edema
15. EKG, Pulse Oximetry, and capnography and 12-lead (as appropriate). (AF)
Management
16. Position, Oxygen and IV(AF)
17. Early us of drugs in an appropriate (prioritized and timely) way.
18. Proper fluid and/or drug administration. The drug and drug dose has to be appropriate and the
standard questioning / assessment needs to occur prior to administration(AF)
19. Moved patient appropriately
20. Provided effective radio report to hospital(AF)
Affective
21. Uses proper non-verbal communication(AF)
22. Uses patient’s name and gives Empathy statements(AF)
23. Communicated thoughts/rationale of clinical impression and treatment plan to patient
24. Looks confident, makes the patient feel at ease. (AF)
Total needed to pass: 40 Total ___ / 48
Instructors name (printed) Pass / Fail
Initials
Comments:
GLEMSA/DU Skill Sheet Name ______________________
79
Medical Emergencies I Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
80
Medical Emergencies I Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
81
Medical Emergencies I Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
82
Medical Emergencies I Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
83
Medical Emergencies I Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
84
Medical Emergencies I Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
85
Medical Emergencies I Module Affective Evaluation
Demographics
Name Class Date
Evaluation Statements
1. Professionalism in the classroom Competent Not yet competent
Showing consideration to fellow students and the instructor by being quiet and participating in discussion at the
appropriate times. Responding appropriately to questions. Does not have a problem turning pagers or phones off prior
to class. Seems eager to learn.
Comments:
2. Self-Motivation Competent Not yet competent Taking initiative to complete assignments; taking initiative to improve and/or correct behavior; taking on and following
through on tasks without constant supervision; showing enthusiasm for learning and improvement; consistently striving
for excellence; accepting constructive feedback in a positive manner; taking advantage of learning opportunities
Comments:
3. Appearance and Personal Hygiene Competent Not yet competent Clothing and uniform is appropriate, neat, clean and well maintained; good personal hygiene and grooming.
Comments:
4. Self-Confidence and Communication Competent Not yet competent Able to communicate thoughts, feelings, and rationale when questioned by the instructor or other students. Uses proper
tone and volume of speech when discussing material. Speaks clearly; writing legibly; listening actively; adjusting
communication strategies to various situations
Comments:
5. Time Management Competent Not yet competent Consistent punctuality; completing tasks and assignments on time. Absenteeism and Tardiness
Comments:
6. Respect Competent Not yet competent Being polite to others; not using derogatory or demeaning terms; behaving in a manner that brings credit to the
profession.
Comments:
Student’s Comments
Signature of Student
Date
Signature of Primary Instructor Date
GLEMSA/DU Skill Sheet Name ______________________
86
Medical Emergencies I Skills and Scenarios
\
GLEMSA/DU Skill Sheet Name ______________________
87
Childbirth - Normal Leader Team
First 60 seconds
32. Assess the scene and take deliberate actions to stay safe. Standard precautions (gloves)
33. As I approach the patient, what do I see (stable/unstable, age, anxiety, position)
34. Initial Assessment (quick assessment of ABCs and AVPU, and ABCs)
35. Good Introduction
36. Tell me more about your complaint why you called 911
Questions Regarding the Urgency of Childbirth
37. How far along are you?
38. Water Broke? Or mucous plug? Any bleeding? If they saw the amniotic fluid was it clear
39. Tell me about the contractions
40. Do you feel the need to push or have a B. M.
41. Questions for Para Gravida
Questions Regarding Possible Complications
42. Previous complications with child birth
43. Have you been seeing your doctor? Who is your doctor? And have you been taking meds?
44. Use of drugs or ETOH during Pregnancy?
45. Hx of Gestational Diabetes? Twins? C-section? Placenta previa
46. History Allergies, Medical Hx, Medications
Management
47. Position and Oxygen possible IV if time / # of people permit
48. Check for crowning and prolapsed cord
49. Check to see if amniotic sac in the way and fix it if it is intact. If amniotic fluid is present is it clear
(looking for meconium)
