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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
* 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
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
Evaluators Initial
Instructor Initials
9/6/2007
Paramedic Program SKILL CHECKLIST
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
Paramedic Program SKILL CHECKLIST
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
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
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
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
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
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
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
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
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
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
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
Oropharyngeal Suction Course Name: PARA 101 Competency Number: AOCP I-1-1 Student Name: NOCP 5.1a, 5.1b Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. 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
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
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
Paramedic Program SKILL CHECKLIST
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
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
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
Paramedic Program SKILL CHECKLIST
Spinal Immobilization and C-Collar application Course Name: PARA 101 Competency Number: AOCP I-8, NOCP 5.7 a Student Name: Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. 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
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
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
* Items are critical items. Omission of the step is an automatic failure. 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
Students Initials
Instructor Initials Comments: .
06/09/2007
Paramedic Program SKILL CHECKLIST
TRACTION SPLINT Course Name: Para 101 Competency Number: AOCP I-9 NOCP 5.7b Student Name: Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. 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
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
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
Instructor Initials Comments:
Paramedic Program Skill Checklist Page - 1
Paramedic Program SKILL CHECKLIST
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
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
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
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
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
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Medication Administration via IM Route Course Name: PARA 120 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
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
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
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
Paramedic Program SKILL CHECKLIST
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
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
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
Paramedic Program SKILL CHECKLIST
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
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
Metered Dose Inhalers (Respiratory)
Course Name: Para 120 Student Name: _____________________________ Competency AOCPG-3, NOCP 5.8l 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)
Records administration (Date, time, medicications, dose, route, initials)
Monitors patient for effects
Students initials
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
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
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
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
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
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
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
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
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
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
Paramedic Program SKILL CHECKLIST
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
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
Students Initials
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
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
Instructor Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
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
Paramedic Program SKILL CHECKLIST
Intravenous Cannulation (Peripheral) Course Name: Para 120 Student Name: _____________________________ Competency AOCP I-10, NOCP 5.5d Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. 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
Students Initials
Instructors Initials Comments:
06/09/2007
Paramedic Program SKILL CHECKLIST
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
Paramedic Program SKILL CHECKLIST
Blood Pressure - Palpation Course Name: PARA 125 Student Name: _______________________ Competency AOCP F-1-1, NOCP4.4e 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
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Instructor Initials
9/6/2007
Paramedic Program SKILL CHECKLIST
Blood Pressure - Auscultation Course Name: PARA 125 Student Name: ________________________ Competency AOCP F-1-1, NOCP 4.4D 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
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
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9/6/2007
Paramedic Program SKILL CHECKLIST
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
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9/6/2007
Paramedic Program SKILL CHECKLIST
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
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9/6/2007
Paramedic Program SKILL CHECKLIST
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
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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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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
* Items are critical items. Omission of the step is an automatic failure. 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)
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Paramedic Program SKILL CHECKLIST
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
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9/6/2007
Paramedic Program SKILL CHECKLIST
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*
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9/6/2007
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