OLTON EMS TRAINING PROGRAM - WordPress.com · 2018-06-06 · OLTON EMS TRAINING PROGRAM 2018...

OLTON EMS

TRAINING PROGRAM

EMS INSTRUCTOR

TRAINING COURSE

STUDENT HANDBOOK

LUBBOCK CLASS

JUNE, 2018

TDSHS COURSE APPROVAL NUMBER: 613868

OLTON EMS TRAINING PROGRAM 2018 LUBBOCK

EMS INSTRUCTOR COURSE

IMPORTANT PHONE NUMBERS

Rusty Powers, Instructor/Coordinator/ Cell: 806-786-7988

Email: [email protected] *

UMC EMS Station 5 Phone: 806-747-1220

For emergency contact only!

*Do not send jokes or chain emails to this email address.

Website for notes and class information:

www.ovaa.wordpress.com Click on 2018 Instructor Course

mailto:[email protected]

http://www.ovaa.wordpress.com/

1

OLTON EMS

TRAINING PROGRAM

EMS INSTRUCTOR

TRAINING COURSE

POLICIES

AND

PROCEDURES

LUBBOCK CLASS

JUNE, 2018

TDSHS COURSE APPROVAL NUMBER: 613868

2

Mission Statement

It is the mission of the Olton EMS Training Program to provide quality

health care education to program applicants, thereby increasing the level of

expertise in Pre-hospital Medicine provided to rural communities throughout

our region.

3

Table of Contents

Goals and Objectives………………………………………………………. 4

Course Composition……………………………………………………….. 5

Tuition……………………………………………………………… ……... 5

Prerequisites………………………………………… …………………… 5

TDSHS EMS Certification…..…………………………………….. 5

Computer, Internet, and Email Access………….…………………..5

Appeals……………………………………………………………………...5

Student Grievances………………………………………………………….5

Insubordination…………………………………………………………….. 6

Insurance…………………………………………………………………… 6

Liability…………………………………………………………………….. 6

Social Media/Photos/Texting/Emails……………………………………….6

Social Media……………………………………………………….. 6

Texting/Emails…………………………………………………….. 6

Classroom Policies…………………………………………………………. 6

Student participation……………………………………………….. 6

Attendance/Absences………………………………………………. 7

Cell Phones…...……………………………………………………..7

Cleaning of Classroom…………………………………………...…7

Exams………………………………………………………………. 7

Cheating……………………………………………………………. 7

Grading policies…………………………………………...……….. 7

Student’s Responsibilities………………………………………….. 7

Homework…………………………………………………………..8

Tobacco Use………………………………………………………...8

Parking……………………………………………………………... 8

EMS living quarters………………………………………………... 8

Course Completion………………………………………………………… 8

4

Goals and Objectives

1. Provide and maintain a quality health education program for Pre-hospital

and hospital personnel

2. Provide and maintain staff education and continuing education for Olton

EMS and surrounding communities.

3. Provide quality health care to the citizens of Lamb and Hale Counties.

4. Strive for excellence in public education and accident prevention, promoting

health and well being to the community.

5. Participate in region and statewide quality improvement programs to provide

growth in quality care.

5

COURSE COMPOSITION

This course will consist of 48 hours of classroom. This course does meet all requirements set by

the Texas Department of State Health Services. The course is based on the National Highway

Traffic Safety Administration’s 2002 Guidelines for Educating EMS Instructors.

TUITION

Tuition is due, in full, and payable on registration. The deadline for submitting payment will be

by the end of the first class. All payments must be made to the lead instructor. No tuition

refunds will be granted after 24 hours from registration. Any request for refund must be

received, in writing by the lead instructor, prior to the 24 hour deadline. Any and all payments

will still be due and payable unless the student withdraws within the 24 hour deadline.

PRE-REQUISITES

TDSHS EMS Certification

Prospective students must hold an active EMS certification as issued by the TDSHS.

Computer, Internet, and Email Access

Students must have access to the internet with printing capabilities and a functioning email

address. Students will be personally responsible to download and print ALL course materials

and notes as directed by the Instructor. Since many communications are handled via email,

students should check their email daily. Students must also have appropriate software to write

editable documents (Microsoft Word is recommended) and appropriate software to give a

presentation (Microsoft PowerPoint is recommended). In addition, students must have at least 2

portable storage devices (jump drives) to transport electronic data and to turn in assignments.

APPEALS

Any applicant not accepted into the course, who has been dismissed from the course, or who has

a grievance with any of the Olton EMS staff or instructors, will have the opportunity to appeal.

The appeal and request for a hearing must be written and submitted to the coordinator within five

(5) working days after being notified of action to be taken. The appeal will be reviewed by a

group made up of the course coordinator, a member of the Olton EMS Board of Directors, and

another instructor from a different EMS Training Program. A decision and explanation will be

provided to the appealing party within five (5) working days of the review. The decision of the

group is final.

STUDENT GRIEVANCES

A grievance is defined as an unsolved conflict that a student has with a member of the Olton

EMS Training Program staff, coordinator or instructor in regards to the enforcement or

interpretation of an EMS Training policy or procedure. If a grievance occurs, it is the student’s

responsibility to file a written grievance and submit it to the course coordinator within five (5)

working days of the conflict. The grievance with be reviewed by a group made up of the course

coordinator, a member of the Olton EMS Board of Directors, and another instructor not affiliated

with the class in which the complainant is enrolled. A decision and explanation will be provided

within five (5) working days of the review. All grievance hearings will be held at the EMS

Station in Olton, Texas. The decision of the group is final.

6

INSUBORDINATION

Any form of disruptive or unprofessional behavior will not be tolerated. All incidents will be

addressed directly by the instructor. Repeated or gross incidents of this manner will result in

termination from the program.

INSURANCE

No health insurance is furnished by this program. It is advisable that all students have their

own personal insurance. The student assumes all personal liability and responsibility for any

personal injury that is a direct result of the student’s actions either intentional or otherwise.

LIABILITY

CHAPTER 773 SEC 773.009 OF THE HEALTH AND SAFETY CODE states “A person who

authorizes, sponsors, supports, finances or supervises the functions of emergency personnel and

emergency medical service personnel is not liable for civil damages for an act or omission

connected with training emergency medical personnel or with service or treatment given to

patient or potential patient by emergency medical service personnel if the training, services or

treatment is performed in accordance with standard of ordinary care”.

SOCIAL MEDIA/PHOTOS/TEXTING/EMAILS

With today’s technology, there are numerous opportunities for almost instantaneous

communications with a large number of persons. This creates challenges for EMS services in

regards to public perception, confidentiality, and professionalism.

Social Media

Students may not post ANY reference to instructors, other students, or any other person or

facility associated with this course. Any derogatory remarks about the staff, instructors, or other

persons or facilities affiliated with this program may result in immediate dismissal from the

program. This includes posts on Twitter, Facebook, Myspace, or other social media sites. Any

violation of this may result in immediate dismissal from the program.

Texting/Emails

Students may NOT send or receive text messages or emails during class time. Any derogatory

remarks about the staff, instructors, or other persons or facilities affiliated with this program may

result in immediate dismissal from the program.

CLASSROOM POLICIES

Student Participation

Students are expected to take an active roll in the learning process. Time is scheduled

throughout the course for mini lectures, skills presentations, discussions and group work. All

students will actively participate and will be called upon by the instructor(s). As this course is

designed to produce high quality EMS instructors and leaders in the EMS field, class

participation is NOT an option. Failure to participate in class activities and discussions may

result in unfavorable evaluations which could lead to failure to successfully complete the course.

7

Attendance/Absences

Classroom attendance is mandatory. Students must notify the instructor if they will not be

attending class. Students are NOT allowed to miss more than 8 hours of class for any reason,

however justified. The State minimum hours for an Instructor course is 40 hours. Any student

that misses more than 8 hours will NOT have met those minimum hour requirements and will

NOT receive a course completion certificate.

Cell Phones

Cell phones are allowed in the classroom during normal classes. However, the phones should be

set on silent or vibrate. Students must leave the classroom to answer or speak on cell phones. No

texting, surfing, or other use of cell phones are allowed during classroom lectures unless

authorized by the instructor. No cell phones will be allowed in the classroom during testing.

Cleaning of Classroom and Skills Areas

Students are expected to straighten up the classroom and skills areas after every class and return

the classroom into the same condition found; or better. Following skills sessions, students are

expected to assist the instructors in picking up all manikins, skills supplies, and equipment prior

to leaving.

Exams

Students are required to take exams on the date the exam is scheduled. Only cases of extreme

emergency, such as work, family emergency, or an excused absence will be considered for

rescheduling of an exam.

Cheating

Cheating will not be tolerated at any time. Students caught cheating will be dismissed from the

course. No cell phones will be allowed in the classroom during testing.

Grading Policies

The acceptable passing grade for this course will be a score of 75 percent and must receive

acceptable evaluations on class presentations. Students will be required to have an average of 75

percent in order to take the course final exam. The Course Final Exam will also have a

minimum passing grade of 75%.

Grades may be taken and recorded for daily quizzes, assignments and pop quizzes. The student

will be evaluated on class presentations as well.

Student’s Responsibilities

It is the student’s responsibility:

To keep track of his/her absences.

To notify the instructor of the absence prior to class.

To acquire lecture materials, assignments, notes and handouts.

To make arrangements to turn in homework that will be late due to an absence.

To make arrangements to take a make up exam within the allotted time.

To arrive on time to class.

To participate in classroom activities and discussions.

To seek clarification on any subject matter that is not understood.

8

Homework

Homework will be assigned by the lead instructor. Homework is a MANDATORY part of the

course. Failure to complete class assignments will result in possible termination from the course.

Tobacco Use

Tobacco is prohibited on all UMC properties. This pertains to Vapor or E-cigarettes as well. To

use tobacco products, the student will have to leave UMC property. Violation of this policy

could result in dismissal from the course.

Parking

Students will not be allowed to park in the reserved parking spaces or in front of the bays at

anytime. Students are to park in un-reserved spots at all times.

EMS Living Quarters

The living quarters, which include the bedrooms and offices, are off limits to students during

class time except as allowed by the instructor.

Behavior, Appearance, Attitude

Students are expected to arrive on time for all classes and prepared for learning.

Guests are allowed provided there is adequate room and the guests are well behaved.

Dress appropriately for the class scheduled. Females should avoid low cut shirts and

short skirts on skills night.

Talking among students, during lectures, is strictly prohibited unless directed by the

instructor.

Food and beverage is allowed during class so long as it does not disrupt the learning

environment. However, loud crunching of ice and food items is not allowed. The

instructor reserves the right to alter the food and beverage privilege.

COURSE COMPLETION

Once a student completes all requirements as set forth, the student will be issued a Course

Completion Certificate (CCC). This certificate will be used to obtain Instructor certification

from the TDSHS.

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1

2018 INSTRUCTOR COURSE KNOWLEDGE OBJECTIVES

Topic: Requirements for Texas EMS Instructor TAC 157.44

Cognitive Objectives

At the completion of this module, the student-instructor should be able to:

List the TDSHS requirements for an EMS Instructor certification

Describe the TDSHS requirements for an EMS instructor course

Describe the TDSHS certification process for an EMS instructor

List and describe the responsibilities of an EMS instructor according to TDSHS rules

Describe the TDSHS recertification process for an EMS instructor

List and describe the TDSHS potential disciplinary actions against an EMS instructor

List the potential reasons for disciplinary actions by the TDSHS against an EMS instructor

Describe the notification and appeal process of TDSHS disciplinary action

Psychomotor Objectives

There are no psychomotor objectives for this section

Affective Objectives


Value the TDSHS rules applied to EMS instructors

Appreciate the procedures of discipline as administered by TDSHS

Value the impact that disciplinary actions can have on an EMS instructor and EMS program

Topic: EMS Certification TAC 157.33



List the TDSHS requirements for an EMS certification

Describe the time limits applied to EMS candidates per TDSHS rule

Describe the TDSHS requirements for reciprocity via NR certification and other state certification

Describe the TDSHS equivalency certification procedure

List and describe the responsibilities of EMS personnel according to TDSHS rules





Value the TDSHS rules applied to EMS personnel

Appreciate the Texas EMS certification process

Topic: EMS Certification TAC 157.34



List the TDSHS requirements for EMS personnel recertification

List and describe the TDSHS options for EMS personnel recertification

Describe the TDSHS process for late recertification of EMS personnel

Describe the TDSHS requirements to obtain inactive certification

Describe the TDSHS process of EMS personnel to move from inactive to active certification





Value the TDSHS rules applied to EMS personnel recertification

Appreciate the Texas EMS recertification process

Topic: Roles and Responsibilities



Use their own words to provide a descriptive definition of the Primary and Secondary EMS Instructor

2

Describe the differences between the Primary and Secondary Instructor

Describe the duties of a Primary Instructor providing the majority of instruction during the entirety of an

EMS course

Describe the duties of a Secondary Instructor assisting a Primary Instructor

Describe the importance of professional development through continuing education, conference offerings

and formal academic coursework for the EMS instructor

Describe sources for locating relevant educational and research materials

Describe the relationship between the instructor and the student, assistant instructor, program director and

medical director

Describe the role of the course syllabus and lesson plan in course management

Describe the major components of the syllabus and lesson plan Psychomotor Objectives




Defend the importance of continuing professional development for the professional educator

Value the role of the instructor in the EMS classroom

Serve as a role model for other educators in the EMS setting

Assess personal attitudes and demeanor that may distract from professionalism

Value the variety of the classroom culture

Appreciate the importance of the teacher-student relationship

Value the need to provide fair, timely and constructive feedback to students

Exhibit professional behaviors in the following areas: integrity, empathy, self-motivation, appearance and

personal hygiene, self-confidence, communications, time management, teamwork, diplomacy, and respect

Explain the value of serving as a mentor

Value the importance of mentoring in the development of a professional EMS instructor

Topic: The Domains of Learning


At the completion of this module the student-instructor should be able to:

Use his or her own words to state a definition of cognitive, psychomotor and affective domains of learning

Identify the domain of learning and level of depth for a correctly written objective

Give examples of behaviors that exemplify the three domains of learning

Within the context of an EMS call, identify knowledge and behavioral examples for cognitive,

psychomotor and affective domains

List classroom activities for each domain of learning

State at least one appropriate evaluation method for each domain of learning


There are no psychomotor objectives for this module.