50. Place hand against baby’s head and allow for gentle delivery
51. Suction Mouth and then Nose
52. Check for nuchal cord and fix it if there is a problem
53. Pull the anterior shoulder downward to clear the mother's symphysis pubis (as needed)
54. Deliver baby and suction again and begin drying off the baby
55. Tie/clamp the umbilical cord in two places and cut the cord when appropriate
56. Dry, warm, position, and suction as needed
57. Continue with appropriate neonatal resuscitation (as needed)
58. 1 minute and 5 minute APGAR
59. Note time of birth
60. Package mom up and assess for delivery of the placenta (lengthening of the cord)
61. Assess for excessive post-partum bleeding and treat appropriately
62. Inspect and Palpate abdomen.
Total needed to pass: 52 Total ____ / 61
Instructors name (printed) Pass / Fail
Initials
Comments:
GLEMSA/DU Skill Sheet Name ______________________
88
Childbirth - Abnormal Leader Team
First 60 seconds
19. Assess the scene and take deliberate actions to stay safe. Standard precautions (gloves)
20. As I approach the patient, what do I see (stable/unstable, age, anxiety, position)
21. Initial Assessment (quick assessment of ABCs and AVPU, and ABCs)
22. Good Introduction
23. Tell me more about your complaint why you called 911
Questions Regarding the Urgency of Childbirth
24. How far along are you?
25. Water Broke? Or mucous plug? Any bleeding? If they saw the amniotic fluid was it clear
26. Tell me about the contractions
27. Do you feel the need to push or have a B. M.
28. Questions for Para Gravida
Questions Regarding Possible Complications
29. Previous complications with child birth
30. Have you been seeing your doctor? Who is your doctor? And have you been taking meds?
31. Use of drugs or ETOH during Pregnancy?
32. Hx of Gestational Diabetes? Twins? C-section? Placenta previa
33. History Allergies, Medical Hx, Medications
Management
34. Position and Oxygen possible IV if time / # of people permit
35. Check for crowning and prolapsed cord
36. Check to see if amniotic sac in the way and fix it if it is intact. If amniotic fluid is present is it
clear (looking for meconium)
Abnormal Delivery This area is worth 5 points
Breech Prolapsed Cord Multiple births
Continues with delivery
Provides airway for neonate if birth
is prolonged
Checks for pulsation of the cord
Pushes baby’s head up/off cord
Immediate transport
Proper positioning
Knows that cord should still be cut
Second delivery may be breech
Total needed to pass: 40 Total ____ /
23
Instructors name (printed) Pass / Fail
Initials
GLEMSA/DU Skill Sheet Name ______________________
89
General Medical Complaint Leader
Team
First 60 seconds
25. Assess the scene and take deliberate actions to stay safe. Standard precautions (gloves) (AF)
26. As I approach the patient, what do I see (stable/unstable, age, anxiety, position) (AF)
27. Initial Assessment (quick assessment of ABCs and AVPU, and ABCs) (AF)
28. Good Introduction
Basic History
29. History Allergies, Medical Hx, Medications (AF)
30. Onset: “what were you doing when it started?”
31. Provocation/palliation: “does anything make it better or worse?”
32. Time: “When did it start and has it been constant?”
33. Follow up questions: “What do you think it is?” “Been short of breath like this before?”
Differential Diagnosis
34. Organized and thorough assessment and integrated findings to expand the assessment
Nausea or have you vomited?
Recent Trauma?
Sickness? Fever? Productive cough?
Risk factors for P.E.
Bowels/ Stool been normal?
Bladder/ Urine been normal?
Running a fever?
Smoker?
Anxiety/psychiatric problems?
Alcohol or illicit drugs?
Any history of surgeries?
Physical Exam
35. Lung sounds. (AF)
36. Palpate abdomen.
37. Blood sugar check
38. Temperature
39. Distal extremities for edema and JVD.
40. EKG, Pulse Oximetry, and capnography and 12-lead (as appropriate). (AF)
Management
41. Position, Oxygen and IV(AF)
42. Proper fluid and/or drug administration. The drug and drug dose has to be appropriate and the
standard questioning / assessment needs to occur prior to administration(AF)
43. Moved patient appropriately
44. Provided effective radio report to hospital(AF)
Affective
45. Uses proper non-verbal communication(AF)
46. Uses patient’s name and gives Empathy statements(AF)
47. Communicated thoughts/rationale of clinical impression and treatment plan to patient
48. Looks confident, makes the patient feel at ease. (AF)
Total needed to pass: 40 Total ___ / 48
Instructors name (printed) Pass / Fail
Initials
Comments:
