Paramedic Skills Checklists

Transcription

1 Paramedic Skills Checklists 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. First Year Checklists

2 Blood Glucose Assessment Course Name: PARA 101 Competency AOCP F-3, NOCP 4.5c Student Name: 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

3 PARAMEDIC PROGRAM Blood Pressure - Palpation Course Name/Number: PARA 101 Competency AOCP F-1-1, NOCP 4.4 E 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 Student Name: Evaluators Initials 9/6/2007

4 PARAMEDIC PROGRAM SKILLSHEET Blood Pressure - Auscultation Course Name/Number: PARA 101 Competency AOCP F-1-1, NOCP 4.4 D Selects correct size of cuff for patient* Places BP cuff on upper arm with correct tension Ensures stethoscope is correctly set to diaphragm and not bell Accurately locates brachial pulse* Ensures cuff is situated correctly on arm relative to brachial artery Closes valve on sphygmomanometer Pumps up cuff while palpating brachial pulse Inflates cuff 20 mmhg higher after pulse no longer felt Places stethoscope over brachial pulse Slowly opens valve lowering pressure 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 Waits approximately 1 minute before re-attempting BP Student Name: Evaluators Initial 9/6/2007

5 Metered Dose Inhalers (Respiratory) Course Name/Number: Para 101 Competency AOCP G-3, NOCP 5.8 l 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 Student Name: Students initials

6 Nasopharyngeal Airway Course Name: PARA 101 Competency Number: AOCP I-1-1 NOCP 5.1e Student Name: 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

7 ORAL MEDICATIONS Course Name/Number: Para 101 Competency AOCP G-2, NOCP 5.8 j 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) Student Name: Monitors patients for effects Students initials

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

9 Patient Assist Administration via IM Route Course Name: PARA 101 Competency Number: AOCP G-4, NOCP 5.8 d Student Name: Take BSI precautions Confirms indications and contraindications (anaphylaxis)* Explains procedure to patient, obtains patient s epi-pen Confirms patient is not allergic to medication* 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

10 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 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

11 Oropharyngeal Suction Course Name: PARA 101 Competency Number: AOCP I-1-1 NOCP 5.1a, 5.1b Student Name: Takes BSI precautions 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

12 Pulse Count Course Name: PARA 101 Competency AOCP F-1-1, NOCP 4.4 A 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* Student Name: Evaluators Initials 9/6/2007

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

14 Respiration Count Course Name: PARA 101 Competency AOCP F-1-1, NOCP 4.4 B 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 Student Name: Evaluators Initials

15 Spinal Immobilization and C-Collar application Course Name: PARA 101 Competency Number: AOCP I-8, NOCP 5.7 a Student Name: Takes BSI precautions 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

16 Insertion of Oropharyngeal Airway and use of BVM Course Name/ PARA 101 Competency Number: AOCP I-3-1, I-1-1 NOCP 5.4a, 5.1d Takes BSI precautions 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 Student Name: Students Initials.

17 TRACTION SPLINT Course Name: Para 101 Competency Number: AOCP I-9 NOCP 5.7b Student Name: Takes BSI precautions 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

18 STRETCHER HANDLING (STRYKER) Course Name/Number: Para 101 Student Name: Competency AOCP J-5-3 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

19 Assess a scene using Triage principles Course Name: PARA 120 Competency Number: AOCP H-17-1 NOCP 4.1a Student Name: 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

20 Medication Administration Withdrawing Medication from a Vial Course Name: PARA 120 Competency Number: AOCP G-1, NOCP 5.8b Student Name: 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

21 Medication Administration Withdrawing Medication from an Ampule Course Name: PARA 120 Competency Number: AOCP G-1, NOCP 5.8 b Student Name: 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

22 Medication Administration via IM Route Course Name: PARA 120 Competency Number: AOCP G-4, NOCP 5.8 d Student Name: Take BSI precautions Confirms indications and contraindications (anaphylaxis)* Explains procedure to patient Checks for known allergies, contraindications or incompatibilities* Selects the correct medication (checks 5 rights X3) 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

23 BASIC RADIO SKILL Course Name: Para 120 Student Name: Competency AOCP C-3, NOCP 2.1a 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 CRITICAL CRITERIA Students initials Includes extraneous information and wastes time Does not ensure channel is clear Inappropriate tone, speed Comments