Acknowledge the need to teach within the three domains of learning as identified within the National

Standard Curriculum for any level of EMS course

Support activities that teach and evaluate the three domains of learning

Value all three domains of performance by the EMS professional

Topic: Goals and Objectives



Use his or her own words to define and describe goal, objective and performance agreement

Use his or her own words to identify and describe the ABCD parts of an objective

Use his or her own words to describe each of the three domains of learning: cognitive, affective and

psychomotor

Use his or her own words to describe how to evaluate a planned learning activity (lecture, demonstration,

etc.) to determine if there is performance agreement between the planned learning event and the course

goals and objectives

3

The student should be able to determine the level (1-3) from the language of the objective based on ABCD

elements



Take objectives and identify the A, B, C, and components

Take incomplete objectives (lacking 1 or 2 of the ABCD components) and rewrite the objective to contain

all of the necessary elements

Compare goals and objectives to determine if performance agreement exists



Explain why goals and objectives are important to well-designed learning

Explain how the evaluation of goals and objective for performance agreement enhances quality

Explain why understanding the three levels within each domain are important in planning and executing

instruction

Topic: Lesson Plans


At the conclusion of this module the student-instructor should be able to:

Define a lesson plan

Define and describe the following components of a lesson plan:

o Needs assessment

o Overall goal of instruction

o Cognitive objectives

o Psychomotor objectives

o Affective objectives

o Lesson motivation

o Recommended list of equipment and supplies

o Recommended schedule

List and describe the components of a needs assessment used for preparing a lesson plan

List and describe the items to consider when evaluating the intended audience during needs assessment

Discuss the methods for determining the depth to which the content will be covered in a prepared lesson

plan

Discuss the process of aligning objectives of the curriculum with the specific objectives of the lesson plan

Discuss how to use a lesson plan to present course content

Discuss methods to evaluate the effectiveness of lesson plans:

o Formative evaluation strategies

o Summative evaluation strategies

o Written testing instruments

o Practical skills demonstrations



Evaluate a lesson plan for completeness and accuracy

Conduct a needs assessment with a group of EMS students

Take a given topic as furnished by the instructor and write a brief lesson plan that includes all of the

elements presented in this module



Support the use of lesson plans in guiding the planning and presentation of instruction

Defend the need to perform a complete and thorough needs assessment prior to the development of a lesson

plan

Topic: Presentation Skills



Describe four different instructional styles

Describe the proper use of instructor presence in the classroom setting

List types of media available for classroom use

List criteria for successful classroom presentations

4

List strategies that can be used to augment classroom presentations



Demonstrate a brief lecture presentation

Demonstrate how to gauge students response to your presentation



Explain how different classroom presentation strategies enhance learning

Describe the importance of including varying learning styles in each lesson plan

Value the importance of diversity in the types of media used to deliver subject matter

Topic: Evaluation Techniques



Define evaluation, formative evaluation and summative evaluation

Distinguish between formal and informal evaluation

Identify various types of evaluation, and the advantages and disadvantages of each

Understand specific types of test items and the advantages and disadvantages of each

Understand general guidelines for test construction

Define reliability

Define content validity

List several examination resources



Develop two examples of correctly constructed test items for cognitive evaluation in each of the following

categories:

o Multiple choice

o True/false

o Matching

o Completion

o Essay

Develop a skills checklist to evaluate a psychomotor skills performance



Explain why evaluation is important to the total quality control of an EMS program

Explain why formative and summative evaluations are both important in the evaluation process

Topic: Teaching Psychomotor Skills



Define psychomotor skills

Explain the relationship between cognitive and affective objectives to psychomotor objectives

Describe teaching methods appropriate for learning a psychomotor skill

Describe classroom activities used to teach and practice psychomotor skills

List methods to enhance the experience of psychomotor skill practice in the classroom



Demonstrate proper facilitation technique when demonstrating EMS skills

Demonstrate the use of corrective feedback during a skill demonstration

Create a skill session lesson plan which maximizes student practice time

Create a skill scenario which enhances realism



Acknowledge the need to teach the mechanics of a skill before students can apply higher level thinking

about the process

Value the need for students to practice until they attain mastery level

Model excellence in skill performance

5

Topic: Facilitation Techniques



Use his or her own words to provide a description of facilitated learning

Describe why motivating students is an important factor in an environment that promotes facilitated

learning

Identify classroom arrangements and formats that promote and enhance facilitation techniques

Explain why the standard lecturing method does not provide a facilitated learning environment

List methods to enhance the lecture method to make it a more facilitated learning experience

Explain the role of group work in a facilitated learning environment

List tips or methods to facilitate a discussion in the classroom

List tips for facilitating a practical (psychomotor) classroom session

Describe methods to maintain classroom control when using a facilitated learning environment



Apply the learning principles described in this module to facilitate a discussion of a small group (three-five

participants) of student-instructors

Apply the learning principles described in this module to facilitate a psychomotor classroom session



Value the need for providing a facilitated learning environment for adult students

Share techniques described within this module with other instructors to promote facilitated learning

principles

Topic: Administrative Issue



Identify resources at the federal level for obtaining information on policies and procedures for EMS

education programs and courses

Identify resources at the state level for obtaining information on policies and procedures for EMS education

programs and courses

Identify resources at the local level for obtaining information on policies and procedures for EMS

education programs and courses





Describe the importance of understanding the policies and procedures put in place for EMS instructors for

conducting EMS education programs and courses

Topic: Legal Issues in EMS Education



Define liability, negligence and the standard of instruction

Identify areas of legal liability for the instructor and the educational institution

Identify risk management considerations for the student, instructor, and educational institution

Explain the importance of confidentiality

Identify applicable federal, State and local laws which affect the EMS teaching profession and the

educational institution

Explain legal considerations regarding copyright and intellectual property issues





Value the importance of adhering to local, state, and federal laws governing the teaching profession and the

conduction of EMS education programs

6

Topic: Ethics in EMS Education



Use their own words to define ethics and morals

Use their own words to identify and describe the basis of the six moral theories described in this module

Describe one strength and one weakness for each of the six moral theories described in this module

Identify sources of ethical mission statements for educational and emergency medical organizations

Describe attributes of an ethical instructor

List venues in education that should have ethical role models

Describe ways in which ethics can be incorporated into the EMS curricula


Given a lesson plan or session topic, describe an activity that incorporates an ethical lesson into that session



Defend the need to model ethical behavior as instructors

Topic: The Learning Environment



State the importance of a positive learning environment

List desirable behaviors for students in your classroom setting

Identify unacceptable student behaviors

Describe methods to engage students in the learning process through a positive learning environment



Create a positive learning environment given a group of students in a classroom setting

Role-play effective methods of engaging students in the learning process as described in this module



Appreciate the importance of a positive learning environment and the overall impact that has on the success

of a class

Act as a role model for the positive behaviors expected in the classroom setting

Discourage rude, offensive or distracting behavior and language in students

Topic: Communication and Feedback



Describe the process of active listening

State the importance of timely feedback

Compare and contrast counseling and evaluation

Describe several unique types of questioning that could be used to solicit student responses

Explain how body language affects one’s verbal communication reception

Recognize the need to check for understanding when giving students information

State the benefits of honest communication in the education environment



Demonstrate active listening during a role-play exercise in the classroom

Employ the use of the pause when questioning students in a role-play exercise in the classroom

Demonstrate the proper use of positive and negative feedback in a counseling scenario

Demonstrate the use of questioning techniques to solicit student responses in a mock classroom

environment

Model body language that is recognized as open, interested and positive



Support the need for positive communication in the learning environment

Encourage open communication in one’s classroom

Value the need for honesty in academic communications

7

Topic: Motivation Cognitive Objectives


Use his or her words to define intrinsic and extrinsic motivation

List intrinsic motivators of behavior

List extrinsic motivators of behavior

Given a description of behavior, identify the motivator for that student's behavior

Describe techniques to increase motivation in different types of students

Identify techniques to increase self-motivation for instructors



Create and conduct an activity to identify motivational factors for students in a given class

Demonstrate behaviors that motivate students

Demonstrate how to create a classroom environment that is motivating to students


Appreciate students have different motivations for participating in an EMS course

Respect an individual’s motivator for success

Value the need to rejuvenate motivation as an instructor

Topic: Teaching Thinking Skills



Differentiate between learning and knowing

List activities that foster thinking skills

Define high level thinking

Describe how “critical thinking” effects the practice of prehospital medicine

Describe the benefits of an active classroom or experiential learning





Acknowledge the importance in developing good judgement and thinking skills in students

Support activities that encourage high level thinking skills

Value the use of scenarios and simulations in the classroom

Topic: The Affective Domain



Use his or her own words to provide a definition of the affective domain of learning

Give examples of student behaviors that illustrate desired behaviors or changes in behavior in the affective

domain

Within the context of EMS practice, identify examples of affective domain behaviors

List classroom activities that support development of the student's affective domain





Acknowledge the need to teach to the affective domain

Support activities that teach and evaluate the affective domain

Value the affective domain of performance for the EMS professional

8

Topic: Learning Styles



Use his or her own words to define and describe "learning style" and "learning preference"

List common learning styles found in adult learners

Identify the following characteristics for each learning style:

o Student needs, desires and preferences in instruction

o Strengths and weaknesses inherent in that style

Explain how learning styles impact classroom dynamics

Given a lesson plan, describe activities that may be used to target a specific learning style

Identify surveys and other tools used to classify learning styles

Describe how his or her own learning style will affect instruction



Create a lesson plan which utilizes a stimulating variety of teaching techniques activities and breaks for the

purpose of maximizing the various learning styles present in students



Value the diversity found in the various learning styles

Support the use of learning styles assessment in EMS education

Support the use of a variety of teaching styles to reach all learning styles

Topic: Discipline



Identify unacceptable classroom behaviors

Articulate the cost and consequences of uncontrolled classroom environments

Discuss possible causes of behavior problems

Describe three strategies for preventing unacceptable behavior

Describe how to create a progressive discipline policy within institutional guidelines

Given a behavior problem scenario describe an appropriate disciplinary action for the situation



Role play a scenario involving a discipline problem by modeling the steps of progressive discipline

described in this module



Appreciate the underlying causes of behavior problems

Respect the student’s dignity when delivering discipline

Value the need to apply discipline in a safe, fair and consistent manner

Topic: Remediation



Use his or her own words to define and describe remediation

Describe the steps of the remediation process

Describe the critical components to include when performing an assessment of a problem requiring

remediation

List skills critical to student learning success



Role play a front end assessment to identify and explore the causes of a problem requiring remediation



Value the need to assist student in becoming independent self-directed learners

9

Topic: Cultural Awareness



Use his or her own words to define and describe cultural awareness

Understand various ethnic and religious values and traditions that may affect a student’s behavior

Explain the behaviors an EMS instructor can model to show awareness of cultural issues in their classroom

Describe aspects of cultural awareness that are important to instill in students in the classroom setting





Defend the need to consider cultural awareness issues when designing and developing instructional plans

and curriculum

Display behaviors that indicate consideration of cultural awareness issues when dealing with students

Share your knowledge of cultural awareness by modeling cultural sensitive behaviors to your students in

the classroom

Topic: Teaching Resources



Discuss the importance of mentors for the development of a professional EMS instructor

Discuss the importance of working with various allied health personnel, including

State EMS agency personnel, area hospital personnel (ER physicians, nurses, respiratory therapists,

pharmacists, etc.), non-hospital affiliated physicians and area paramedic program faculty (e.g., college and

university)

Discuss the importance of validity, utility and the effective use of resources in delivering content in a

program

Discuss the importance of attending professional development opportunities (e.g., EMS and education

conferences and workshops)

Discuss the usefulness of a library in developing educational content

Discuss the importance of research for each of the following:

o When developed for a specific organizational need

o Used when participating in larger multi-organizational projects

o As a contribution to the body of knowledge

Discuss the importance of developing a support network with each of the following:

o local political officers (e.g., county council, mayor, city manager)

o physicians

o publishers

o area EMS instructors

o area paramedic program faculty (e.g., college and university)

o other faculty within your agency

Discuss the importance of using community service as a means of developing teaching skills

o through presentations to public groups (e.g., scouts, schools, civic groups)

o assisting with area EMS courses



Given a specific EMS instructional setting (with audience, teaching site, and course type provided) the

student-instructor should be able to take specific EMS course content resources (provided to them) and

evaluate that resource for validity, utility and effectiveness in the described setting

Use the resources described in this module to enhance lesson plan content



Describe why it is important for EMS instructors to seek a mentor

Explain the importance of critical evaluation of teaching resources

Value the importance of developing methods designed to enhance personal growth and life-long learning

10

Topic: Research



Describe the nature and characteristics of research as it relates to the practice of EMS

Understand the common types and methods of conducting research

Distinguish between the different types of research commonly conducted in the EMS setting

Understand how research studies are designed and conducted

Describe methods used to read the research literature with understanding

Identify sources for locating relevant research materials and findings





Defend the importance of teaching research methods in the curriculum

Value the importance of research in the clinical and educational settings of EMS

Value the need to assist in the research process and data collection activities

Explain the value of research to the EMS provider and the EMS Educator

Topic: National Registry Application and Certification



Describe the resources available to assist students with the NR application

Describe the steps to take to complete an NR application

Describe the NR authorization to test process

Describe the process to schedule a written exam with the NR

Explain the procedures used at the VUE testing centers

Discuss the process and rules regarding retesting of the NR written exam

Discuss the time limitations to pass the NR written exam

Describe the time limit of skills verification for the NR

Describe the Texas certification process and procedures including:

o Application and fee

o Fingerprint requirement

Define “Computer Adaptive Testing (CAT)” and “Item Response Theory (IRT)”

Explain how “Computer Adaptive Testing (CAT)” and “Item Response Theory (IRT)” are utilized by the

NR for the written exam





Defend the accuracy of the NR exam

Appreciate the NR application and certification exam process

Explain the value of the NR application and certification exam process

Topic: Requirements for Texas Education and Course Approval (TAC 157.32)



List and describe the standard components of a Texas EMS education program

List the curriculum requirements for a Texas ECA course

List the curriculum requirements for a Texas EMT course

List the curriculum requirements for a Texas AEMT course

List the curriculum requirements for a Texas Paramedic course

Describe the approval requirements required for a Texas Basic training program

Describe the approval requirements required for a Texas Advanced training program

Describe the Self-Study for an EMS education program

List the components of a Self-Study for an EMS education program

List the topics that must be covered in a program’s policies

11

Describe the TDSHS course notification and approval process

List the components of a TDSHS course application

List and describe the reasons for disciplinary action against education programs





Appreciate the components of an EMS training program

Explain the value of knowing the policies affecting EMS training programs

Appreciate the complexity of gaining approval of an EMS training program

Defend the need for following the rules of an EMS training program

Topic: Criteria for Denial and Disciplinary Actions for EMS Personnel (TAC 157.36)



Define the following terms:

o Emergency suspension

o Suspension

o Refuse to renew

o Reprimand

o Probation

Describe the process and criteria for emergency suspension

List and describe reasons for disciplinary action against EMS personnel

List and describe the criteria for denial of EMS certification

List the Disqualifying Convictions for EMS certification

List the reviewable offenses for EMS certification

Describe the pre-enrollment criminal history/prescreening of EMS candidates

Describe the criteria that the State uses for consideration of candidates with criminal offenses

List the criteria for denial of EMS certification

Describe the notification and appeal process in regard to denial of EMS certification