GLEMSA/DU Skill Sheet Name ______________________
90
Overdose - Prescription Leader
Team
First 60 seconds
1. Assess the scene and take deliberate actions to stay safe. Standard precautions (gloves) (AF)
2. As I approach the patient, what do I see (stable/unstable, age, anxiety, position) (AF)
3. Initial Assessment (quick assessment of ABCs and AVPU, and ABCs) (AF)
4. Good Introduction
Basic Toxicology
1. What was taken?
2. How much was taken?
3. When was it taken?
4. Accurate weight of the patient
Basic History
5. History Allergies, Medical Hx, Medications
6. Tell me more about the poisoning / exposure
7. Is there anything else that was ingested / injected / taken?
8. Follow up questions: “Has this happened before?”
Differential Diagnosis
9. Organized and thorough assessment and integrated findings to expand the assessment
Nausea or have you vomited?
Abdominal Pain? Chest pain?
Drugs or Alcohol?
Shortness of Breath?
Psychiatric/suicidal in the past?
Physical Exam
10. Lung sounds and check skin (rash)
11. Pupils check and H-pattern test
12. Blood sugar check and Temperature
13. EKG, Pulse Oximetry, and capnography and 12-lead (as appropriate). (AF)
Management
14. Proper Decontamination !! Position, Oxygen and IV(AF)
15. Proper fluid and/or drug administration. The drug and drug dose has to be appropriate and the
standard questioning / assessment needs to occur prior to administration(AF)
Opiates
BVM
Narcan
Ca++ blocker
Calcium
Glucogon
(at E.R.)
Aspirin
NaHCO3
Beta blockers
Glucogon
(at E.R.)
TCA
NaHCO3
APAP
Mucomyst
(at E.R.)
Affective
16. Uses proper non-verbal communication(AF)
17. Uses patient’s name and gives Empathy statements(AF)
18. Communicated thoughts/rationale of clinical impression and treatment plan to patient
19. Looks confident, makes the patient feel at ease. (AF)
Total needed to pass: 34 Total ___ / 40
Instructors name (printed) Pass / Fail
Initials
GLEMSA/DU Skill Sheet Name ______________________
91
Toxic Exposure Leader
Team
First 60 seconds
1. Assess the scene and take deliberate actions to stay safe. Standard precautions (gloves) (AF)
2. As I approach the patient, what do I see (stable/unstable, age, anxiety, position) (AF)
3. Initial Assessment (quick assessment of ABCs and AVPU, and ABCs) (AF)
4. Good Introduction
Basic Toxicology
5. What was the toxic substance? Asks about MSDSs or Placards / Labels
6. Assessment of how the long the patient was exposed and concentration of substance
7. When did the exposure occur?
8. Accurate weight of the patient
Basic History
5. History Allergies, Medical Hx, Medications
6. Tell me more about the poisoning / exposure
7. Is there anything else that was ingested / injected / taken?
8. Follow up questions: “Has this happened before?”
Differential Diagnosis
9. Organized and thorough assessment and integrated findings to expand the assessment
Nausea or have you vomited?
Abdominal Pain? Chest pain?
Illicit drug or alcohol?
Shortness of Breath?
Psychiatric/suicidal in the past?
Physical Exam
10. Lung sounds. (AF)
11. Pupils check and H-pattern test
12. Blood sugar check and Temperature
13. EKG, Pulse Oximetry, and capnography and 12-lead (as appropriate). (AF)
Management
14. Position, Oxygen and IV(AF)
15. Proper fluid and/or drug administration. The drug and drug dose has to be appropriate and the
standard questioning / assessment needs to occur prior to administration(AF)
Cyanide
Amyl nitrite
Na+ nitrite
Na+ thiosulfate
Or Cyanokit
Organophophate
Atropine
2-PAM
CO
Oxygen
Hyperbaric chamber
Corrosives
No vomiting
Pulm edema
EKG !
Hydrocarbons
No vomiting
Pulm edema
EKG !
