Paramedic Skills Checklists - Blackboard Learn Skills Checklists First Year Checklists. Paramedic...

Contained in this PDF is a copy of the skills checklists required for tracking the Paramedic student’s progress.

For easy searching, Click on the “Bookmarks” tab that runs vertically on the left. There you will find links to all the pages in this document without having to scroll though every page. Click on your desired checklist and Adobe Acrobat will automatically go to that page in the document. Simple!

If you have any questions about the checklists or cannot find the item you are looking for, please contact one of the appointed Practicum Advisors. Contact information can be found in the back of the Student’s Logbook or online.

Paramedic Skills Checklists

First Year Checklists

Paramedic Program SKILL CHECKLIST

Blood Glucose Assessment Course Name: PARA 101 Student Name: ______________________ Competency AOCP F-3, NOCP 4.5c Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Gather required equipment (BG monitor, lancet, test strip, alcohol swab, gauze, band-aid)

Explain procedure to patient*

Dons PPE

Chooses finger and identifies site (side of finger at tip)

Preps site and allows to dry

Correctly lances finger*

Inserts test strip into monitor

Milks finger to ensure sufficient blood for test strip to wick up

Places gauze on finger with pressure

Correctly reads BG monitor at correct time

Expresses BGL as xx mmol/L in oral and written format*

Disposes of supplies appropriately

Evaluator Initials

Instructors Initials

9/6/2007

PARAMEDIC PROGRAM SKILL CHECKLIST

Blood Pressure - Palpation Course Name/Number: PARA 101 Student Name: ____________________ Competency AOCP F-1-1, NOCP 4.4 E Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Selects correct size of cuff for patient*

Places BP cuff on upper arm with correct tension

Accurately locates radial or brachial pulse*

Ensures cuff is situated correctly on arm relative to brachial artery

Closes valve on sphygmomanometer

Pumps up cuff while palpating radial or brachial pulse

Inflates cuff 20 mmHg higher after pulse no longer felt

Slowly opens valve lowering pressure

Correctly identifies the systolic pressure as first pulse beat felt*

Reports BP as systolic over “P” in mmHg in oral and written formats

Waits approximately 1 minute before re-attempting BP

Identifies that systolic pressure approximately <10 mmHg than auscultated pressure

Evaluators Initials

Instructor Initials

9/6/2007

PARAMEDIC PROGRAM SKILLSHEET

Blood Pressure - Auscultation Course Name/Number: PARA 101 Student Name: ____________________ Competency AOCP F-1-1, NOCP 4.4 D Date of Attempt



Ensures stethoscope is correctly set to diaphragm and not bell

Accurately locates brachial pulse*



Pumps up cuff while palpating brachial pulse


Places stethoscope over brachial pulse


Correctly identifies the systolic pressure as first sound*

Correctly identifies the diastolic pressure as where sound changes or no longer heard*

Reports BP as systolic over diastolic in mmHg in oral and written formats


Evaluators Initial

Instructor Initials

9/6/2007


Metered Dose Inhalers (Respiratory) Course Name/Number: Para 101 Student Name: _____________________________ Competency AOCP G-3, NOCP 5.8 l Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Confirms indications and contraindications*

Explains procedure to patient

Confirms patient is not allergic to medication*

Selects the correct medication (checks 5 rights X3)*

Inspects medication for discoloration, particulate and exp. date

Prepares patient (Opens mouth, holds breath)

Administers medications (Patient inhales as medication administered) (salbutamol, Ipratropium Bromide)

Records administration (Date, time, medicications, dose, route, initials)

Monitors patient for effects

Students initials

Instructor Initials Comments:

06/09/2007


Nasopharyngeal Airway

Course Name: PARA 101 Competency Number: AOCP I-1-1 Student Name: NOCP 5.1e Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Recognize need for NPA ( unable to use OPA due to trismus)

Describe contraindications for its use

Measure appropriate size (measure from nose to tragus of ear)*

Consider diameter of nare

Lubricate NPA with water soluble lubricant

Insert NPA caudally with leading edge of bevel away from the septum (Avoid Kiesselbach’s plexus)*

If NPA doesn’t pass freely attempt insertion in other nare

Do not force insertion!*

Assist ventilation with BVM

Document procedure

Students Initials



ORAL MEDICATIONS Course Name/Number: Para 101 Student Name: _____________________________ Competency AOCP G-2, NOCP 5.8 j Date of Attempt

Items marked * are considered critical. Omission of the step is an automatic failure.