Describe the process for volunteer surrender of EMS certificate or license





Explain the value of knowing the policies of criteria for denial and disciplinary actions for EMS personnel

certification

Defend the importance of TDSHS policies affecting denial and disciplinary actions for EMS personnel

certification

Value the need to keep persons with certain convictions out of the EMS field

Topic: Requirements for Texas Continuing Education (TAC 157.38)



List the required CE hours and content areas for each level of EMS certification for a four year period

List examples of each content area of required CE

List four topics that are NOT allowed for CE

Define the following terms:

o Accrediting agency

o Continuing Education Audit

o Contact Hour

o Clinical Learning Experience

o Continuing Education

o Continuing Education Program

o Credit Course

o Continuing Education Provider

o Couse

o Self-Directed Study

12

List the types of acceptable CE as allowed by TDSHS

List the criteria for acceptable CE as allowed by TDSHS

List and describe the responsibilities of the certified or licensed EMS personnel as it relates to continuing

education

Describe the TDSHS CE Audit process





Value the importance of continuing education in the EMS field

Explain the value of knowing the policies and requirements of continuing education requirements

Defend the importance of TDSHS continuing education requirements for EMS personnel certification

Topic: Competency Based Instruction and Class Design



Define competency based instruction

List the formula for achievement according to the instruction

Describe the process of determining minimum hours for a course

Define the goal of competency based instruction

Define Entry Level Competent and list the components

List and describe the communities of interest to help determine entry level competency

List the practice components that will aid with competency based instruction

List the 5 basic components of competency based instruction

List the 5 components of the 1998 NSC Clinical Objectives





Value the importance of competency based instruction

Defend the importance of planning for competency based instruction when designing a course

Topic: Putting it all Together; The Successful School



Use own words to define what is a successful school

List and describe 5 items that an instructor can do to make a successful school





Value the importance of the impact that EMS instructors have on EMS and EMS education

Defend need for good instructors teaching EMS

Olton EMS Training Program 8/10

MECHANICAL AIDS TO BREATHING CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST OXYGEN [5 MINUTES] START TIME:

END TIME:

0 1 2 1. Prepares and assembles equipment 0 2 *2. Assembles regulator to tank 0 1 2 3. Checks tank pressure (Examiner shall ask for gauge reading and safe residual) 0 1 2 *4. Adjusts liter flow to 15 liters per minute (lpm) or greater 0 2 *5. Prefills reservoir bag 0 1 2 *6. Applies and adjusts mask with reservoir to the patient’s face 0 2 *7. Removes the mask prior to discontinuation of oxygen flow 0 1 2 *8. Shuts off regulator 0 1 2 *9. Maintains safety precautions throughout Candidate’s Total Points (minimum passing total: 13 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail

Examiner: Cert. No. (if assigned):

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - OROPHARYNGEAL AIRWAY [2 MINUTES] START TIME:

END TIME:

0 1 2 *1. Selects proper size, measuring from earlobe to corner of mouth or other appropriate method 0 1 2 *2. Inserts airway 0 2 *3. Removes airway Candidate’s Total Points (minimum passing total: 4 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail


Documenting Comments:


MECHANICAL AIDS TO BREATHING CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST MOUTH-TO-MASK [3 MINUTES] START TIME:

END TIME:

0 2 1. Connects one-way valve to mask 0 1 2 *2. Positions mask properly and opens airway 0 1 2 3. Establishes and maintains a proper mask-to-face seal 0 1 2 *4. Begins effective ventilations within 30 seconds of beginning of station time 0 2 *5. Performs effective ventilations for one (1) minute at rate of 10-20 ventilations per minute 0 2 6. Connects mask to oxygen source and adjusts liter flow 0 2 *7. Resumes ventilations within 15 seconds and continues effective ventilations for 30 seconds

at rate of 10-20 ventilations per minute Candidate’s Total Points (minimum passing total: 10 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail




MECHANICAL AIDS TO BREATHING CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST BAG-VALVE-MASK [3 MINUTES] START TIME:

END TIME:

0 1 2 *1. Positions mask properly and opens airway 0 1 2 2. Maintains adequate seal around mouth and nose 0 1 2 *3. Begins effective ventilations (chest or lung inflation) within 30 seconds of beginning of

station time 0 1 2 *4. Performs effective ventilations for one (1) minute at a rate of 10-20 ventilations per minute 0 2 5. Connects BVM to oxygen source and adjusts liter flow 0 2 *6. Resumes ventilations within 15 seconds and continues effective ventilations for 30 seconds

at rate of 10-20 ventilations per minute Candidate’s Total Points (minimum passing total: 7 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail


- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - SUCTIONING [2 MINUTES] START TIME:

END TIME:

0 2 *1. Positions patient to prevent aspiration by turning patient's head to side or turning the

patient to the side as a unit 0 2 *2. Prepares suction device 0 1 2 *3. Inserts catheter and applies suction properly 0 1 2 *4. Suctions for 5-15 seconds Candidate’s Total Points (minimum passing total: 6 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail




PATIENT ASSESSMENT VITAL SIGNS

CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST STATION TIME 5 MINUTES START TIME:

END TIME:

0 1 2 *1. Calculates and reports pulse Candidate _ ____

Examiner Difference 0 1 2 *2. Calculates and reports respiratory rate Candidate ______

Examiner Difference 0 1 2 *3. Palpates and reports systolic blood pressure Candidate _____

Examiner Difference 0 1 2 *4. Auscultates and reports auscultated blood pressure Candidate Systolic

Examiner Difference

Candidate Diastolic Examiner Difference

Candidate’s Total Points (Minimum pasing total: 6 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail




PATIENT ASSESSMENT PHYSICAL SURVEY

CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST STATION TIME 15 MINUTES START TIME:

END TIME:

0 2 *1. Takes or verbalizes body substance isolation precautions 0 1 2 *2. Performs scene size-up

-*Assures scene is safe -Number of patients -Mechanism of Injury

0 2 *3. Performs primary assessment/Immobilizes c-spine as indicated 0 2 *4. Describes interventions for problems found during primary assessment 0 2 *5. Identifies patient priority; makes transport decisions 0 1 2 *6. Performs rapid trauma scab or focused physical examination as indicated 0 2 *7. Obtains baseline vital signs 0 2 *8. Obtains SAMPLE history from patient or others 0 1 2 *9. Describes interventions for problems identified during history and focused examination

(Indicate care described on attached sheet.) 0 1 2 10. Performs detailed physical examination, as indicated by patient’s condition 0 1 2 11. Reports to hospital after obtaining appropriate information

-Age and sex -Treatments -Chief Complaint/MOI -Pertinent History -Vital Signs -ETA

0 2 *12. Describes reassessment Candidate’s Total Points (Minimum passing total: 18 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail




BRONCHODILATOR ADMINISTRATION-HANDHELD METERED DOSE INHALER CANDIDATE’S NAME: DATE: EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST STATION TIME 5 MINUTES START TIME:

END TIME:

0 2 *1. Avoids contamination of equipment or replaces contaminated equipment prior to use. 0 2 *2. Confirms order (medication, dosage and route) 0 1 2 *3. Informs patient of order for medication and inquires about allergies and recent doses of

other bronchodilators 0 2 *4. Selects correct medication from drug box as requested by Examiner 0 2 *5. Verbalizes check of medication for contamination and expiration date 0 2 *6. Shakes the inhaler 0 2 7. Attaches spacer to inhaler, if ordered 0 2 8. Verbalizes recheck of the medication label 0 2 9. Removes nonrebreather mask from patient 0 2 10. Verbalizes recheck of the medication label 0 2 *11. Performs steps 1-10 prior to step 12 and performs at least one (1) recheck of the

medication label 0 2 12. Instructs patient to exhale deeply 0 2 *13. Instructs patient to put the mouthpiece in mouth and make a seal with lips 0 2 *14. Instructs patient to depress the inhaler canister while inhaling and then hold breath as

long as comfortable 0 2 *15. Replaces non-rebreather mask on patient Candidate’s Total Points (Minimum pasing total: 21 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail




BRONCHODILATOR ADMINISTRATION-SMALL VOLUME NEBULIZER CANDIDATE’S NAME: DATE: EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST STATION TIME 5 MINUTES START TIME:

END TIME:

0 2 *1. Avoids contamination of equipment or replaces contaminated equipment prior to use. 0 2 *2. Confirms order (medication, dosage and route) 0 1 2 *3. Informs patient of order for medication and inquires about allergies and recent doses of

other bronchodilators 0 2 *4. Selects correct medication from drug box as requested by Examiner 0 2 *5. Verbalizes check of medication for contamination and expiration date 0 2 *6. Adds appropriate volume of medication to the nebulizer 0 2 *7. Assembles nebulizer according to the manufacturer’s standard (or local protocol) and

connects to oxygen regulator 0 2 8. Verbalizes recheck of the medication label 0 1 2 *9. Adjusts oxygen liter flow as ordered and allows mist to fill breathing tube or mask prior

to applying to patient 0 2 10. Verbalizes recheck of the medication label 0 2 *11. Performs steps 1-10 prior to step 12 and performs at least one (1) recheck of the

medication label 0 2 *12. Removes non-rebreather mask and positions nebulizer device on patient Candidate’s Total Points (Minimum pasing total: 17 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail



Olton EMS Training Programs 8/10

BANDAGING [STATION TIME 10 MINUTES]

CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST INJURY: START TIME:

END TIME

0 2 *1. Takes or verbalizes body substance isolation precautions 0 2 *2. Checks circulation (pulse or capillary refill), motor function and

sensation distal to injury before bandaging 0 2 3. Covers injury completely with clean dressing(s) demonstrating aseptic technique 0 1 2 *4. Secures dressing using appropriate pressure with no excessive movement 0 1 2 *5. Uses bandaging technique appropriate to injury 0 2 *6. Checks circulation (pulse or capillary refill), motor function and sensation distal to injury

after bandaging Note: The examiner must now inform candidate that the wound continues to bleed (on extremity sites

only) 0 2 *7. The student shall verbalize the correct placement of a tourniquet if wound is on extremity. Candidate’s Total Points (minimum passing total: 9 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail



Olton EMS Training Programs 8/10

SPLINTING [STATION TIME 10 MINUTES]

CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST INJURY: START TIME:

END TIME

0 2 *1. Takes or verbalizes body substance isolation precautions 0 2 *2. Checks circulation (pulse or capillary refill), motor function and sensation distal to injury

before splinting 0 1 2 *3 Immobilizes injury 0 2 *4. Checks circulation (pulse or capillary refill), motor function and sensation distal to injury

after splinting Candidate’s Total Points (minimum passing total: 7 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail




TRACTION SPLINTING CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL COURSE RENEWAL EQUIVALENCY RETEST STATION TIME 10 MINUTES START TIME:

END TIME

CANDIDATE PULLING TRACTION CANDIDATE APPLYING SPLINT 0 2 *1. Takes BSI Precautions 0 1 2 *2. Checks circulation, motor function, and sensation distal to injury before applying ankle hitch 0 2 *3. Applies ankle hitch 0 1 2 *4. Applies and maintains traction, elevation, and gentleness 0 2 *5. Monitors circulation, motor function, and sensation distal to injury after procedure is completed 0 1 2 6. Communicates with partner & patient Minimum passing total: 9 points

0 2 *1. Takes BSI Precautions 0 1 2 2. Prepares equipment 0 2 *3. Stabilizes fracture while ankle hitch applied 0 2 *4. Positions splint 0 1 2 5. Fastens ischial strap 0 1 2 6. Connects hitch to frame 0 2 *7. Tightens mechanical device to achieve traction and immobilize injury 0 1 2 *8. Secures cravats or velcro straps without aggravating injury 0 2 9. Verbalizes securing torso and splint to longboard to immobilize hip and prevent movement of splint 0 1 2 10. Communicates with partner & patient Minimum passing total: 17 points

Candidate’s Total Points

Partner’s Name (Print):

Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail

Examiner:

Cert. No. (if assigned):



SPINAL IMMOBILIZATION OF SEATED PATIENT CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST STATION TIME 10 MINUTES START TIME:

END TIME

0 2 *1. Takes or verbalizes body substance isolation precautions 0 2 *2. Directs partner to establish and maintain neutral spinal alignment 0 2 *3. Checks circulation, motor function, and sensation in all four extremities 0 1 2 *4. Applies extrication collar 0 1 2 *5. Positions short device 0 2 *6. Secures short device to patient's torso 0 2 *7. Secures short device to patient's head to assure neutral cervical spine alignment 0 2 *8. Checks circulation, motor function, and sensation in all four extremities 0 2 9. Performs steps 1-7 in sequence 0 2 *10. Does not compromise airway or impede respirations 0 1 2 11. Communicates Candidate’s Total Points (minimum passing total: 16 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail




SPINAL IMMOBILIZATION OF SUPINE PATIENT CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST STATION TIME 10 MINUTES START TIME:

END TIME

0 2 *1. Takes or verbalizes body substance isolation precautions 0 2 *2. Directs partner to establish and maintain neutral spinal alignment. 0 2 *3. Checks circulation, motor function, and sensation in all four extremities 0 1 2 *4. Applies extrication collar 0 1 2 *5. Moves patient onto device without compromising integrity of spine 0 2 *6. Secures patient to long device 0 2 *7. Checks circulation, motor function, and sensation in all four extremities 0 2 8. Performs steps 1-7 in sequence 0 2 *9. Does not compromise airway or impede respirations 0 1 2 10. Communicates Candidate’s Total Points (minimum passing total: 15 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail




PNEUMATIC ANTI-SHOCK GARMENT (P.A.S.G.) CANDIDATE’S NAME: DATE: EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST STATION TIME 5 MINUTES START TIME:

END TIME:

0 2 *1. Takes or verbalizes body substance isolation procedures 0 2 2. Prepares patient for application of the P.A.S.G. (Removes clothing or states

"Clothing has been removed," as appropriate) 0 1 2 *3. Positions and aligns garment 0 1 2 *4. Secures leg sections 0 1 2 *5. Secures abdominal section 0 2 *6. Inflates garment (Three (3) compartments all at one time or leg sections then

abdominal section) NOTE: DO NOT ALLOW INFLATION.