Affective
16. Uses proper non-verbal communication(AF)
17. Uses patient’s name and gives Empathy statements(AF)
18. Communicated thoughts/rationale of clinical impression and treatment plan to patient
Total needed to pass: 34 Total ___ / 40
Instructors name (printed) Pass / Fail
Initials
GLEMSA/DU Skill Sheet Name ______________________
92
Overdose – Illicit Drugs Leader
Team
First 60 seconds
1. Assess the scene and take deliberate actions to stay safe. Standard precautions (gloves) (AF)
2. As I approach the patient, what do I see (stable/unstable, age, anxiety, position) (AF)
3. Initial Assessment (quick assessment of ABCs and AVPU, and ABCs) (AF)
4. Good Introduction
Basic Toxicology
9. What was taken?
10. How much was taken?
11. When was it taken?
12. Is there anything else that was ingested / injected / taken?
Basic History
5. History Allergies, Medical Hx, Medications
6. Tell me more about the poisoning / exposure
7. Is there anything else that was ingested / injected / taken?
8. Follow up questions: “Has this happened before?”
Differential Diagnosis
9. Organized and thorough assessment and integrated findings to expand the assessment
Nausea or have you vomited?
Abdominal Pain? Chest pain? Shortness of Breath?
Drugs or Alcohol?
Psychiatric/suicidal in the past?
Physical Exam
10. Lung sounds and check skin (rash)
11. Pupils check and H-pattern test
12. Blood sugar check and Temperature
13. EKG, Pulse Oximetry, and capnography and 12-lead (as appropriate). (AF)
Management
14. Proper Decontamination !! Position, Oxygen and IV(AF)
15. Proper fluid and/or drug administration. The drug and drug dose has to be appropriate and the
standard questioning / assessment needs to occur prior to administration(AF)
CNS stimulant
EKG!
Benzo is OK
hyperthrmia
Opiates
Narcan
CNS depressant
BVM assist
Seizure
precautions
Hallucinogen
Safety #1
Calm / quiet
Methanol
ETOH
NaHCO3
MDMA / X
BVM support
hyperthermia
Affective
16. Uses proper non-verbal communication(AF)
17. Uses patient’s name and gives Empathy statements(AF)
18. Communicated thoughts/rationale of clinical impression and treatment plan to patient
Total needed to pass: 33 Total ___ / 38
Instructors name (printed) Pass / Fail
Initials
GLEMSA/DU Skill Sheet Name ______________________
93
Abdominal Pain Leader Team
First 60 seconds
1. Assess the scene and take deliberate actions to stay safe. Standard precautions (gloves)
2. As I approach the patient, what do I see (stable/unstable, age, anxiety, position)
3. Initial Assessment (quick assessment of ABCs and AVPU, and ABCs)
4. Good Introduction
Basic History
5. History Allergies, Medical Hx, Medications
6. Onset: “what were you doing when it started?”
7. Provocation/palliation: “does anything make it better or worse?”
8. Quality: “Can you describe the pain?”
9. Region/radiation: “Can you point to the pain and does it go anywhere?”
10. Severity: “can you put it on a scale from 1 – 10?”
11. Time: “When did it start and has it been constant?”
12. Follow up questions: “What do you think it is?” “Have you ever had pain like this before?”
Differential Diagnosis
13. Organized and thorough assessment and integrated findings to expand the assessment
Short of breath?”
Nausea / Vomiting
Trauma to the Abdomen?”
Risk factors for cardiac
History of GERD or GI problems
Sick lately? Running a fever?
Have you had any problems with your Bowel/Stools?”
Any history of surgeries
Changes in your diet [This area is worth a total of 5 pts]