Confirms indications and contraindications

Explains procedure to patients

Confirms patient is not allergic to medications*

Selects the correct medications (5 rights)*

Inspects medication for discolorations, particulate and exp. date

Administers medication (ASA, Oral Glucose)

Record administration (Date, time medication, dose, route, initials)

Monitors patients for effects

Students initials


06/09/2007


Cardiac Arrest Management and AED Course Name: PARA 101 Competency Number: AOCP I-4-1, I-5 Student Name: NOCP 5.5a, 5.5i Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Takes BSI precautions

Briefly questions rescuer about events

Attaches automated defibrillator to patient (Proper lead placement)*

Turns on defibrillator power

Directs rescuer to stop CPR and verifies absence of spontaneous pulse.

Ensures all individuals are standing clear of the patient*

Initiates analysis of rhythm*

Delivers shock followed by immediate compressions 30-2 for 2 minutes

Verifies absence of spontaneous pulse while initiating analysis of rhythm. Delivers subsequent shocks as needed

Directs and evaluates high quality CPR

Inserts airway adjunct (OPA)

Directs ventilation of the patient

Assures high concentration of oxygen is connected to adjunct

Re-evaluates patient after 2 minute *

Repeats defibrillator sequence

Verbalizes transportation of patient

Students Initials


06/09/2007


Patient Assist Administration via IM Route Course Name: PARA 101 Competency Number: AOCP G-4, NOCP 5.8 d Student Name: Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Take BSI precautions

Confirms indications and contraindications (anaphylaxis)*

Explains procedure to patient, obtains patient’s epi-pen


Selects the correct medication (checks 5 rights X3)

Inspects medication for discolouration, particulate and exp. date

Chooses the appropriate site, aseptic technique*

Removes safety cap from auto - injector

Properly places the tip of auto injector against thigh*

Hold injector in place until medication is injected

Properly dispose of auto injector in sharps container*

Proper documentation on procedure

Students Initials


06/09/2007


Oxygen Administration Course Name: PARA 101 Competency Number: AOCP I-2-1, I-2-6, 1-2-7, I-2-8, I-2-9 Student Name: ______ NOCP 5.2a, 5.2b, 5.2c, 5.2d, 5.2e Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Recognize indications for oxygen administration

Takes BSI precautions

Checks tank for presence of oil or dirt*

Cracks tank

Checks for leaks

Checks tank pressure

Attaches appropriate oxygen device to the nipple off the regulator*

Pre fills the reservoir as required*

Applies and adjusts the mask to the patients face*

Adjust flow rate to keep reservoir bag filled while in use

Removes mask and shuts off regulator and tank valve when not in use

Relieves the pressure from the regulator by bleeding off at the end of use

Checks tank pressure and replaces tank as required

Knowledge of nasal cannula, NRB, simple mask

Students Initials


06/09/2007


Oropharyngeal Suction Course Name: PARA 101 Competency Number: AOCP I-1-1 Student Name: NOCP 5.1a, 5.1b Date of Attempt


Position airway to maintain patency

Pre-oxygenate patient

Turns on suction device/or checks equipment

Assures presence of mechanical suction

Uses yankauer tip or appropriate suction catheter

Inserts suction tip/catheter through the mouth to desired location (oropharynx)

Applies suction when in correct location applying suction only as tip/catheter is removed*

Ensures suction procedure takes no longer than 10-5 seconds for adult patients or 5 seconds for pediatric patients

Clears with water if suction should become plugged

Students Initials


06/09/2007


Pulse Count Course Name: PARA 101 Student Name: ____________________ Competency AOCP F-1-1, NOCP 4.4 A Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Identifies correct location(s) for pulse assessment*

Uses pads of index and middle fingers to palpate pulse

Counts pulse over 15 seconds

Considers counting pulse over 30 seconds if irregular

Correctly calculates pulse rate multiplying 15 second value by 4*

Expresses pulse in written and oral formats with rate, rhythm and quality*

Evaluators Initials

Instructor Initials

9/6/2007


Removal of an airway foreign body Course Name: PARA 101 Competency Number: AOCP I-1-1 Student Name: NOCP 5.1i Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Recognizes choking victim

Instructs patient to keep coughing if able to do so.