0 2 *7. Sets valves to prevent loss of air from garment Candidate’s Total Points (Minimum passing total: 10 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail




CARDIAC ARREST MANAGEMENT/AED CANDIDATE’S NAME: DATE: EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST STATION TIME 5 MINUTES START TIME:

END TIME:

0 2 *1. Takes or verbalizes body substance isolation precautions

0 2 *2. Assures scene safety

0 1 2 3. Attempts to question any bystanders about arrest events

0 2 4. Checks patient responsiveness

0 2 *5. Checks pulse and breathing simultaneously (no more than 10 seconds)

0 2 *6. Begins immediate chest compressions (No breaths given prior to compressions)

0 2 7. Requests additional EMS response

0 1 2 *8. Performs 2 minutes of high quality 1-Rescuer CPR

0 1 2 *9. Adequate depth and rate

0 1 2 *10. Correct compression to ventilation ratio

0 1 2 *11. Allows chest to recoil completely

0 1 2 *12. Adequate volume for each breath

0 2 *13. Minimal interruptions of less than 10 seconds throughout

0 2 14. Assesses patient for return of spontaneous pulse

0 2 *15. Directs second rescuer to resume CPR while candidate applies AED

0 2 16. Turns on power to AED

0 2 *17. Follows prompts and properly places pads on patient

0 2 *18. Directs rescuer to stop CPR and to “CLEAR”

0 2 *19. Initiates analysis of rhythm if not automatically performed by AED

0 2 *20. Confirms that personnel are clear

0 2 *21. Delivers shock (3 shocks if AED is configured to 2000 Standards)

0 2 *22. Directs rescuer to immediately resume chest compressions (no pulse check) Candidate’s Total Points (Minimum passing total: 32 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail




MECHANICAL AIDS TO BREATHING

TIME ALLOWED FOR SKILL PERFORMANCE - VARIES PER COMPONENT PERFORMANCE OBJECTIVES for each Mechanical Aids component are as follows: 1. OXYGEN - Given an adult manikin or a human “patient”, an oxygen cylinder, a regulator, a humidifier

(optional), an oxygen wrench and an adult non-rebreather mask with a reservoir bag, the candidate shall, within the allotted station time, demonstrate proper attachment of the regulator, the ability to read the pressure gauge accurately and the ability to deliver oxygen using the criteria herein prescribed.

2. OROPHARYNGEAL AIRWAY - Given an adult manikin and oropharyngeal airways (in adult, child and

infant sizes), the candidate shall, within the allotted station time, demonstrate proper insertion of an oro-pharyngeal airway using the criteria herein prescribed.

3. BAG-VALVE-MASK - Given an adult manikin, a bag-valve-mask, an oxygen reservoir (optional), a

preassembled oxygen source and oxygen tubing, the candidate shall, within the allotted station time, demonstrate artificial ventilation using the criteria herein prescribed.

4. MOUTH-TO-MASK WITH SUPPLEMENTAL OXYGEN - Given an adult manikin, mouth-to-mask

resuscitators with one-way valves, an oxygen inlet, a preassembled oxygen source and oxygen tubing, the candidate shall, within the allotted station time, demonstrate artificial ventilation using the criteria herein prescribed.

5. SUCTION - Given an adult manikin, a portable suction device powered by electricity, battery or gas and a

suction catheter, the candidate shall, within the allotted station time, demonstrate proper suctioning technique using the criteria herein prescribed.

TESTING CONDITIONS 1. Examiner shall insure that station is conducted as a testing station and NOT as a teaching session. 2. The station shall test only the skill of Mechanical Aids to Breathing and shall NOT be conducted as a part of any

other skill or scenario. 3. Candidates shall be tested in private and one candidate at a time. 4. Examiner shall require candidate to take or verbalize body substance isolation precautions before station time

begins. STATION EQUIPMENT: 1. Adult manikin with lungs capable of being inflated 9. Watch or clock with reading in seconds 2. A human “patient” (optional) 10. Oxygen cylinder wrench 3. Oxygen cylinder with adequate supply of oxygen 11. Humidifier (optional) 4. An adult non-rebreather mask with reservoir bag 12. Oxygen regulator 5. Oropharyngeal airways in adult, child and infant sizes 13. Oxygen reservoir (optional) 6. Bag-valve with adult mask 14. Oxygen supply tubing 7. Mouth-to-mask resuscitator with one-way valves 15. Suction catheters (soft or rigid) 8. Suction device powered by electricity, battery or gas 16. Tongue depressor (optional)


INSTRUCTIONS TO EXAMINER 1. The Course Coordinator, lead Instructor and Examiner are responsible for insuring the presence of all necessary

equipment and also for insuring that all equipment is in working order prior to beginning the test session. 2. Examiner will NOT remove or hide equipment required to complete the skill. 3. Before the test session begins, the candidate shall be allowed to familiarize with the equipment. During this

time Examiner shall answer any questions the candidate has about the equipment. 4. Scenarios must NOT be used except as indicated by the criteria. 5. Examiner shall prompt candidate ONLY as indicated by the criteria. 6. Each of the 5 Mechanical Aids components shall be timed and tested separately. Candidate need retest only on

failed components. 7. At this station the candidate will be required to orally answer questions from Examiner as outlined in the testing

criteria. Examiner must therefore insure that directions and questions do not infringe upon the station time limits.

8. Station time shall begin immediately after Examiner finishes examination instructions and informs candidate to

begin. 9. Examiner shall record starting and ending times in the appropriate section of the score sheet. 10. Once a test session has begun, it must be completed within the allotted time with NO restarts allowed. 11. Station time shall NOT be restarted or extended for any reason. 12. If station time limit is exceeded, Examiner shall end the test, record skill as failure. 13. Sequence errors shall NOT be penalized unless specified by the grading criteria. 14. Documentation by narrative is required on all steps awarded a "0" and on all skills failures. 15. Candidate shall NOT fail because of Examiner error.


OXYGEN GRADING CRITERIA [STATION TIME 5 MINUTES] 1. Prepares and assembles equipment a. Opens and closes (cracks) cylinder quickly to blow out debris

b. Checks for O-ring

2 = Performs above criteria 1 = Does not check for O-ring 0 = Does not clear debris

*2. Assembles regulator to tank

a. Attaches regulator b. Opens cylinder c. Insures no leakage or corrects leakage quickly

2 = Performs above criteria 0 = Unable to prevent cylinder from leaking

3. Checks tank pressure (Examiner shall ask for gauge reading and safe residual)

a. States pressure accurately (within 100 psi) when asked by Examiner b. States safe residual when asked by Examiner (200 psi)

2 = Performs above criteria 1 = Does not state correct safe residual 0 = Reads pressure in error by more than 100 psi

*4. Adjusts liter flow to 15 liters per minute (LPM.) or greater

a. Connects delivery device to flowmeter b. Adjusts liter flow to 15 LPM. or greater

2 = Connects delivery device to flowmeter correctly and adjusts flow rate to at least 14 LPM. 1 = Connects delivery device to flowmeter correctly and adjusts flow rate to 13 LPM. 0 = Connects delivery device incorrectly and/or adjusts flow rate to deliver less than 13 LPM.

*5. Prefills reservoir bag

2 = Performs above criteria 0 = Does not perform above criteria

*6. Applies and adjusts mask with reservoir to the patient’s face

a. Begins oxygen flow before device placed on patient b. Positions device properly on patient

2 = Performs above criteria 1 = Begins oxygen flow properly, but positions device improperly on patient 0 = Does not begin oxygen flow before device placed on patient

*7. Removes the mask prior to discontinuation of oxygen flow



OXYGEN (Continued) *8. Shuts off regulator

a. Closes cylinder valve b. Bleeds regulator valve completely to return pressure indicator to zero c. Detaches regulator

2 = Performs above criteria 1 = Does not to bleed regulator valve or detach regulator 0 = Does not close cylinder valve prior to detaching regulator

*9. Maintains safety precautions throughout

a. Cracks cylinder away from self and patient b. Turns front of gauges away from self and patient when turning on oxygen, hands do not cover gauge c. Cylinder secured when unattended

2 = Performs above criteria 1 = Secures cylinder but omits "a" and/or "b" 0 = Does not secure cylinder or attempts to remove cylinder yoke

OROPHARYNGEAL AIRWAY GRADING CRITERIA [STATION TIME 2 MINUTES] *1. Selects proper size airway, measuring from earlobe to corner of mouth or other appropriate method

2 = Chooses correct size using appropriate method 1 = Chooses one size larger or smaller than correct size using appropriate method 0 = Chooses greater than one size larger or smaller,

Uses inappropriate method to measure or fails to measure *2. Inserts airway

a. Opens mouth using jaw lift or cross finger technique b. Inserts in front of mouth with tip pointed toward roof, or inserts inside of mouth with tip toward inside of

cheek, or tongue depressor is used to hold tongue and airway is inserted tip down c. Does not push tongue posteriorly

2 = Performs above criteria 1 = Omits “a” 0 = Inserts using method other than in “b”

Pushes tongue posteriorly NOTE: The Examiner shall advise the candidate that the patient is gagging. *3. Removes airway

2 = Performs above step 0 = Omits step


MOUTH-TO-MASK WITH SUPPLEMENTAL OXYGEN GRADING CRITERIA [STATION TIME 3 MINUTES] 1. Connects one-way valve to mask


*2 Positions mask properly and opens airway

a. Places apex of mask over bridge of nose b. Places base of mask between lower lip and prominence on the chin c. Opens airway

2 = Performs above criteria 1 = Positions mask improperly 0 = Fails to open airway

3. Establishes and maintains a proper mask-to-face seal

2 = Performs above criteria 1 = Allows moderate leakage 0 = Allows gross leakage

*4. Begins effective ventilations within 30 seconds of beginning of station time

a. Ventilations shall be 1½-2 seconds in duration b. Ventilations shall cause chest rise or lung inflation

2 = Begins effective ventilations within 30 seconds of beginning of station time 1 = Begins effective ventilations within 31-45 seconds of beginning of station time 0 = Does not begin effective ventilations within 45 seconds of beginning of station time

*5. Performs effective ventilations for one (1) minute at rate of 10-20 ventilations per minute

NOTE: The Examiner shall tell the candidate to stop after 1 minute


6. Connects mask to oxygen source and adjusts liter flow

a. Attaches oxygen tubing to inlet on mask and oxygen source b. Opens cylinder c. Adjusts liter flow to 12-15 liters per minute (LPM.) or greater

2 = Performs above criteria 0 = Fails to properly connect mask to oxygen source

Fails to open cylinder Adjusts flow rate to deliver less than 12 LPM.

*7. Resumes ventilations within 15 seconds and continues effective ventilation for 30 seconds at rate of 10-12

ventilation per minute

NOTE: The Examiner shall tell the candidate to stop after 30 seconds



BAG-VALVE-MASK GRADING CRITERIA [STATION TIME 3 MINUTES] *1. Positions mask properly and opens airway

a. Places apex of mask over bridge of nose b. Places base of mask between lower lip and prominence on the chin c. Opens airway

2 = Performs above criteria 1 = Positions mask improperly 0 = Fails to open airway

2. Maintains adequate seal around mouth and nose

2 = Performs above criteria 1 = Allows moderate leakage 0 = Allows gross leakage

*3. Begins effective ventilations (chest rise or lung inflation) within 30 seconds of beginning of station time

2 = Begins effective ventilations within 30 seconds of beginning of station time 1 = Begins effective ventilations within 31-45 seconds of beginning of station time 0 = Does not begin effective ventilations within 45 seconds of beginning of station time

*4. Performs effective ventilations for one (1) minute at rate of 10-20 ventilations per minute

NOTE: The Examiner shall tell the candidate to stop after 1 minute


5. Connects BVM to oxygen source and adjusts liter flow

a. Attaches oxygen tubing to BVM and oxygen source b. Opens cylinder c. Adjusts liter flow to 12-15 liters per minute (LPM.) or greater

2 = Performs above criteria 0 = Fails to properly connect BVM to oxygen source

Fails to open cylinder Adjusts flow rate to deliver less than 12 LPM.

*6. Resumes ventilation within 15 seconds and continues effective ventilation for 30 seconds at rate of 10-12

ventilation per minute

NOTE: The Examiner shall tell the candidate to stop after 30 seconds



SUCTIONING GRADING CRITERIA [STATION TIME 2 MINUTES] *1. Positions patient to prevent aspiration by turning patient's head to side or turning the patient to the side

as a unit


*2. Prepares suction device

a. Turns on suction device b. Assures presence of mechanical suction


*3. Inserts catheter and applies suction properly

a. Measures from earlobe to corner of mouth or uses other acceptable technique b. Inserts to measured depth c. Applies suction only as catheter is being removed from mouth

2 = Performs above criteria 1 = Applies suction when entering mouth and/or inserts beyond measured depth 0 = Omits step "a" or fails to suction

*4. Suctions for 5-15 seconds

2 = Performs above criteria 1 = Suctions for 16-30 seconds 0 = Suctions for less than 5 seconds or more than 30


1

PATIENT ASSESSMENT TIME ALLOWED FOR SKILL PERFORMANCE - 15 MINUTES FOR PHYSICAL SURVEY

- 5 MINUTES FOR VITAL SIGNS PERFORMANCE OBJECTIVE 1. PHYSICAL SURVEY - Given a human “patient,” a stethoscope, a blood pressure cuff, a pen light and a

scenario describing the circumstances of the patient’s illness or injury, the candidate shall, within the allotted station time, perform an assessment of the patient, including the scene size-up, initial assessment and focused history and physical examination or detailed physical examination and state appropriate interventions for the patient’s problems, using the criteria herein prescribed..

2. VITAL SIGNS - Given a human “patient” the candidate shall, within the allotted station time, determine

the pulse, respirations, and palpated and auscultated blood pressure. TESTING CONDITIONS 1. Examiner shall insure that the session is conducted as a testing station and NOT as a teaching session. 2. Examiner shall prompt the candidate only as indicated by the criteria. 3. Candidates shall be tested in private and one candidate at a time. 4. A non-candidate or a previously tested candidate MUST be used as the "patient." If it is necessary to use a

candidate who has not yet tested this skill, that candidate shall NOT be tested using the same scenario. The Examiner shall determine that the patient has readily palpable radial pulses. Examiner shall NOT be used as the "patient."

5. The patient shall NOT "cue" the candidate being examined but may assist to the extent that an actual patient

would be able. The patient shall be cooperative. 6. Based on the scenario, the candidate should talk to the “patient” and/or Examiner as the candidate

progresses through the test. 7. Examiner shall require candidate to take or verbalize body substance isolation precautions before station

time begins. 8. Examiner shall require candidates to have pen or pencil and a piece of paper on which to chart vital signs

and other observations. Other methods such as writing on gloves, etc. are also acceptable. 9. The scenario(s) will be based on protocols established by the Course Medical Director and/or Course

Coordinator that are appropriate to the skill level of the course and shall have been submitted as part of the course approval documents. Scenarios must include both medical and trauma patients.

STATION EQUIPMENT: 1. A human “patient” 2. A watch with a second hand or a digital watch (provided by candidate). 3. Pen or pencil and paper (provided by candidate). 4. A blood pressure cuff of appropriate size. 5. A stethoscope 6. A teaching stethoscope 7. A penlight 8. A watch or clock with readings in seconds (for Examiner)


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INSTRUCTIONS TO THE EXAMINER 1. The Course Coordinator, lead Instructor and Examiner are responsible for insuring the presence of all

necessary equipment; and also for insuring that all equipment is in working order prior to beginning the test session.