24 Combitube Course Name: Para 120 Competency AOCP I-1-2, NOCP 5.1f, 5.1g * 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 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 Student Name:

25 DOCUMENTATION Course Name: PARA 120 Student Name: Competency AOCP C-7-1, C-7-2 NOCP, 2.2a, 2.2b 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 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

26 Inhalation Analgesia Entonox Course Name: Para 120 Competency AOCP G-3, NOCP 5.8l 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 Student Name:

27 Metered Dose Inhalers (Respiratory) Course Name: Para 120 Competency AOCPG-3, NOCP 5.8l 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) Records administration (Date, time, medicications, dose, route, initials) Monitors patient for effects Student Name: Students initials

28 IV Medication Administration Course Name: Para 120 Competency AOCP G-8, NOCP 5.8e * 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 Student Name: Students Initials

29 Nasotracheal Suction Course Name: Para 120 Student Name: Competency AOCP I-1-2, NOCP 5.1c * 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

30 ORAL MEDICATIONS Course Name: Para 120 Student Name: Competency AOCP G-2, NOCP 5.8j 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

31 PASG (Pneumatic Anti-Shock Garment) Course Name: Para 120 Competency # FYI 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.* Student Name: Students Initials

32 Patient Care Report Course Name: Para120 Student Name: Competency AOCP C-7-1, C-7-2, NOCP 2.2a, 2.2b 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 CRITICAL CRITERIA Includes extraneous information/waste time Does not include critical patient information

33 Administration of Subcutaneous Route Course Name: Para 120 Competency AOCP G-6, NOCP 5.8c 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 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) Monitors patient for effects Student Name: Students Initials

34 STRETCHER HANDLING (STRYKER) Chair Stretcher (Stryker) Course Name: Para 120 Student Name: Competency AOCP A-6-1, NOCP 3.2b 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

35 Nebulized Medications Course Name: Para 120 Competency Number: AOCP G-3, NOCP 5.8l 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 Student Name: Students Initials 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.

36 Intravenous Cannulation (Peripheral) Course Name: Para 120 Competency AOCP I-10, NOCP 5.5d Confirms indications and contraindications* 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 Student Name: Students Initials Instructors Initials

37 Blood Glucose Assessment Course Name: PARA 125 Competency AOCP F-3, NOCP4.5c 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 Student Name: Evaluator Initials Instructors Initials 9/6/2007

38 Blood Pressure - Palpation Course Name: PARA 125 Competency AOCP F-1-1, NOCP4.4e 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 Student Name: Evaluators Initials 9/6/2007

39 Blood Pressure - Auscultation Course Name: PARA 125 Competency AOCP F-1-1, NOCP 4.4D Selects correct size of cuff for patient* Places BP cuff on upper arm with correct tension Ensures stethoscope is correctly set to diaphragm and not bell Accurately locates brachial pulse* Ensures cuff is situated correctly on arm relative to brachial artery Closes valve on sphygmomanometer Pumps up cuff while palpating brachial pulse Inflates cuff 20 mmhg higher after pulse no longer felt Places stethoscope over brachial pulse Slowly opens valve lowering pressure 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 Waits approximately 1 minute before re-attempting BP Student Name: Evaluators Initial 9/6/2007

40 Cincinnatti Stroke Scale Course Name: PARA 125 Competency AOCP E-1, NOCP 4.3d Student Name: 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 9/6/2007

41 Glasgow Coma Scale Course Name: PARA 125 Competency AOCP E-1, NOCP 4.3d 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 as mild dysfunction as moderate to severe dysfunction and 10 or less: severe dysfunction Student Name: Evaluators Initials 9/6/2007

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

43 Pulse Count Course Name: PARA 125 Student Name: Competency AOCP F-1-1, NOCP 4.4A 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 9/6/2007

44 Pulse Oximetry Course Name: PARA 125 Competency AOCP F-2, NOCP 4.5a Take BSI precautions 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) Student Name: Evaluators Initials

45 Respiration Count Course Name: PARA 125 Student Name: Competency AOCP F-1-1, NOCP 4.4b 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 9/6/2007

46 Tympanic Temperature Assessment Course Name: PARA 125 Student Name: Competency AOCP F-1-1, NOCP 4.4c 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 9/6/2007