Calls 911 or ALS back-up (depending on scenario)

Performs Heimlich maneuver on conscious patient

Proper hand placement is used for specific patient*

If patient loses consciousness chest compressions are used in attempt to dislodge foreign body

Ensures other help is on the way if not present

Students Initials



Respiration Count

Course Name: PARA 101 Student Name: _____________________ Competency AOCP F-1-1, NOCP 4.4 B Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Observes the rise/fall of patient’s chest for breathing

Counts respirations over 30 seconds*

Considers counting pulse over 1 minute if respirations are irregular

Correctly multiplies 30 second assessment count by 2*

Notes use of accessory muscle use, signs of distress

Expresses respirations verbally and written with rate, quality, rhythm

Evaluators Initials

Instructor Initials


Spinal Immobilization and C-Collar application Course Name: PARA 101 Competency Number: AOCP I-8, NOCP 5.7 a Student Name: Date of Attempt


Takes manual stabilization of cervical spine (not to be released until secured to backboard)*

Evaluates CMS

Correctly measures cervical collar*

Applies cervical collar

Directs the patient to be log rolled on side as a unit

Checks posterior

Positions spineboard underneath patient

Directs the patient to be log rolled as a unit

Positions and attaches straps in a criss-cross pattern (torso first)*

Position head pads beside patient’s head

Attaches head straps

Re-evaluates CMS

Students Initials


06/09/2007


Insertion of Oropharyngeal Airway and use of BVM Course Name/ PARA 101 Competency Number: AOCP I-3-1, I-1-1 Student Name: NOCP 5.4a, 5.1d Date of Attempt


Ensures OPA is properly measured and properly inserted*

Stands at the head of the patient

Selects proper size of mask

Ensures reservoir is attached to BVM

Seals mask against patients face

Delivers slow breaths to ensure adequate chest rise*

Ensures BVM is connected to oxygen source

Selects correct rate to ventilate the patient

Students Initials

Instructor Initials Comments: .

06/09/2007


TRACTION SPLINT Course Name: Para 101 Competency Number: AOCP I-9 NOCP 5.7b Student Name: Date of Attempt


Directs and maintains application of manual stabilization and traction of injured leg*

Assess PMS of injured leg

Prepares/adjust splint to the proper length

Positions the splint on the injured leg

Applies the proximal strap (Not applicable in Speed Splint Traction Splint)

Applies the distal securing device (strap)

Applies manual traction

Positions and attaches support straps

Re-evaluates PMS*

Verbalizes securing the torso to the long board and securing hip

Verbalizes securing the splint to the board

Students Initials


06/09/2007


STRETCHER HANDLING (STRYKER)

Course Name/Number: Para 101 Student Name: _____________________________ Competency AOCP J-5-3 Date of Attempt

Shaded items are critical items. Omission of the step is an automatic failure.

Able to raise and lower stretcher

Able to put stretcher into fowlers/Semi-fowlers position

Able to raise and lower IV pole

Able to put stretcher into trendlenberg position

Able to raise and lower side rails

Able to describe the steps involved in loading the stretcher into ambulance

Able to describe/demonstrate the steps in unloading the stretcher from the ambulance

Able to shorten the length of the stretcher

Students Initials


Paramedic Program Skill Checklist Page - 1


Assess a scene using Triage principles

Course Name: PARA 120 Competency Number: AOCP H-17-1 Student Name: NOCP 4.1a Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Assesses scene for safety

Ensures Incident command and agency notification*

Dons appropriate BSI

Proceeds safely to closest patient

Conducts rapid triage assessment*

Performs rapid life saving measure if needed (control deadly bleed)

Fills out appropriate triage tag

Places triage tag while explaining actions to patient

Moves safely to the next patient

Repeats procedure

Once all patients have been assessed reports findings to Incident Command*

Students Initials



Medication Administration – Withdrawing Medication from a Vial

Course Name: PARA 120 Competency Number: AOCP G-1, NOCP 5.8b Student Name: Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Takes BSI Precautions *

Confirms order for medication

Identifies/selects appropriate equipment

Calculates correct Medication dose *

Cleanses rubber stopper with alcohol

Using 18-guage needle, injects a volume of air into vial equivalent to volume of solution to be withdrawn