2. Examiner will NOT remove or hide equipment required to complete the skill. 3. Before the test session begins, the candidate shall be allowed to familiarize with the equipment. During

this time Examiner shall answer any questions the candidate has about the equipment. 4. Once vital sign values are given, no further attempts will be allowed. 5. Vital sign reports will be compared to values obtained by Examiner. 6. Once a test session has begun, it must be completed within the allotted time with NO restarts allowed. 7. Station time shall NOT be restarted or extended for any reason. 8. Station time shall begin immediately after Examiner finishes examination instructions, reads the scenario

to the candidate, and informs candidate to begin. 9. Examiner shall record starting and ending times in the appropriate section of the score sheet. 10. If station time limit is exceeded, Examiner shall end the test, record skill as failure. 11. Sequence errors shall NOT be penalized unless specified by the grading criteria. 12. The candidate shall be assigned a scenario randomly. Examiner will read the scenario to the

candidate, giving the candidate the dispatch information and what the candidate can see upon arrival at the scene. The candidate then is expected to continue the assessment of the patient as would be appropriate in a real situation.

13. ONLY scenarios submitted with the course approval application are to be used. 14. Documentation by narrative is required on all steps awarded a "0" and on all skills failures. 15. Candidate shall NOT fail because of Examiner or “patient” error.


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PHYSICAL SURVEY GRADING CRITERIA [STATION TIME 15 MINUTES] *1. Takes or verbalizes body substance isolation precautions a. Determines appropriate BSI equipment needed b. Gloves are minimum BSI 2=Performs above criteria 0= Does not take appropriate BSI precautions *2. Performs scene size-up

a. Determines scene safety before beginning initial assessment b. Determines mechanism of injury/nature of illness c. Determines number of patients d. Requests additional help, if necessary

2 = Performs above criteria 1 = Omits “c” or “d” 0 = Omits step

Omits “a” or “b” *3. Performs initial assessment

a. Determines general impression of patient (Candidate should ask, “How does the patient look?” or make some other inquiry regarding the patient’s general appearance

b. Assesses mental status (AVPU) c. Assesses airway d. Assesses breathing e. Assesses presence/quality of perfusion (radial/carotid pulse, skin color/temperature/condition or

capillary refill f. Assesses for major bleeding, if applicable g. Controls C-spine as indicated

2 = Performs above criteria 0 = Omits “a”, “b”, “c”, “d” , “e” , or “g” in any patient

Omits “f” in trauma patient Performs detailed or focused physical examination, takes baseline vital signs, or attempts to obtain

SAMPLE history before completing initial assessment *4. Describes interventions for problems found during initial survey

a. Provides immediate manual immobilization of C-spine if indicated by mechanism of injury b. Opens airway appropriately c. Assures adequate oxygenation/ventilation d. Controls major bleeding, if applicable

NOTE: Verbalization of interventions is acceptable.


Performs detailed or focused physical examination, takes baseline vital signs, or attempts to obtain SAMPLE history before providing care for problems found during initial survey

Attempts to manage less serious problems before life threats and potential life threats have been identified and corrected

Opens airway inappropriately


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*5. Identifies patient priority; makes transport decisions

2 = Correctly determines if patient requires immediate transport or continued on-scene evaluation and stabilization

0 = Does not correctly determine if patient requires immediate transport or continued on-scene evaluation and stabilization

NOTE: If not obvious from the scenario, the Examiner should ask the candidate to justify rationale

for transport decision. *6. Performs rapid trauma assessment or focused physical examination as indicated

a. Trauma patients (Serious injuries or mechanisms of injury): Performs rapid trauma assessment (head-to-toe exam) (DCAP-BTLS); examines neck for distended jugular veins and tracheal deviation; examines chest for crepitation, paradoxical motion, equality of breath sounds, examines abdomen for rigidity or distension

b. Trauma patients (Isolated injury and no significant mechanism of injury): Evaluates local injury or injuries

c. Medical patients (Responsive): Performs exam guided by patient’s chief complaint d. Medical patients (Unresponsive): Performs rapid detailed physical exam (head-to-toe exam)

as for unstable trauma patients

2 = Performs above criteria 1 = Performs above criteria but exam is not organized 0 = Does not perform rapid head-to-toe exam when indicated by patient condition or mechanism of injury/

nature of illness *7. Obtains baseline vital signs (The candidate will simulate assessing the pulse, respirations, and blood

pressure. The Examiner will then provide the: a. pulse, rate, rhythm, and quality

b. respiratory rate, rhythm, and quality c. blood pressure


*8. Obtains SAMPLE history from patient or others

2 = Attempts to obtain signs and symptoms (history of present illness), allergies, medications, past history, last oral intake, and events leading up to emergency

1 =Does not attempt to obtain information about last oral intake 0 = Does not attempt to obtain signs and symptoms (history of present illness), allergies, medications, past

history, or events leading up to emergency *9. Describes interventions for problems identified during history and focused examination NOTE: Verbalization of interventions is acceptable.

2 = Provides appropriate care for problems identified during focused history and physical examination 1 = Omits care or provides inappropriate care which would NOT have resulted in significant deterioration

of patient’s condition and/or injury 0 = Omits care or provides inappropriate care which would have resulted in significant deterioration of

patient’s condition and/or injury Performs interventions on-scene with priority patient who should have been treated enroute to hospital Does not provide spinal protection when indicated

10. Performs detailed physical examination, as indicated


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a. Head: Inspects/palpates scalp; inspects/palpates face; inspects nose, mouth, ears; inspects eyes/pupils b. Neck: Inspects/palpates; assesses for jugular vein distension; assesses for tracheal deviation c. Chest: Inspects/palpates; auscultates for equality of breath sounds d. Abdomen: Inspects/palpates all four quadrants e. Pelvis: Palpates for instability; verbalizes assessment of genitalia/perineum, as needed f. Extremities: Inspects/palpates all four extremities; assesses circulation, motor and sensory function g. Back: Inspects/palpates thoracic/lumbar spine; inspects/palpates entire back

2 = Performs above criteria

Step not required in this scenario 1 = Does not inspect nose, mouth, ears

Does not assess extremity circulation, motor and sensory function in all four extremities 0 = Does not perform detailed physical examination when indicated

Omits any portion of detailed physical examination EXCEPT failing to inspect nose, mouth, ears or does not assess extremity circulation and motor/sensory function

11. Reports to hospital after obtaining appropriate information

a. Age/gender of patient and problems found in primary assessment, if any b. Patient’s chief complaint c. Estimate of severity of patient’s condition

d. Brief history of present illness/injury e. Vital signs f. Allergies, medications, past history, last oral intake, and events leading up to incident g. Physical exam findings h. Pertinent treatment provided i. Anticipated time of arrival

NOTE: A required sequence of reporting information is not implied. “Disorganized” means that

candidate fails to obtain all information before beginning report and interrupts report to obtain patient information.

2 = Performs above criteria 1 = Radio traffic disorganized

Radio report omits “a”, “f”, or “i” 0 = Radio report omits “b”, “c”, “d”, “e”, “g” or “h”

*12. Describes ongoing assessment (Examiner should ask candidate to describe how candidate would

manage the patient during the remainder of the transport to the hospital.) a. Repeats initial assessment (AVPU, ABC’s) b. Repeats vital signs (every 5 minutes for unstable patients; every 15 minutes for stable patients) c. Repeats focused assessment regarding patient complaint or injuries d. Checks interventions

NOTE: Verbalization of interventions is acceptable.



6

VITAL SIGNS GRADING CRITERIA [STATION TIME 5 MINUTES] *1. Calculates and reports pulse

a. Avoids using thumb b. Reports rate within 10% of Examiner’s value c. Describes quality (strong, weak, thready, etc.) d. Describes regularity (regular or irregular)

2 = Performs above criteria 1 = Fails to report “c” and/or “d” 0 = Omits step

Uses thumb Reports value that is in error greater than 10% from Examiner’s value

*2. Calculates and reports respiratory rate

a. Reports rate within plus or minus two (2) of Examiner’s value b. Describes quality (shallow, labored, etc.) c. Describes regularity (regular or irregular)

2 = Performs above criteria 1 = Fails to report “b” and/or “c”

Reports rate within three (3) of Examiner’s value 0 = Omits step

Reports rate that is in error greater than three (3) from Examiner’s value. NOTE: Examiner shall direct candidate to palpate blood pressure before auscultating blood pressure. *3. Palpates and reports systolic blood

a. Uses brachial or radial pulse b. Locates pulse before cuff inflation c. Reports palpated systolic within 10 mm Hg of Examiner’s palpated value d. Deflates cuff completely prior to reinflation (if 2nd or 3rd attempt performed)

2 = Performs above criteria 1 = Reports value differing 11-16 mm Hg from Examiner’s palpated value

Omits “a”, “b” and/or “d” 0 = Omits step

Reports value that is in error greater than 16 mm Hg from Examiner’s palpated value NOTE: Examiner shall NOT palpate at the same time as the candidate *4. Auscultates and reports auscultated blood pressure

a. Systolic over diastolic b. Reports each value within 8 mm Hg of Examiner’s values c. Deflates cuff completely prior to reinflation (If 2nd or 3rd attempt performed)

2 = Performs above criteria 1 = Reports any value differing 9-12 mm Hg from Examiner’s value

Omits “c” 0 = Omits step

Requires more than 3 attempts Reports any value that is in error greater than 12 mm Hg from Examiner’s values Reports diastolic over systolic


7

SUGGESTED FORMAT FOR PATIENT ASSESSMENT SCENARIOS NOTE: This is a SUGGESTED format. If you are already using a scenario format it is NOT

necessary to reformat your scenarios to an identical format. Scenario: (Describe the scene, including the situation, information about the patient to include

age, position, etc., clues to mechanism of injury, and scene safety or lack thereof.) Initial Assessment: Level of Consciousness: (Primary Survey) Airway:

Breathing: Circulation:

Vital Signs: Pulse: (To include rate, regularity, strength, and location, if applicable)

Blood Pressure: Respirations: (To include rate, regularity & quality)

Detailed Physical Exam: Head: (Head-to-toe Exam) Neck:

Chest: Abdomen: (To include pelvis in trauma patients) Back: Extremities:

SAMPLE: Signs & Symptoms:

Allergies: Medications: Past History: Last Meal: Events:

Management: (Intervention that should be verbalized by the candidate to include: interventions

for problems found during initial survey; transport decision; interventions for problems found during history and focused examination.)

Report: (Information that MUST be reported to hospital.)


8

SAMPLE SAMPLE SAMPLE

PATIENT ASSESSMENT PATIENT CARE PROVIDED

YES NO N/A BASIC CARE Activated Charcoal Airway, Manual Anti-Shock Measures Bag-Valve-Mask Bandaging Cervical Collar Cervical Immobilization Device Control Bleeding Extrication Flow Restricted Oxygen Powered Ventilation Device Foreign Body Airway Obstruction Management Glucose Irrigation Long Spinal Immobilization Device Mouth-to-Mask Resuscitator (Pocket Mask) Nasopharyngeal/Oropharyngeal Airway Oxygen: Nasal Cannula Non-Rebreather Mask Short Spine Immobilization Device Splinting Suctioning Tourniquet Traction Splint Other: Other: NOTE: This is an optional sheet that MAY be used by the Examiner to assist in grading this skill. SAMPLE SAMPLE SAMPLE


BRONCHODILATOR ADMINISTRATION Handheld Metered Dose Inhaler, Small Volume Nebulizer

TIME ALLOWED FOR SKILL PERFORMANCE - 5 MINUTES PER COMPONENT PERFORMANCE OBJECTIVE Given an adult manikin or a human “patient” and appropriate equipment and supplies, the candidate shall, within the allotted station time, be able to recognize and select the medication ordered, properly assemble the delivery device and administer the drug using the criteria herein prescribed. TESTING CONDITIONS 1. Examiner shall insure that the session is conducted as a testing station and NOT as a teaching session. 2. The station shall test only the skill of Bronchodilator Administration and shall NOT be conducted as a part of

any other skill or scenario. 3. Candidates shall be tested in private and one candidate at a time. 4. Examiner shall require candidate to take or verbalize body substance isolation precautions before station time

begins. STATION EQUIPMENT: 1. Adult manikin or a human “patient” 2. Oxygen tank, regulator and nonrebreather mask 3. Small volume nebulizer administration device and oxygen supply tubing 4. Drug box containing the following items:

a. handheld metered dose inhaler and, if required by local protocol, a spacer b. sample or simulation of a bronchodilator packaged for use in a nebulizer

5. A watch or clock with readings in seconds INSTRUCTIONS TO THE EXAMINER 1. The Course Coordinator, lead Instructor and Examiner are responsible for insuring the presence of all necessary

equipment; and also for insuring that all equipment is in working order prior to beginning the test session. 2. Examiner will NOT remove or hide equipment required to complete the skill. 3. Before the test session begins, the candidate shall be allowed to familiarize with the equipment. During this

time Examiner shall answer any questions the candidate has about the equipment. 4. Scenarios must NOT be used except as indicated by the criteria. 5. Examiner shall prompt candidate ONLY as indicated by the criteria. 6. The initial setting is the manikin or simulated patient sitting up. Assessment indicates that bronchodilator

administration is appropriate. Oxygen is being administered via nonrebreather mask at 15 liters per minute (simulated flow is acceptable).

7. Examiner, acting as medical control, shall specify the drug name (as labeled), dose (number of metered doses)

and the route of administration ordered. Instruct the candidate to select that drug and administer it. This is a test of psychomotor skills, not a test of the candidate’s knowledge of specific drugs.


8. Choose a drug which is contained in the drug box for the handheld metered dose inhaler segment. Instruct the candidate to select that drug and administer it. The order should include the use of the spacer, if its use is desired or expected. This station is a test of psychomotor skills, not a test of the candidate’s knowledge of specific drugs.

9. Choose a drug which is contained in the drug box for the small volume nebulizer segment. Instruct the

candidate to select that drug and administer it via nebulizer with an oxygen flow rate of 8 liters per minute. This station is a test of psychomotor skills, not a test of the candidate’s knowledge of specific drugs. .

10. When questioned about allergies, Examiner shall state: “There are no allergies.” 11. If questioned about self-administered doses of other bronchodilators, Examiner shall state: “No medications

have been taken.” 12. Once a test session has begun, it must be completed within the allotted time with NO restart allowed. 13. Station time shall NOT be restarted or extended for any reason. 14. Station time shall begin immediately after Examiner finishes examination instructions and informs candidates

to begin. 15. Examiner shall record starting and ending times in the appropriate section of score sheet. 16. If station time limit is exceeded, Examiner shall end the test, record skill as failure. 17. Sequence errors shall NOT be penalized unless specified by the grading criteria. 18. Additional steps not called for in criteria shall NOT be penalized as sequence errors 19. Omitted steps shall NOT be penalized as sequence errors. 20. Documentation by narrative is required on all steps awarded a "0" and on all skills failures. 21. Candidate shall NOT fail because of Examiner error.


HANDHELD METERED DOSE INHALER GRADING CRITERIA [STATION TIME 5 MINUTES] Examiner states: “The patient meets all criteria for administration of a bronchodilator. Medical Control has authorized the administration of (drug name and dose) via handheld metered dose inhaler.” *1. Avoids contamination of equipment or replaces contaminated equipment prior to use.