Risk of pregnancy and the menstrual cycle
Physical Exam
14. Lung sounds.
15. Inspect and Palpate abdomen.
16. Distal extremities for edema and JVD.
17. Compare pulses in both Feet to assess for aortic aneurysm.
18. EKG, Pulse Oximetry, and capnography (as appropriate). 12 lead or 15 lead if appropriate.
Management
19. Position, Oxygen and IV
20. Proper fluid and/or drug administration
21. Moved patient appropriately
22. Provided effective radio report to hospital
Affective
23. Uses proper non-verbal communication. Uses patient’s name and gives Empathy statements
24. Communicated thoughts/rationale of clinical impression and treatment plan to patient
Total needed to pass: 40 Total ____ / 48
Instructors name (printed) Pass / Fail
Initials
Comments:
GLEMSA/DU Skill Sheet Name ______________________
94
Behavioral Emergency Leader
Team
First 60 seconds
1. Assess the scene and take deliberate actions to stay safe. Standard precautions (gloves) (AF)
2. As I approach the patient, what do I see (stable/unstable, age, anxiety, position) (AF)
3. Initial Assessment (quick assessment of ABCs and AVPU, and ABCs) (AF)
4. Good Introduction
Basic History
5. History Allergies, Medical Hx, Medications (AF)
6. Onset: “what were you doing when it started?”
7. Provocation/palliation: “does anything make it better or worse?”
8. Time: “When did it start and has it been constant?”
9. Follow up questions: “What do you think it is?” “Been short of breath like this before?”
Differential Diagnosis
10. Organized and thorough assessment and integrated findings to expand the assessment
Nausea or have you vomited?
Recent Trauma?
Sickness? Fever? Productive cough?
Bowels/ Stool been normal?
Bladder/ Urine been normal?
Running a fever?
Smoker?
Anxiety/psychiatric problems?
Alcohol or illicit drugs?
Any history of surgeries?
Physical Exam
11. Lung sounds. (AF)
12. Palpate abdomen.
13. Blood sugar check
14. Temperature
15. Distal extremities for edema and JVD.
16. EKG, Pulse Oximetry, and capnography and 12-lead (as appropriate). (AF)
Management
17. Position, Oxygen and IV(AF)
18. Proper fluid and/or drug administration. The drug and drug dose has to be appropriate and the
standard questioning / assessment needs to occur prior to administration(AF)
19. Moved patient appropriately
20. Provided effective radio report to hospital(AF)
Affective
21. Uses proper non-verbal communication(AF)
22. Uses patient’s name and gives Empathy statements(AF)
23. Communicated thoughts/rationale of clinical impression and treatment plan to patient
24. Looks confident, makes the patient feel at ease. (AF)
Total needed to pass: 40 Total ___ / 48
Instructors name (printed) Pass / Fail
Initials
Comments:
GLEMSA/DU Skill Sheet Name ______________________
95
Medical Emergencies II Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
96
Medical Emergencies II Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
97
Medical Emergencies II Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
98
Medical Emergencies II Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
99
Medical Emergencies II Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
100
Medical Emergencies II Module Affective Evaluation
Demographics
Name Class Date
Evaluation Statements
1. Professionalism in the classroom Competent Not yet competent
Showing consideration to fellow students and the instructor by being quiet and participating in discussion at the
appropriate times. Responding appropriately to questions. Does not have a problem turning pagers or phones off prior
to class. Seems eager to learn.
Comments:
2. Self-Motivation Competent Not yet competent Taking initiative to complete assignments; taking initiative to improve and/or correct behavior; taking on and following
through on tasks without constant supervision; showing enthusiasm for learning and improvement; consistently striving
for excellence; accepting constructive feedback in a positive manner; taking advantage of learning opportunities
Comments:
3. Appearance and Personal Hygiene Competent Not yet competent Clothing and uniform is appropriate, neat, clean and well maintained; good personal hygiene and grooming.
Comments:
4. Self-Confidence and Communication Competent Not yet competent Able to communicate thoughts, feelings, and rationale when questioned by the instructor or other students. Uses proper
tone and volume of speech when discussing material. Speaks clearly; writing legibly; listening actively; adjusting
communication strategies to various situations
Comments:
5. Time Management Competent Not yet competent Consistent punctuality; completing tasks and assignments on time. Absenteeism and Tardiness
Comments:
6. Respect Competent Not yet competent Being polite to others; not using derogatory or demeaning terms; behaving in a manner that brings credit to the
profession.
Comments:
Student’s Comments
Signature of Student
Date
Signature of Primary Instructor Date
GLEMSA/DU Skill Sheet Name ______________________
101
Trauma Module Skills and Scenarios
GLEMSA/DU Skill Sheet Name ______________________
102
Orthopedic Injuries Date
Date
Date
Joint or Long bone fracture (J=Joint and L= Long bone)
Upper or Lower extremity (U=Upper and L=Lower)
Traction Splint (T)
17. “Scene is safe and standard precautions”
18. Asks about general impression of patient (anxiety, position, age, LOC etc)
19. Completes Initial assessment (ABCs and mental status)
20. Asks questions regarding M.O.I.
21. Directs application of manual stabilization of the joint / extremity
22. Removes all clothes from around injury (verbalized when appropriate)
23. Assess PMS (actually checks not verbalized)
Examiner: “PMS is normal.”