Withdraws correct volume of fluid required for injection *

Removes needle from vial

Gently advances plunger to expel air from syringe *

Administers medication by appropriate route *

Disposes of sharps in proper container *

Students Initials



Medication Administration – Withdrawing Medication from an Ampule

Course Name: PARA 120 Competency Number: AOCP G-1, NOCP 5.8 b Student Name: Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Takes BSI precautions *

Confirms order for medication

Identifies/selects appropriate equipment

Calculates correct medication dosage *

Taps or shakes ampule

Wraps neck of ampule with gauze

Grasps ampule and snaps off top

Insert 18-guage needle on a syringe into ampule without touching sides

Withdraws correct volume of fluid required for injection *

Removes needle from ampule

Removes 18 –gauge needle from syringe

Applies appropriate needle for injection

Gently advances plunger to expel air from syringe *

Administers medication by appropriate route *

Disposes of sharps in proper container *

Students Initials



Medication Administration via IM Route Course Name: PARA 120 Competency Number: AOCP G-4, NOCP 5.8 d Student Name: Date of Attempt


Confirms indications and contraindications (anaphylaxis)*


Checks for known allergies, contraindications or incompatibilities*


Calculates correct medication dose

Measures correct volume into syringe

Selects appropriate needle size

Chooses the appropriate site, aseptic technique*

Holds skin taut; with other hand introduces needle bevel up at a 90 degree angle in one quick motion

Pulls back on plunger (aspirates) to verify absence of blood (if blood is present, withdraw needle, appropriately discard syringe and begin again)

Administer prescribed medication; withdraw needle and dress injection site

Properly dispose of syringe in sharps container*

Verbalize need to observe patient for desired/adverse side effects

Proper documentation the procedure

Students Initials


06/09/2007


BASIC RADIO SKILL Course Name: Para 120 Student Name: _____________________________ Competency AOCP C-3, NOCP 2.1a Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Verifies open channel before speaking

Presses transmit button 1 second before speaking

Holds microphone 2-3 inches from mouth

Speaks slowly and clearly

Speaks in normal pitch, avoiding emotion

Is brief-knows what to say before transmitting

Writes down patch information/Doctor’s orders

Confirms message received

Students initials

Instructor Initials CRITICAL CRITERIA _____Includes extraneous information and wastes time _____Does not ensure channel is clear _____Inappropriate tone, speed

Comments

06/09/2007


Combitube Course Name: Para 120 Student Name: _____________________________ Competency AOCP I-1-2, NOCP 5.1f, 5.1g Date of Attempt

* Items are critical items Omission of the step is an automatic failure. Confirms indications and contraindications

Hyper-oxygenates patient with BVM & OPA*

Assembles equipment, tests cuffs

Positions patient (head neutral, jaw forward)

Inserts Combitube until black rings are between teeth and lips

Inflates pharyngeal cuff with 100cc of air

Inflates distal cuff with 10-15 cc of air

Attach the BVM to the external tube marked #1 and ventilate

Confirm placement-see chest rise, auscultate lungs/epigastrium*

If tube in trachea, change BVM to external tube #2

Confirm placement-see chest rise, auscultate lungs/epigatriums

Continues to ventilate periodically confirming placement

Documents procedure including which port used to ventilate

Monitor patient (vitals, skin color, O2 sat)

Removes appropriately when gag reflex returns*

Students Initials


06/09/2007


DOCUMENTATION Course Name: PARA 120 Student Name: _____________________________ Competency AOCP C-7-1, C-7-2 NOCP, 2.2a, 2.2b Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Skills Demonstrated & Properly Documented

On Arrival

Chief Complaint

History of Chief Complaint/Incident

Past Medical History & Allergies

On Examination/Assessment

Vitals/Medications Listed

Treatment

Students initials

Instructor Initials Comments: ½ mark deducted for each spelling mistake (max 10 marks) Unreadable or Illegible, deducted up to 10 marks max Accuracy of Information, deductions as per evaluator’s discretion No Signature, deduct 1 mark Must follow a logical order

06/09/2007


Inhalation Analgesia Entonox

Course Name: Para 120 Student Name: _____________________________ Competency AOCP G-3, NOCP 5.8l Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Understands indications and contraindications*

Prepares and instructs patient in use of medication

Prepares equipment- inverts cylinder 3 times min.*

Checks patient for bilateral breath sounds

Allows patient to self ventilate

Monitors patient for effect- drowsiness & cyanosis

Records tanks pressure before and after use

Records date, time, medication, dose, route & initials

Students Initials


06/09/2007


Metered Dose Inhalers (Respiratory)