*2. Confirms order (medication, dosage and route)

2 = Performs step 0 = Omits any portion of step

*3. Informs patient of order for medication and inquires about allergies and recent doses of other

bronchodilators

2 = Performs step 1 = Inquires about allergies but does not inform patient of order or inquire about use of other bronchodilators 0 = Does not inquire about allergies

*4. Selects correct medication from drug box as requested by Examiner

2 = Performs step 0 = Omits step

*5. Verbalizes check of medication for contamination and expiration date


*6. Shakes the inhaler


7. Attaches spacer to inhaler, if ordered

2 = Performs step, if ordered 0 = Omits step, if ordered

8. Verbalizes recheck of the medication label


9. Removes nonrebreather mask from patient





*11. Performs steps 1-10 prior to step 12 and performs at least one (1) recheck of the medication label

2 = Performs as above 0 = Does not perform as above

12. Instructs patient to exhale deeply


*13. Instructs patient to put the mouthpiece in mouth and make a seal with lips


*14. Instructs patient to depress the inhaler canister while inhaling and then hold breath as long as

comfortable


*15. Replaces non-rebreather mask on patient



SMALL VOLUME NEBULIZER GRADING CRITERIA [STATION TIME 5 MINUTES] Examiner states: “The patient meets all criteria for administration of a bronchodilator. Medical Control has authorized the administration of (drug name and dose) via small volume nebulizer at liters per minute (l.p.m.).” *1. Avoids contamination of equipment or replaces contaminated equipment prior to use.




*3. Informs patient of order for medication and inquires about allergies and recent doses of other

bronchodilators

2 = Performs step 1 = Inquires about allergies but does not inform patient of order or inquire about use of other bronchodilators 0 = Does not inquire about allergies





*6. Adds appropriate volume of medication to the nebulizer


*7. Assembles nebulizer according to the manufacturer’s standard (or local protocol) and connects to

oxygen regulator





*9. Adjusts oxygen liter flow as ordered and allows mist to fill breathing tube or mask prior to applying to patient

2 = Adjusts flow rate to within one (1) l.p.m. of requested flow 1 = Adjusts flow rate to within two (2) l.p.m of requested flow 0 = Omits any portion of step

Adjusts flow rate to deliver more than two (2) l.p.m. above or below the requested flow 10. Verbalizes recheck of the medication label




*12. Removes non-rebreather mask and positions nebulizer device on patient

a. Begins oxygen flow rate and mist before nebulizer placed on patient b. Positions device according to manufacturer’s standard or local protocol


NOTE: Examiner shall state that the medication administration has been completed.


1

BANDAGING AND SPLINTING

TIME ALLOWED FOR SKILLS PERFORMANCE - 10 MINUTES PER COMPONENT

PERFORMANCE OBJECTIVES for each Bandaging and Splinting component are as follows: 1. BANDAGING - Given a human “patient” and a description of the "patient's" injuries, the candidate shall, within

the allotted station time, apply a dressing and bandage according to the principles of hemorrhage control and aseptic technique.

2. SPLINTING - Given a human “patient” and a description of the "patient's" injuries, the candidate shall, within

the allotted station time, apply splinting techniques according to the principles of fracture immobilization. TESTING CONDITIONS 1. Examiner shall insure that station is conducted as a testing station and NOT as a teaching session. 2. The station shall test only the skill of Bandaging and Splinting and shall NOT be conducted as a part of any

other skill or scenario. 3. Candidates shall be tested in private and no more than two candidates at a time. If two candidates are to be

tested, starting times for each shall be staggered. 4. Bandaging and Splinting may be tested at the same station. 5. A non-candidate or a previously tested candidate MUST be used as the "patient." The Examiner shall NOT be

used as the "patient." 6. The patient shall NOT "cue" the candidate being examined but may assist to the extent that an actual patient

would be able. The patient shall be cooperative. 7. The determination of whether to remove the patient's shoe and sock before beginning exam in situations

involving the foot shall be based on policies established by the training program's medical director, consulting physician, or Course Coordinator.

8. Examiner shall require candidate to take or verbalize body substance isolation precautions before station time

begins. STATION EQUIPMENT 1. Body substance isolation supplies (minimum of disposable gloves) 2. A human “patient” 3. Clean 4x4 dressings 4. Self-adhering roller bandages 5. A pillow or blanket 6. Board splints, 2 each - 15", 36", and 54" (wire ladder or cardboard splints are optional) 7. Cravats 8. Tape 9. Paper cups (optional) 10. Watch or clock with reading in seconds


2

INSTRUCTIONS TO THE EXAMINER 1. The Course Coordinator, lead Instructor and Examiner are responsible for insuring the presence of all necessary

equipment and also for insuring that all equipment is in working order prior to beginning the test session. 2. Examiner will NOT remove or hide equipment required to complete the skill. 3. Before the test session begins, the candidate shall be allowed to familiarize with the equipment. During this

time the Examiner shall answer any questions the candidate has about the equipment. 4. Scenarios must NOT be used except as indicated by the criteria. 5. Examiner shall prompt candidates ONLY as indicated by criteria. 6. The primary objectives in performing this skill are control of hemorrhage, use of aseptic wound management

techniques, and adequate immobilization of fractures and dislocations. Although there are many suggested methods of bandaging and splinting, only effectiveness in meeting the performance objectives without aggravating the injury shall be graded.

7. While the candidate shall be tested on bandaging and splinting at the same station, determining which skill

should be performed first shall NOT be tested. 8. Combinations of injuries used for testing bandaging and splinting will come ONLY from the attached list. 9. Injuries MUST be assigned randomly. This shall be done by having candidates draw a number corresponding

to the number of one of the injuries from the injury list. Splinting injury shall be drawn first. If injury designated “S/B" is drawn it shall serve as both bandaging & splinting. Both grading sheets shall be completed.

10. A candidate drawing an injury that serves as both bandaging and splinting shall be allowed 20 minutes to

complete the skill. 11. "Patients" will be positioned by Examiner - i.e., Examiner shall NOT say, "You have a Colles' fracture," and

expect the “patient” to assume the correct position. 12. Injury sites shall be marked with tape or by some other means to avoid confusion over locations of injuries.

Use of moulage is acceptable. 13. Use of tape to secure bandages and splints is acceptable. 14. On request, Examiner will restate the location and nature of an injury for the candidate. 15. When candidate checks, Examiner will state that “circulation, motor and sensory function are present and

normal.” 16. Station time shall begin immediately after Examiner finishes examination instructions and informs candidate to

begin. 17. Examiner shall record starting and ending times in the appropriate section of the score sheet. 19. Once a test session has begun, it must be completed within the allotted time with NO restarts allowed. 19. Station time shall NOT be restarted or extended for any reason. 20. If station time limit is exceeded, Examiner shall end the test, record skill as failure.


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20. Sequence errors shall NOT be penalized unless specified by the grading criteria. 21. Documentation by narrative is required on all steps awarded a "0" and on all skills failures. 22. Candidate shall NOT fail because of Examiner error.

BLEEDING CONTROL/BANDAGING INJURY LIST *B1. Avulsed eye *B2. Amputated hand (fist to be used as stump) B3. Burned extremity (Examiner to specify location and position) B4. Impaled object (extremity) *B5. Lacerated cheek *B6. Lacerated eyeball B7. Lacerated joint (Examiner to specify) *B8. Lacerated neck (Examiner to specify location) *B9. Lacerated scalp (cranium depressed) *B10. Lacerated scalp (no fracture) B11. Lacerated arm (extremity) B12. Lacerated leg (extremity) * = These injuries do NOT require check of distal circulation, motor function, and sensation. Award 2 points for

step 1 and step 9.

SPLINTING INJURY LIST (closed unless specified below)

S1. Dislocated shoulder (adducted) S2. Fractured knee (Examiner to specify position) S3. Fractured ankle S4. Fractured clavicle S5. Fractured elbow (Examiner to specify position) S6. Fractured hand (Examiner to specify position) S7. Fractured humerus S8. Fractured wrist (angulated, Examiner to specify position) S9. Fractured radius/ulna (open) S10. Fractured tib/fib (open)


4

BANDAGING GRADING CRITERIA *1. Takes or verbalizes body substance isolation precautions a. Determines appropriate BSI equipment needed b. Gloves are minimum BSI 2=Performs above criteria 0= Does not take appropriate BSI precautions *2. Checks circulation (pulse or capillary refill), motor function and sensation distal to injury before

bandaging

2 = Performs above criteria Criteria not applicable to situation

0 = Does not perform above criteria Monitors at inappropriate location

NOTE: This step does not apply to injuries marked with an "*" on the injury list.

3. Covers injury completely with clean dressing(s) demonstrating aseptic technique

2 = Performs above criteria 0 = Does not cover injury site completely

Contaminates dressing Does not use dressing

*4. Secures dressing using appropriate pressure with no excessive movement

a. Applies pressures sufficient to control hemorrhage without compromising circulation unless pressure is contraindicated

b. Uses adequate bulk to control hemorrhage, if pressure is contraindicated c. Secures dressing and bandage so they remain in place d. Covers dressing completely with bandage e. Avoids excessive movement

2 = Performs above criteria 1 = Does not cover dressing with bandage 0 = Does not apply adequate pressure or bulk to control hemorrhage

Compromises distal circulation with excessive pressure Applies pressure when contraindicated Causes excessive movement

*5. Uses bandaging technique appropriate to injury

a. Uses technique to control hemorrhage, if applicable b. Uses technique which does not further aggravate injury

2 = Performs above criteria 1 = Commits errors which are NOT likely to result in significant deterioration of patient’s condition and/or

injury 0 = Commits errors which are likely to result in significant deterioration of patient’s condition and/or injury

through hemorrhage, contamination, or technique which aggravates wound


5

*6. Checks circulation (pulse or capillary refill), motor function and sensation distal to injury after bandaging


Criteria not applicable to situation 0 = Does not perform above criteria

Monitors at inappropriate location

NOTE: This step does not apply to injuries marked with an "*" on the injury list. The examiner must now inform candidate that the wound continues to bleed (on extremity sites only) *7. Student shall verbalize the correct placement of a tourniquet if wound is on extremity 2 = Performs above criteria Criteria not applicable to situation (wound other than on extremity) 1 = Does not perform above criteria Verbalizes improper location or technique of tourniquet

SPLINTING GRADING CRITERIA *1. Takes or verbalizes body substance isolation precautions a. Determines appropriate BSI equipment needed b. Gloves are minimum BSI 2=Performs above criteria 0= Does not take appropriate BSI precautions *2. Checks circulation (pulse or capillary refill), motor function and sensation distal to injury before

splinting



*3. Immobilizes injury

a. Applies splinting techniques which immobilize injury site b. Applies splinting techniques immobilizing bones or joints above and below injury site c. Does not further aggravate injury by technique

2 = Performs above criteria 1 = Commits errors which are not likely to result in significant deterioration of patient's condition and/or

injury 0 = Commits errors which are likely to result in significant deterioration of patient's condition/injury through

hemorrhage, contamination, or technique which aggravates wound or fails to adequately immobilize fracture

*4. Checks circulation (pulse or capillary refill), motor function and sensation distal to injury after splinting




1

TRACTION SPLINTING

TIME ALLOWED FOR SKILLS PERFORMANCE - 10 MINUTES

PERFORMANCE OBJECTIVE

Given a traction splint and a human “patient”, the team shall, within the allotted station time, apply the traction

splint to immobilize a closed femur fracture in 10 minutes or less.

TESTING CONDITIONS

1. Examiner shall insure that station is conducted as a testing session and NOT as a teaching session.

2. The station shall test only the skill of Traction Splinting and shall NOT be conducted as a part of any other skill

or scenario.

3. Each team shall be tested in private and one team at a time.

4. A non-candidate or a previously tested candidate MUST be used as the "patient." Examiner shall NOT be used

as the "patient."

5. The patient shall NOT "cue" the candidates being examined but may assist to the extent that an actual patient

would be able. The patient shall be cooperative.

6. Each team shall be instructed that they are being tested as individuals but that cooperation and communication

with their partners are part of their individual scores.

7. Candidates MUST be tested on one of the types of splints listed in the “Station Equipment” section.

8. The patient's shoe and sock MUST be removed before beginning the exam.

9. All fractures shall be mid-shaft with the leg straight. Coordinators should insure that candidates are trained in

local procedures for management of situations where the fracture is angulated, the leg is bent at an odd angle, or

the fracture is not at mid-shaft.


begins.

STATION EQUIPMENT

1. A human “patient”

2. Half Ring Splint (with necessary accessories)

Ratchet-action adjustable splint (with necessary accessories)

3. Watch or clock with reading in seconds


2

INSTRUCTIONS TO THE EXAMINER

1. The Course Coordinator, lead Instructor and Examiner are responsible for insuring the presence of all necessary

equipment and also for insuring that all equipment is in working order prior to beginning the test session.

2. Examiner will NOT remove or hide equipment required to complete the skill.

3. Before the test session begins, the candidate shall be allowed to familiarize with the equipment. During this

time Examiner shall answer any questions the candidate has about the equipment.

4. Scenarios must NOT be used except as indicated by the criteria.

5. Examiner shall prompt candidate ONLY as indicated by the criteria.

6. Examiner shall RANDOMLY assign each candidate his role in the team. This shall be done by having one of

the candidates draw a position.

7. Station time shall begin immediately after Examiner finishes examination instructions and informs candidates

to begin.

8. Examiner shall record starting and ending times in the appropriate section of score sheet.

9. Once a test session has begun, it must be completed within the allotted time with NO restarts allowed.

10. Station time shall NOT be restarted or extended for any reason.

11. If station time limit is exceeded, Examiner shall end the test, record skill as failure.

12. Sequence errors shall NOT be penalized unless specified by the grading criteria.

13. Documentation by narrative is required on all steps awarded a "0" and on all skills failures.

14. Candidate shall NOT fail because of Examiner error.


3

TRACTION SPLINTING GRADING CRITERIA CANDIDATE PULLING TRACTION

CANDIDATE APPLYING SPLINT

*1. Takes BSI Precautions

a. Determines proper BSI equipment needed

b. Gloves are minimum BSI


0 = Does not take appropriate BSI precautions

*2. Checks circulation, motor function, and

sensation distal to injury before applying ankle

hitch


1 = Checks after ankle hitch applied

0 = Does not check circulation, motor function, or

sensation before pulling traction

*3. Applies ankle hitch

a. Applies so that pull is in line with long axis of

leg

b. Uses minimal manipulation


0 = Does not perform above criteria

(Candidate Pulling Traction continued on next page)

*1. Takes BSI Precautions

a. Determines proper BSI equipment needed

b. Gloves are minimum BSI


0 = Does not take appropriate BSI precautions

2. Prepares equipment

a. Adjusts and secures splint to insure adequate

length

b. Adjusts cravats or velcro straps

c. Places equipment within reach

d. Releases ratchet, if applicable

e. Opens ischial strap


1 = Cravats or straps not adjusted

Equipment not within reach

0 = Ischial strap closed

Splint measured or adjusted to an inappropriate

length

*3. Stabilizes fracture while ankle hitch applied

a. Minimizes movement of leg during application

of ankle hitch

b. Does not apply pressure over fracture site

sufficient to cause further injury


0 = Does not attempt stabilization

Allows movement of leg or applies pressure

over fracture site sufficient to cause

further injury

(Candidate Applying Splint continued on next page)


4

CANDIDATE PULLING TRACTION (Cont’d.)