24. Selects proper splinting material
25. Immobilizes the bone above and below the injury
26. Reassess PMS (actually checks not verbalized)
Examiner: “PMS is still normal.”
27. Talks to the patient throughout the scenario
28. Gains a SAMPLE history
29. Gives the patient on statement of empathy regarding situation
QUESTIONS
30. Name 6 of the principles of splinting.
31. What would you do to care for an open fracture
32. Later, patient complains of numbness and tingling. What do you do?
CRITICAL CRITERIA
Did not support the joint during immobilization
Did not properly immobilize the joint
Did not check PMS before or after the skill
Total needed to Pass 26 Points: ___/32 ___/32 ___/32
1. Professionalism in the classroom Competent Not yet competent
Showing consideration to fellow students and the instructor by being quiet and participating in discussion at the
appropriate times. Responding appropriately to questions. Does not have a problem turning pagers or phones off prior
to class. Seems eager to learn.
Comments:
2. Self-Motivation Competent Not yet competent Taking initiative to complete assignments; taking initiative to improve and/or correct behavior; taking on and following
through on tasks without constant supervision; showing enthusiasm for learning and improvement; consistently striving
for excellence; accepting constructive feedback in a positive manner; taking advantage of learning opportunities
Comments:
3. Appearance and Personal Hygiene Competent Not yet competent Clothing and uniform is appropriate, neat, clean and well maintained; good personal hygiene and grooming.
Comments:
4. Self-Confidence and Communication Competent Not yet competent Able to communicate thoughts, feelings, and rationale when questioned by the instructor or other students. Uses proper
tone and volume of speech when discussing material. Speaks clearly; writing legibly; listening actively; adjusting
communication strategies to various situations
Comments:
5. Time Management Competent Not yet competent Consistent punctuality; completing tasks and assignments on time. Absenteeism and Tardiness
Comments:
6. Respect Competent Not yet competent Being polite to others; not using derogatory or demeaning terms; behaving in a manner that brings credit to the
profession.
Comments:
Student’s Comments
Signature of Student
Date
Signature of Primary Instructor Date
GLEMSA/DU Skill Sheet Name ______________________
116
Operations and Review Module Skills and Scenarios
GLEMSA/DU Skill Sheet Name ______________________
117
Operations and Review Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
118
Operations and Review Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
119
Operations and Review Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
120
Operations and Review Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
121
Cardiology Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
122
Cardiology Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
123
Operations and Review Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
124
Operations and Review Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
125
Operations and Review Module Testing (NREMT)
GLEMSA/DU Skill Sheet Name ______________________
126
Affective Evaluation
Demographics
Name Class Date
Evaluation Statements
1. Professionalism in the classroom Competent Not yet competent
Showing consideration to fellow students and the instructor by being quiet and participating in discussion at the
appropriate times. Responding appropriately to questions. Does not have a problem turning pagers or phones off prior
to class. Seems eager to learn.
Comments:
2. Self-Motivation Competent Not yet competent Taking initiative to complete assignments; taking initiative to improve and/or correct behavior; taking on and following
through on tasks without constant supervision; showing enthusiasm for learning and improvement; consistently striving
for excellence; accepting constructive feedback in a positive manner; taking advantage of learning opportunities
Comments:
3. Appearance and Personal Hygiene Competent Not yet competent Clothing and uniform is appropriate, neat, clean and well maintained; good personal hygiene and grooming.
Comments:
4. Self-Confidence and Communication Competent Not yet competent Able to communicate thoughts, feelings, and rationale when questioned by the instructor or other students. Uses proper
tone and volume of speech when discussing material. Speaks clearly; writing legibly; listening actively; adjusting
communication strategies to various situations
Comments:
5. Time Management Competent Not yet competent Consistent punctuality; completing tasks and assignments on time. Absenteeism and Tardiness
Comments:
6. Respect Competent Not yet competent Being polite to others; not using derogatory or demeaning terms; behaving in a manner that brings credit to the