Course Name: Para 120 Student Name: _____________________________ Competency AOCPG-3, NOCP 5.8l Date of Attempt




Selects the correct medication (checks 5 rights X3)*


Prepares patient (Opens mouth, holds breath)

Administers medications (Patient inhales as medication administered)

Records administration (Date, time, medicications, dose, route, initials)


Students initials


06/09/2007


IV Medication Administration Course Name: Para 120 Student Name: _____________________________ Competency AOCP G-8, NOCP 5.8e Date of Attempt

* Items Omission of the step is an automatic failure. Prepares the necessary equipment

Confirms the patient is not allergic to the medication*

Selects the correct medication (5 Rights)*

Inspects the medications for discoloration, particulate and exp. date

Assembles syringe as required

Expels air from the syringe

Cleanse the medications administration port with alcohol prep

Inserts needle into port using aseptic technique

Pinches line above port

Injects correct amount of medication*

Removes and disposes of syringe (does not recap)*

Open IV control valve to flush line- resets correct rate

Records administration (date, time, medication, dose, route, initials)

Monitors patient for desired effects

Students Initials


06/09/2007


Nasotracheal Suction

Course Name: Para 120 Student Name: _____________________________ Competency AOCP I-1-2, NOCP 5.1c Date of Attempt

* Items are critical items Omission of the step is an automatic failure. Confirms indications and contraindications*

Confirms negative basal skull fracture

Assembles equipment

Selects appropriate size suctions catheter*

Measures catheter insertion length against external landmarks*

Correctly inserts suction catheter to measured point

Applies suction and twist catheter as removed

Suctioning not to exceed 15 seconds

Monitor patient and document procedure

Students Initials


06/09/2007


ORAL MEDICATIONS

Course Name: Para 120 Student Name: _____________________________ Competency AOCP G-2, NOCP 5.8j Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Confirms indications and contraindications

Explains procedure to patients

Confirms patient is not allergic to medications*

Selects the correct medications (5 rights)*

Inspects medication for discolorations, particulate and exp. date

Administers medication

Record administration (Date, time medication, dose, route, initials)

Monitors patients for effects

Students initials


06/09/2007


PASG (Pneumatic Anti-Shock Garment)

Course Name: Para 120 Student Name: _____________________________ Competency # FYI Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Understands indications and contraindications*

Demonstrates ability to untangle PASG in reasonably time

Inflates PASG appropriately

Demonstrates a working knowledge of values & gauges

Notes finishing PASG pressure

Describes the effect of altitude changes and rising temperature on PASG suit.

Demonstrates appropriate deflations of PASG garment.*

Students Initials


06/09/2007


Patient Care Report

Course Name: Para120 Student Name: _____________________________ Competency AOCP C-7-1, C-7-2, NOCP 2.2a, 2.2b Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Identifies agency, unit call name, self

Describes scene

Provides patient, age, sex and Level of consciousness

Provides chief complaint or presenting problem

Brief History of present illness

Associated symptoms including pertinent positives/negatives

General appearance of patient

Assessment/findings

Treatment provided and time

Signs PCR appropriately

Completes all necessary boxes and information

Students initials

Instructor Initials CRITICAL CRITERIA ___Includes extraneous information/waste time ___Does not include critical patient information

06/09/2007


Administration of Subcutaneous Route

Course Name: Para 120 Student Name: _____________________________ Competency AOCP G-6, NOCP 5.8c Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Confirms indications and contraindications





Shakes down the ampoule & safely breaks ampoule

Withdraws the medications properly

Chooses the appropriate site, prep site with alcohol site

Inserts needle at proper angle using aseptic technique

Aspirates for blood

Injects medication

Removes and recaps or disposes of syringe

Records administration (Date, time, medications, dose, route, initials)


Students Initials


06/09/2007


STRETCHER HANDLING (STRYKER) Chair Stretcher (Stryker)

Course Name: Para 120 Student Name: _____________________________ Competency AOCP A-6-1, NOCP 3.2b Date of Attempt

* Items are critical items. Omission of the step is an automatic failure.