CANDIDATE APPLYING SPLINT (Cont’d.)

*4. Applies and maintains traction, elevation and

gentleness

a. Uses smooth action when pulling straight line

traction

b. Provides sufficient elevation to ease splint

application

c. Maintains traction until mechanical device

provides equal or greater force and is secured

d. Supports leg until cravats or straps are in place

e. Ensures that splint remains elevated after

device provides traction and support


1 =Changes elevation frequently

0 = Releases traction before mechanical device

tightened and secured

Does not support leg after traction taken by

mechanical device

Foot is excessively rotated or extended after

splinting

Achieves traction insufficient to immobilize

injury and/or support femur

Allows movement likely to cause further injury

Does not ensure elevation of splint

(Candidate Pulling Traction continued on next page)

*4. Positions splint

a. Places ischial pad under ischium without

excessive patient movement

b. Places pad firmly against ischial tuberosity

c. Aligns splint with leg


0 = Places ischial pad improperly

Allows excessive movement likely to cause

further injury

Does not align splint with leg

5. Fastens ischial strap

a. Fastens before ankle hitch connected to frame

b. Fastens tight enough to secure splint without

impairing circulation

c. Does not entrap genitalia


1 = Fastens strap to loosely to secure splint

Secures after ankle hitch connected to frame

0 = Does not fasten strap

Entraps genitalia

Fastens strap too tightly compromising

circulation

6. Connects hitch to frame

a. Connects hitch to frame

b. Makes connection before cravats or velcro

straps secured


1 = Connects hitch before ischial strap is secured

0 = Connects hitch after cravats or velcro straps

secured

*7. Tightens mechanical device to achieve traction

and immobilize injury

a. Tightens mechanical device to achieve traction

and prevent movement

b. Secures windlass across frame (if applicable)


0 = Applies insufficient traction

Does not secure windlass (if applicable)


5

CANDIDATE PULLING TRACTION (Cont’d.)

CANDIDATE APPLYING SPLINT (Cont’d.)

*5. Monitors circulation, motor function, and

sensation distal to injury after procedure is

completed


0 =Does not perform above criteria

5. Communicates with partner & patient

a. Informs partner and patient of his actions

b. Attempts to correct errors made by partner


1 = Communicates minimally with partner or

patient with no serious errors resulting

0 = Does not communicate with partner or patient

Serious errors resulting from minimal

communication

*8. Secure cravats or velcro straps without

aggravating injury

a. Ties cravats and applies velcro so that leg is

supported and secured

b. Uses technique that does not further aggravate

injury

c. Pads any knots that may impede circulation


1 = Omits “b” or “c”

0 = Leg is not supported and/or secured

Uses technique likely to further aggravate

injury

NOTE: Placing velcro straps over the fracture site

does NOT constitute excessive pressure.

9. Verbalizes securing torso and splint to

longboard to immobilize hip and prevent

movement of splint


0 = Does not perform above criteria

10. Communicates with partner & patient

a. Informs partner and patient of his actions

b. Attempts to correct errors made by partner


1 = Communicates minimally with partner or

patient with no serious errors resulting

0 = Does not communicate with partner or patient

Serious errors resulting from minimal

communication


1

SPINAL IMMOBILIZATION

TIME ALLOWED FOR SKILL PERFORMANCE - 10 MINUTES PER COMPONENT

PERFORMANCE OBJECTIVE

Given a human “patient” with a potential spinal injury, the candidate shall, within the allotted station time, use the

proper technique to immobilize the spine using short and long spinal immobilization devices.

TESTING CONDITIONS

1. The Examiner shall insure that the session is conducted as an testing station and NOT as a teaching session.

2. The station shall test only the skill of Spinal Immobilization and shall NOT be conducted as a part of any other

skill or scenario.

3. Candidates shall be tested in private and one candidate at a time.

4. A non-candidate or a previously tested candidate MUST be used as the "patient." The Examiner shall NOT be

used as the "patient."

5. The patient or the partner shall NOT "cue" the candidate. The patient shall be cooperative.

6. In “Spinal Immobilization of Seated Patient” the patient will be conscious, sitting with head flexed slightly

forward and complaining only of neck and/or back pain.

7. In “Spinal Immobilization of Supine Patient” the patient will be lying supine on floor and complaining only of

neck and/or back pain.

8. The candidate shall be assisted by a partner who is a non-candidate or a previously tested candidate. The

candidate shall communicate clearly with the patient and the partner. The Examiner shall NOT be used as the

partner.

9. A third person may be used during the transfer to the long immobilization device. The Examiner may be this

third person but the use of a non-involved "bystander" is encouraged.


begins.

STATION EQUIPMENT

1. A human “patient”

2. Extrication collars

3. A vest-type short spinal immobilization device or a short board with straps

4. A long spinal immobilization device with straps

5. All necessary accessories for devices

6. Tape (for use only in immobilizing the head)

7. Watch or clock with reading in seconds


2

INSTRUCTIONS TO THE EXAMINER

1. The Course Coordinator, lead Instructor and Examiner are responsible for insuring the presence of all necessary

equipment; and also for insuring that all equipment is in working order prior to beginning the test session.

2. The Examiner will NOT remove or hide equipment required to complete the skill.

3. Before the test session begins, the candidate shall be allowed to familiarize with the equipment and may attach

straps or other immobilization devices. During this time the Examiner shall answer any questions the candidate

has about the equipment.

4. The Examiner shall prompt candidates ONLY as indicated by criteria.

5. Scenario must NOT be used in the test session.


7. Station time shall NOT be restarted or extended for any reason.

8. Station time shall begin immediately after Examiner finishes examination instructions and informs candidate to

begin.

9. The Examiner shall record starting and ending times in the appropriate section of score sheet.

10. If time limit is exceeded, Examiner shall end the test, record skill as failure.


12. Additional steps not called for in criteria shall NOT be penalized as sequence errors.

13. Omitted steps shall NOT be penalized as sequence errors.


15. Candidate shall NOT fail because of Examiner or assistant error.


3

SPINAL IMMOBILIZATION OF SEATED PATIENT GRADING CRITERIA

*1. Takes or verbalizes body substance isolation precautions a. Determines appropriate BSI equipment needed b. Gloves are minimum BSI 2=Performs above criteria 0= Does not take appropriate BSI precautions

*2. Directs partner to establish and maintain neutral spinal alignment

2 = Performs step

0 = Omits step

*3. Checks circulation, motor function, and sensation in all four extremities


0 = Does not perform criteria

*4. Applies extrication collar

a. Explains procedure to patient

b. Applies proper size extrication collar

c. Secures extrication collar to maintain cervical spine immobilization


1 = Omits "a"

0 = Does not provide adequate cervical spine immobilization due to improper application and/or size selection

*5. Positions short device

a. Positions device properly on patient

b. Adjusts device without interfering with neutral cervical spine alignment


1 = Requires more than 1 attempt to position device

0 = Omits step

Applies device improperly

Interferes with neutral cervical spine alignment

*6. Secure short device to patient's torso

2 = Performs above step

0 = Omits step

*7. Secures short device to patient's head to assure neutral cervical spine alignment


0 = Does not meet criteria


4




9. Performs steps 1-7 in sequence


0 = Performs steps 1-7 in improper sequence

*10. Does not compromise airway or impede respirations

2 = Performs as above

0 = Compromises airway or impedes respirations

11. Communicates

a. Communicates with patient

b. Communicates with partner


1 = Omits "a"

0 = Omits "b"

SPINAL IMMOBILIZATION OF SUPINE PATIENT GRADING CRITERIA

*1. Takes or verbalizes body substance isolation precautions a. Determines appropriate BSI equipment needed b. Gloves are minimum BSI 2=Performs above criteria 0= Does not take appropriate BSI precautions

*2. Directs partner to establish and maintain neutral spinal alignment

2 = Performs step

0 = Omits step





5

*4. Applies extrication collar

a. Explains procedure to patient

b. Applies proper size extrication collar

c. Secures extrication collar to maintain cervical spine immobilization


1 = Omits "a"

0 = Does not provide adequate cervical spine immobilization due to improper application and/or size selection

*5. Moves patient onto device without compromising integrity of spine


1 = Patient repositioned but done without compromising integrity of spine

0 = Patient manipulated or moved excessively, causing potential spinal compromise

*6. Secures patient to long device

2 = Patient secured so that there is no excessive up, down or lateral movement

0 = Patient moves up, down or laterally so as to cause potential spinal compromise




8. Performs steps 1-7 in sequence


0 = Performs steps 1-7 in improper sequence

*9. Does not compromise airway or impede respirations

2 = Performs as above

0 = Compromises airway or impedes respirations

10. Communicates

a. Communicates with patient

b. Communicates with partner


1 = Omits "a"

0 = Omits "b"


1

PNEUMATIC ANTI-SHOCK GARMENT (P.A.S.G.) TIME ALLOWED FOR SKILLS PERFORMANCE - 5 MINUTES PERFORMANCE OBJECTIVE Given a full-body manikin or a human “patient” the candidate shall, within the allotted time, demonstrate the proper application of the P.A.S.G. using the criteria herein prescribed. TESTING CONDITIONS 1. The Examiner shall insure that station is conducted as a testing station and NOT as a teaching session. 2. The station shall test only the skill of Pneumatic Anti-Shock Garment and shall NOT be conducted as a part of

any other skill or scenario. 3. Candidates shall be tested in private and one candidate at a time. 4. A non-candidate, a previously tested candidate, or a full-body manikin MUST be used as the "patient." The

Examiner shall NOT be used as the "patient." 5. The "patient" shall NOT "cue" the candidate being tested but may assist to the extent that an actual patient

would be able. The patient shall be cooperative. 6. The candidate shall be assisted by a partner who shall perform as an EMT. The partner shall be a non-candidate

or a previously tested candidate. The Examiner shall NOT be used as the partner. 7. Examiner shall require candidate to take or verbalize body substance isolation precautions before station time

begins. STATION EQUIPMENT 1. Adult Pneumatic Anti-Shock Garment (P.A.S.G.) 2. A full-body manikin or a human “patient” 3. Watch or clock with reading in seconds INSTRUCTIONS TO THE EXAMINER 1. The Course Coordinator, lead Instructor and Examiner are responsible for insuring the presence of all necessary

equipment and also for insuring that all equipment is in working order prior to beginning the test session. 2. The Examiner will NOT remove or hide equipment required to complete the skill. 3. Before the skills examination begins the candidate should be allowed to check packaging of the P.A.S.G. The

P.A.S.G. shall be in its carrying case when the skills examination begins. 4. Care should be taken to remove all sharp objects from the patient before the examination begins. 5. The Examiner shall instruct the candidate to remove the "patient's" clothing if the "patient" is wearing a bathing

suit underneath clothing. If "patient" is not wearing bathing suit the Examiner shall instruct the candidate to verbalize clothing removal at the proper time. The Examiner shall also state that there is NO spinal injury.

6. Scenarios must NOT be used except as indicated by the criteria.


2

7. The Examiner shall prompt candidate ONLY as indicated by the criteria. 8. The Examiner will provide information regarding the patient's history ONLY as indicated in the criteria. 9. Once a test session has begun, it must be completed within the allotted time with NO restarts allowed. 10. Station time shall NOT be restarted or extended for any reason. 11 Station time shall begin immediately after Examiner finishes examination instructions and informs candidate

to begin. 12. The Examiner shall record starting and ending times in the appropriate section of the score sheet. 13. If station time limit is exceeded, Examiner shall end the test, record skill as failure. 14. Sequence errors shall NOT be penalized unless specified by the grading criteria. 15. Documentation by narrative is required on all steps awarded a "0" and on all skills failures. 16. Candidate shall NOT fail because of Examiner or assistant error.


3

PNEUMATIC ANTI-SHOCK GARMENT (P.A.S.G.) GRADING CRITERIA Examiner states: "The patient meets all criteria for the application of the P.A.S.G." *1. Takes or verbalizes body substance isolation precautions a. Determines appropriate BSI equipment needed b. Gloves are minimum BSI 2=Performs above criteria 0= Does not take appropriate BSI precautions 2. Prepares patient for application of the P.A.S.G. (Removes clothing or states "Clothing has been

removed," as appropriate)


*3. Positions and aligns garment

2 = Positions garment so top of abdominal section is immediately below lowest lateral rib 1 = Positions garment so top of abdominal section is no lower than the top of the iliac crest 0 = Positions garment so abdominal section is above lowest lateral rib or below the top of the iliac crest.

Applies garment inside out. *4. Secures leg sections

2 = Completes snug application of leg sections 1 = Applies leg sections loosely 0 = Omits step

*5. Secures abdominal section

2 = Completes snug application of abdominal section 1 = Applies abdominal section loosely 0 = Omits step

*6. Inflates garment (Three (3) compartments all at one time or leg sections then abdominal section)

NOTE: DO NOT ALLOW INFLATION. After candidate begins inflation of P.A.S.G. Examiner shall stop candidate then state "The garment is inflated," or "The leg section is inflated," whichever is appropriate.

2 = Begins inflation in proper order 0 = Fails to begin inflation

Inflates abdominal section prior to leg sections *7. Sets valves to prevent loss of air from garment



1

CARDIAC ARREST MANAGEMENT/AED TIME ALLOWED FOR SKILL PERFORMANCE - 5 MINUTES PERFORMANCE OBJECTIVE Given the proper equipment and being informed by the Examiner that two-rescuer CPR is in progress, the candidate shall, within the allotted station time, demonstrate proper cardiac arrest management with an AED or AED trainer, using the criteria herein prescribed. TESTING CONDITIONS 1. Examiner shall insure that the session is conducted as a testing station and NOT as a teaching session. 2. The station shall test only the skill of cardiac arrest management with an AED and shall NOT be conducted as a

part of any other skill. 3. Candidates shall be tested in private and one candidate at a time. 4. Examiner shall require candidate to take or verbalize body substance isolation precautions before station time

begins. STATION EQUIPMENT: 1. All equipment, components and supplies necessary to conduct this station using the specific type of AED or

AED training equipment that is being utilized. 2. A BVM or pocket mask 3. A watch or clock with readings in seconds INSTRUCTIONS TO THE EXAMINER 1. The Course Coordinator, lead Instructor and Examiner are responsible for insuring the presence of all necessary

equipment; and also for insuring that all equipment is in working order prior to beginning the test session. 2. Examiner will NOT remove or hide equipment required to complete the skill. 3. Before the test session begins, the candidate shall be allowed to familiarize with the equipment. During this

time Examiner shall answer any questions the candidate has about the equipment. 4. Scenarios must NOT be used except as indicated by the criteria. 5. Examiner shall prompt candidate ONLY as indicated by the criteria. 6. Examiner will provide information regarding the patient’s history ONLY as indicated in the criteria. 7. Once a test session has begun, it must be completed within the allotted time with NO restarts allowed. 8. Station time shall NOT be restarted or extended for any reason. 9. Station time shall begin immediately after Examiner finishes examination instructions and informs candidate to

begin. 10. Examiner shall record starting and ending times in the appropriate section of the score sheet. 11. If station time limit is exceeded, Examiner shall end the test, record skill as failure.


2

12. Sequence errors shall NOT be penalized unless specified by the grading criteria. 13. Documentation by narrative is required on all steps awarded a "0" and on all skills failures. 14. Candidate shall NOT fail because of Examiner error.


3

CARDIAC ARREST MANAGEMENT/AED GRADING CRITERIA [STATION TIME 5 MINUTES] Examiner will prepare equipment as appropriate for the specific type of AED or AED training equipment that is being utilized. If an arrhythmia generator is used, Examiner will set it to generate ventricular fibrillation. Examiner will state: “You respond alone as a First Responder with No AED. You arrive to find a patient lying supine on the living room floor. There are no signs of movement by the patient.” *1. Takes or verbalizes body substance isolation precautions a. Determines appropriate BSI equipment needed b. Gloves are minimum BSI 2=Performs at or above criteria 0= Does not take appropriate BSI precautions *2. Assures scene safety

a. Inquires and assures that the scene is safe for EMS personnel

2 = Performs above criteria 0 = Omits step

3. Attempts to question any bystanders about arrest events

Candidate should check for bystanders and inquire about traumatic injuries, history, length of arrest, etc. 2=Performs at or above criteria 1=Inquires about partial criteria 0=Omits step 4. Checks patient responsiveness

2 = Attempts to awake patient (shake and shout) 0 = Does not perform above criteria

*5. Checks pulse and breathing simultaneously

2 = Checks carotid pulse no less than 5 seconds or more than 10 seconds 0 = Checks pulse other than carotid, or pulse checked for less than 5 seconds or more than 10 Seconds 0 = Candidate performs “look, listen, and feel” that delays the initiation of CPR by more than 5 seconds

NOTE: After candidate checks pulse Examiner shall state: “No pulse.” *6. Begins immediate chest compressions (No breaths given prior to compressions)

2 = Performs above criteria 0 = Does not perform above criteria (gives breaths prior to compressions or delays compressions)

7. Request additional EMS response



4

*8. Performs 2 minutes of high quality CPR (as described in steps 9-13)

2 = Performs step as described in steps 9-13 0 = Omits step

*9. Adequate depth and rate

Depth of at least 2” Rate of at least 100 per minute 2 = Performed all compressions and rates appropriately 1 = 2 or less improper compressions per cycle (rate or depth) 0 = More than 2 improper compressions per cycle (rate or depth)

*10. Correct compressions to ventilation ratio Ratio of 30 compressions and 2 ventilations 2 = Performed all cycles with appropriate compression to ventilation ratio 1 = 1 mistake, per 2 minutes, of compression to ventilation ratio of 28-32 compressions to 2 ventilations 0 = More than 1 mistake of compression to ventilation ratio of 28-32 compressions to 2 ventilations 0 = Gave less than 2 ventilations or less than 28 compressions or more that 32 compressions per any cycle *11. Allows chest to recoil completely 2 = Allowed chest to recoil completely for each compression without hands losing contact with chest 1 = 2 or less improper mistakes per cycle 0 = More than 2 mistakes per cycle *12. Adequate volume for each breath Volume adequate for each breath to cause visible chest rise 2 = Performed each breath per criteria 1 = 2 or less improper breaths per 2 minute cycle 0 = More than 2 improper breaths per 2 minute cycle *13. Minimal interruptions of less than 10 seconds throughout

Interruptions should NOT exceed more than 10 seconds throughout exam except for analyzing and defibrillations. However, there should not be a delay once the “shock” button is activated. Compressions may be resumed while AED is charging. 2 = No interruptions of more than 10 seconds 0 = Interrupted compressions at any time for more than 10 seconds (except as described above)

Note: During 5th cycle, the examiner is to “arrive” with the AED and assist candidate as directed by the candidate. 14. Assess patient for return of spontaneous pulse After 5th cycle (and 2 breaths) candidate is to assess for the return of a carotid pulse 2 = Checked for presence of carotid pulse (no more than 10 seconds) 0 = Failure to check for the presence of a carotid pulse or checked for more than 10 seconds


5

15. Directs second rescuer to resume CPR while candidate applies AED Directs examiner to resume one rescuer CPR 2 = Directs assistant to resume CPR immediately (no delay) 0 = Does not direct immediate resumption of CPR 16. Turns on power to AED


*17. Follows prompts and properly places pads on patient

Places pads in accordance to diagram on pads

2 = Performs above criteria 0 = Places pads other than as directed on pads packaging

*18. Directs rescuer to stop CPR and to “CLEAR”


*19. Initiates analysis of rhythm if not automatically performed by AED

2 = Performs step (or AED automatically performs step) 0 = Omits step

*20. Confirms that personnel are clear a. Instructs personnel to “CLEAR” b. Confirms that no one is in contact with the patient, bed, or conductive equipment attached to the patient

NOTE: Examiner shall state: “I am clear.”


*21. Delivers shock(s) - Follows verbal prompts of AED


*22. Directs rescuer to immediately resume chest compressions (No pulse check)


Note: Examiner is to end skill station upon resumption of CPR


1

EPINEPHRINE AUTO-INJECTOR TIME ALLOWED FOR SKILL PERFORMANCE - 5 MINUTES PERFORMANCE OBJECTIVE Given an epinephrine auto-injector trainer, an injection pad and appropriate equipment and supplies, the candidate shall, within the allotted station time, be able to recognize and select the medication ordered, properly utilize the auto-injector and administer the drug using the criteria herein prescribed. If epinephrine auto-injector trainer is needle-less, candidate may simulate administration on himself. TESTING CONDITIONS 1. Examiner shall insure that the session is conducted as a testing station and NOT as a teaching session. 2. The station shall test only the skill of Epinephrine Auto-injector and shall NOT be conducted as a part of any

other skill or scenario. 3. Candidates shall be tested in private and one candidate at a time. 4. Examiner shall require candidate to take or verbalize body substance isolation precautions before station time

begins. STATION EQUIPMENT: 1. Epinephrine auto-injector trainer 2. Injection pad or other device capable of being injected, if needed 3. Alcohol/betadine preps 4. Sharps container 5. A watch or clock with readings in seconds INSTRUCTIONS TO THE EXAMINER 1. The Course Coordinator, lead Instructor and Examiner are responsible for insuring the presence of all necessary

equipment; and also for insuring that all equipment is in working order prior to beginning the test session. 2. Examiner will NOT remove or hide equipment required to complete the skill.

3. Before the test session begins, the candidate shall be allowed to familiarize with the equipment. During this

time Examiner shall answer any questions the candidate has about the equipment. 4. Scenarios must NOT be used except as indicated by the criteria.

5. Examiner shall prompt candidate ONLY as indicated by the criteria.

6. Examiner, acting as medical control, shall specify the drug name (as labeled), adult dose and the route of

administration ordered. Instruct the candidate to select that drug and administer it. This station is a test of psychomotor skills, not a test of the candidate’s knowledge of specific drugs.

7. The use of betadine may be verbalized to protect the training model.

8. When questioned about allergies, Examiner shall state: “There are no allergies.”



2

10. Station time shall NOT be restarted or extended for any reason. 11. Station time shall begin immediately after Examiner finishes examination instructions and informs

candidates to begin. 12. Examiner shall record starting and ending times in the appropriate section of score sheet.

13. If station time limit is exceeded, Examiner shall end the test, record skill as failure.


15. Additional steps not called for in criteria shall NOT be penalized as sequence errors

16. Omitted steps shall NOT be penalized as sequence errors.


18. Candidate shall NOT fail because of Examiner error.

EPINEPHRINE AUTO-INJECTOR GRADING CRITERIA [STATION TIME 5 MINUTES] Examiner states: “The patient meets all criteria for administration of epinephrine. Medical Control has authorized the administration of an adult dose of epinephrine via auto-injector.” *1. Takes or verbalizes body substance isolation precautions a. Determines appropriate BSI equipment needed b. Gloves are minimum BSI 2=Performs above criteria 0= Does not take appropriate BSI precautions *2. Avoids contamination of equipment or replaces contaminated equipment prior to use.




*4. Informs patient of order for medication and inquires about allergies

2 = Performs step 1 = Inquires about allergies but does not inform patient of order 0 = Does not inquire about allergies




3



*7. Selects appropriate site and identifies it by pointing to (touching) the site on self

2 = Performs step 0 = Omits step or points out an inappropriate site



9. Prepares the injection site

a. Cleanses the injection site with betadine or alcohol prep b. Cleanses in a circular motion from the injection site outward

2 = Performs above criteria 1 = Cleanses skin in a manner other than that stated above 0 = Does not clean the injection site



*11. Removes safety cap from the injector




*13. Places the tip of auto-injector against the injection site and pushes the injector firmly

against the injection site


*14. Holds auto-injector against the site for 10 seconds

2 = Holds auto-injector against site for at least 10 seconds 0 = Holds auto-injector against site for less than 10 seconds

15. Removes auto-injector and applies pressure



4

*16. Disposes of contaminated equipment



EPINEPHRINE AUTO INJECTOR Candidate’s Name: Date: EMT EMTI EMTP School #: Initial Renewal Equivalency Retest Station Time 5 Minutes Start Time:

End Time:

0 2 *1. Takes or verbalizes proper BSI precautions 0 2 *2. Avoids contamination of equipment or replaces contaminated equipment prior to use. 0 2 *3. Confirms order (medication, dosage and route) 0 1 2 *4. Informs patient of order for medication and inquires about allergies 0 2 *5. Selects correct medication from drug box as requested by Examiner 0 2 *6. Verbalizes check of medication for contamination and expiration date 0 2 *7. Selects appropriate site and identifies it by pointing to (touching) the site on self 0 2 8. Verbalizes recheck of the medication label 0 1 2 9. Prepares the injection site 0 2 10. Verbalizes recheck of the medication label 0 2 *11. Removes safety cap from the injector 0 2 *12. Performs steps 1-10 prior to step 12 and performs at least one (1) recheck of the

medication label 0 2 *13. Places the tip of auto-injector against the injection site and pushes the injector firmly

against the injection site 0 1 2 *14. Holds auto-injector against the site for 10 seconds 0 2 15. Removes auto-injector and applies pressure 0 2 *16. Disposes of contaminated equipment Candidate’s Total Points (minimum passing total: 23 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)

Pass Fail



Olton EMS Training Program

Student Instructor Evaluation Form

2018 EMS Instructor Course

Date: __________________________ Mini Lecture # ______________________

Student Instructor: _______________________ Topic: _____________________________

On a scale of 1 to 5, evaluate the instructor.

1-unacceptable

2-poor

3-fair

4-good

5-excellent Unacceptable Excellent

1. The student instructor clearly identified 1 2 3 4 5

the learning objectives for the topic.

2. The student instructor was knowledgeable 1 2 3 4 5

of and prepared for the topic covered.

3. The student instructor presented the topic 1 2 3 4 5

in a manner that was easy to understand.

4. The student instructor answered questions 1 2 3 4 5

appropriately and completely.

5. The student instructor used the allocated 1 2 3 4 5

time effectively.

6. Student instructor demeanor 1 2 3 4 5

7. The instructor demonstrated skills in an 1 2 3 4 5 N/A

orderly, easy to follow manner that was

consistent with testing sheets/criteria

8. Proper use of audio/visual equipment 1 2 3 4 5

9. Student instructor remained focused and 1 2 3 4 5

on topic

10. Overall rating of this student instructor 1 2 3 4 5

11. What could this student instructor do to better serve the needs of the student?

(If necessary, use the back of this page)

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

_____________________________________

Course Instructor Signature


Student Evaluation of Instructor

2018 EMS Instructor Course

Date: ________________ Course #: 613868 (2018 Lubbock Instructor Class)

Instructor: ____Rusty Powers______ Topic: ______OVERALL____________

On a scale of 1 to 5, evaluate the instructor.

1-unacceptable

2-poor

3-fair

4-good

5-excellent Unacceptable Excellent

1. The instructor clearly identified 1 2 3 4 5

the learning objectives for the topic.

2. The instructor was knowledgeable 1 2 3 4 5

of and prepared for the topic covered.

3. The instructor presented the topic 1 2 3 4 5

in a manner that was easy to understand.

4. The instructor answered questions 1 2 3 4 5

appropriately and completely.

5. The instructor used the allocated 1 2 3 4 5

time effectively.

6. Instructor demeanor 1 2 3 4 5

7. Proper use of audio/visual equipment 1 2 3 4 5

8. Instructor remained focused and 1 2 3 4 5

on topic

9. Overall rating of this instructor 1 2 3 4 5

10. What could this instructor do to better serve the needs of the student?

(If necessary, use the back of this page)

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

11. What did you like about this instructor?

________________________________________________________________________

____________________________________________________________

Additional comments: (use back if necessary)


Student Evaluation of EMS Instructor Course

Date: ________________ Course #: 613868 Course Location: Lubbock

Course Level: EMS Instructor Course

Instructions to Student: This form will be used to evaluate the effectiveness of your

course. Please complete the questions carefully, honestly and candidly. Your signature

is NOT required. CIRCLE THE BEST RATING FOR EACH STATEMENT.

RATING SCALE:

1 – Unacceptable 2 – Below Average

3 – Average 4 – Above average

5 – Excellent

Effectiveness of Presenter Teaching styles used 1 2 3 4 5 Overall level of presentation 1 2 3 4 5 Use of teaching aids/techniques 1 2 3 4 5 Ability to communicate major points 1 2 3 4 5

Content of Course Objectives were clearly defined 1 2 3 4 5 Objectives were specific to this program 1 2 3 4 5 Content followed outline 1 2 3 4 5 Content fullfilled program objectives 1 2 3 4 5

Supporting Resources Physical facilities 1 2 3 4 5 Equipment 1 2 3 4 5 Audiovisuals 1 2 3 4 5

Overall Overall, I found my experiences to be worthwhile and would recommend this class to others 1 2 3 4 5

PLEASE USE SPACE BELOW AND BACK OF THIS FORM TO GO INTO FURTHER DETAIL OR MAKE ADDITIONAL COMMENTS.

OLTON EMS TRAINING PROGRAM - WordPress.com · 2018-06-06 · OLTON EMS TRAINING PROGRAM 2018...

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