Able to raise and lower stretcher

Able to put stretcher into fowlers/Semi-fowlers position

Able to raise and lower IV pole

Able to put stretcher into trendlenberg position

Able to raise and lower side rails

Able to describe the steps involved in loading the stretcher into ambulance

Able to describe/demonstrate the steps in unloading the stretcher from the ambulance

Able to shorten the length of the stretcher

Students Initials


06/09/2007


Nebulized Medications Course Name: Para 120 Competency Number: AOCP G-3, NOCP 5.8l Student Name: Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Observe universal precautions

Initiate pulse oximetry (if available)

Explain procedure to patient

Check patients known allergies*

Check medication for expiration date, discoloration

Use a length-based resuscitation tape (if patient not an adult) to determine correct dosage for the child’s age or weight

Assemble nebulizer and connect it to oxygen delivery system

Open nebulizer and insert the proper amount of medication. Add normal saline if the medication is not premixed.*

Close nebulizer and attach it to the facemask or T-piece and mouthpiece.

Set oxygen flow rate to 5 to 10 litres per minute. Check nebulizer for moderate mist.

Prepare the patient. Reassure preschool or early school-aged children

Give the nebulizer T=piece or place the nebulizer and mask over patients face as appropriate. Explain proper usage. Ensure proper fit.

Continue administration until medication is gone.

When medication is gone, resume oxygen administration via nasal cannula or non-rebreather mask*

Repeat medication delivery as indicated

Students Initials

Instructor Initials Comments: Indications: Wheezing associated with respiratory illness, respiratory distress or respiratory failure Complications: Tachycardia and extreme restlessness or agitation are common side effects Contraindications: hypersensitivity or history of severe side effects.

06/09/2007


Intravenous Cannulation (Peripheral) Course Name: Para 120 Student Name: _____________________________ Competency AOCP I-10, NOCP 5.5d Date of Attempt


Dons appropriate PPE

Selects appropriate IV Fluid or saline lock*

Inspects IV bag for colour, clarity,particulate and exp.date*

Inserts and flushes IV tubing correctly, removes air*

Gathers and prepares associated supplies

Applies tourniquet

Selects site and preps with iodine and/or alcohol prep

Selects appropriate size angiocatheter

Using aseptic technique, correctly insert angiocatheter into vein*

Confirm flashback, remove and safely dispose needle

Attach IV tubing to catheter using

Students Initials

Instructors Initials Comments:

06/09/2007


Blood Glucose Assessment

Course Name: PARA 125 Student Name: _____________________ Competency AOCP F-3, NOCP4.5c Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Gather required equipment (BG monitor, lancet, test strip, alcohol swab, gauze, band-aid)

Explain procedure to patient*

Dons PPE

Chooses finger and identifies site (side of finger at tip)

Preps site and allows to dry

Correctly lances finger*

Inserts test strip into monitor

Milks finger to ensure sufficient blood for test strip to wick up

Places gauze on finger with pressure

Correctly reads BG monitor at correct time

Expresses BGL as xx mmol/L in oral and written format*

Disposes of supplies appropriately

Evaluator Initials

Instructors Initials

9/6/2007


Blood Pressure - Palpation Course Name: PARA 125 Student Name: _______________________ Competency AOCP F-1-1, NOCP4.4e Date of Attempt



Accurately locates radial or brachial pulse*



Pumps up cuff while palpating radial or brachial pulse



Correctly identifies the systolic pressure as first pulse beat felt*

Reports BP as systolic over “P” in mmHg in oral and written formats


Identifies that systolic pressure approximately <10 mmHg than auscultated pressure

Evaluators Initials

Instructor Initials

9/6/2007


Blood Pressure - Auscultation Course Name: PARA 125 Student Name: ________________________ Competency AOCP F-1-1, NOCP 4.4D Date of Attempt



Ensures stethoscope is correctly set to diaphragm and not bell

Accurately locates brachial pulse*



Pumps up cuff while palpating brachial pulse


Places stethoscope over brachial pulse


Correctly identifies the systolic pressure as first sound*

Correctly identifies the diastolic pressure as where sound changes or no longer heard*

Reports BP as systolic over diastolic in mmHg in oral and written formats


Evaluators Initial

Instructor Initials

9/6/2007


Cincinnatti Stroke Scale

Course Name: PARA 125 Student Name: ______________________ Competency AOCP E-1, NOCP 4.3d Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Observes signs and symptoms indicative of CVA Asks the patient to smile or show their teeth observing for facial droop

Notes facial droop as one side does not move as well as the other

Asks the patient to close their eyes and hold their hands out in front of them for 10 seconds…observes for arm drift *

Notes arm drift as one side does not move or one side drifts down compared to the other*

Asks the patient to say “you can’t teach an old dog new tricks” observing for abnormal speech*

Notes that patient slurs words, uses the wrong words or is unable to speak

Notes that a person with one or more of these signs is abnormal and there is a probability of at least 72% that the patients has suffered a stroke

Notifies the hospital that this is a possible stroke patient Evaluator Initials

Instructor Initials

9/6/2007


Glasgow Coma Scale

Course Name: PARA 125 Student Name: ______________________ Competency AOCP E-1, NOCP 4.3d Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Correctly attributes numeric value to eye opening:

• Spontaneous 4 • In Response to speech 3 • In Response to pain 2 • None 1

Correctly attributes numeric value to best verbal response: • Oriented conversation 5 • Confused conversation 4 • Inappropriate words 3 • Incomprehensible sounds 2 • None 1

Correctly attributes numeric value to best motor response: • Obeys 6 • Localizes 5 • Withdraws 4 • Abnormal flexion 3 • Abnormal extension 2 • None 1

Correctly totals

Correctly interprets GCS of 14-15 as mild dysfunction 11-13 as moderate to severe dysfunction and 10 or less: severe dysfunction

Evaluators Initials

Instructor Initials

9/6/2007


Los Angeles Prehospital Stroke Screen Course Name: PARA 125 Student Name: ______________________ Competency AOCP E-1, NOCP 4.3d Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Observes signs and symptoms indicative of CVA

Notes the answer to Question #1: Is the patients over 45 years of age?

Notes the answer to Question #2: Is there no history of seizure disorder?

Notes the answer to Question #3: Is this a new onset of neurological symptoms? (within the last 24 hours)

Notes the answer to Question #4: Was the pt. ambulatory at baseline

Notes the answer to Question #5: Is the pt’s blood glucose between 3.3 and 22.2 mmol/l (60 and 400 mg/dl)

Notes the answer to Question #6: Does the pt exhibit signs of unilateral weakness?

• Facial droop • Unequal grip strength • Unequal arm strength

Notes that a person who answers ‘yes’ to all 6 of these criteria, has a probability of 97% that the patient may be experiencing a stroke

Notifies the hospital that this is a possible stroke patient

Evaluators Initials

Instructor Initials

Paramedic Program

SKILL CHECKLIST

Pulse Count Course Name: PARA 125 Student Name: ________________________ Competency AOCP F-1-1, NOCP 4.4A Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Identifies correct location(s) for pulse assessment*

Uses pads of index and middle fingers to palpate pulse

Counts pulse over 15 seconds

Considers counting pulse over 30 seconds if irregular

Correctly calculates pulse rate multiplying 15 second value by 4*

Expresses pulse in written and oral formats with rate, rhythm and quality*

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Instructor Initials

9/6/2007

Paramedic Program

SKILL CHECKLIST

Pulse Oximetry Course Name: PARA 125 Student Name: ________________________ Competency AOCP F-2, NOCP 4.5a Date of Attempt


Connect the sensor lead to the monitor and clip the sensor to the patients fingertip

Turn on pulse oximeter

Correctly observes for SpO2 reading and heart rate, making sure heart rate displayed is same as the patient’s palpated pulse rate. *

Expresses oximetry in written and oral formats with Room air or oxygen device (if applicable)

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Respiration Count Course Name: PARA 125 Student Name: _________________________ Competency AOCP F-1-1, NOCP 4.4b Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Observes the rise/fall of patient’s chest for breathing

Counts respirations over 30 seconds*

Considers counting pulse over 1 minute if respirations are irregular

Correctly multiplies 30 second assessment count by 2*

Notes use of accessory muscle use, signs of distress

Expresses respirations verbally and written with rate, quality, rhythm

Evaluators Initials

Instructor Initials

9/6/2007


Tympanic Temperature Assessment Course Name: PARA 125 Student Name: ________________________ Competency AOCP F-1-1, NOCP 4.4c Date of Attempt

* Items are critical items. Omission of the step is an automatic failure. Places cover over thermometer

Gently pulls ear up and back*

Gently places covered probe into external ear canal

Presses and holds button to obtain reading

Correctly expresses reading as degrees centigrade by tympanic in oral and written formats*

Evaluators Initials

Instructor Initials

9/6/2007

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