2006-cbtskills-checksheetsrevd

2006 CBT/OTEP 434 Cardiovascular Emergencies
SKILLS CHECKLIST
Objective: Given a partner, appropriate equipment and a patient with chest pain, demonstrate appropriate
assessment and treatment as outlined in CBT/OTEP 434 and EMT Patient Care Guidelines.
SCENE SIZE-UP (must verbalize)
…Additional Resources ular
INITIAL ASSESSMENT (must verbalize)
SUBJECTIVE
Establishes rapport with patient (reassures and calms) and obtains consent to treat (implied/actual)
…Determines patient’s chief complaint and follows SAMPLE and OPQRST investigation
…Determines time of onset of complaint, signs or symptoms
…Obtains names/dosages of current medications and were any taken – (e.g., Viagra, Cialis, Levitra, NTG)
OBJECTIVE (PHYSICAL EXAM)
Records and documents baseline vital signs - listens to lung sounds and compares sides
…Performs appropriate medical / trauma exam — exposes/checks for bleeding and/or injuries
Connects monitoring leads and monitors patient (if trained to do so and if appropriate) …Obtains second set of vital signs and compares to baseline ASSESSMENT (IMPRESSION)
Verbalizes impression
…Determines if ALS is needed — states rationale ___________________________________________
PLAN (TREATMENT)
CRITICAL (FAIL) CRITERIA
…Indicates need for ALS and/or
immediate transport (SICK)
DID NOT…
…Administers appropriate rate and …Monitors patient’s vital signs
…Take/verbalize BSI
delivery of oxygen (as indicated)
…Considers Index of Suspicion
…Properly positions patient
nitroglycerine (if indicated)
_____________________________(additional) …Connects monitoring leads and …
_____________________________(additional) delivery of oxygen
…Indicate need for ALS and/or
immediate transport (SICK)
COMMUNICATION AND DOCUMENTATION
MEETS STANDARDS (RECERT) __(o
Delivers timely and effective short report
2nd ATTEMPT
Completes SOAP narrative portion of incident response form 2006 CBT/OTEP 442 Stroke
SKILLS CHECKLIST
Objective: Given a partner, proper equipment and a patient with s/s of a stroke, demonstrate appropriate
assessment and treatment as outlined in CBT/OTEP 442 and EMT Patient Care Guidelines.
SCENE SIZE-UP (must verbalize)
INITIAL ASSESSMENT (must verbalize)
SUBJECTIVE (FOCUSED HISTORY)
…Establishes rapport with patient (reassures and calms) and obtains consent to treat (implied/actual)
Determines patient’s chief complaint and follows SAMPLE and OPQRST investigation
…Determines time of onset of complaint, signs or symptoms (appreciates 3 hr. time frame for definitive care) ___
Obtains names/dosages of current medications
OBJECTIVE (PHYSICAL EXAM)
…Records and documents baseline vital signs
Performs appropriate medical / trauma exam — exposes/checks for bleeding and/or injuries
…Performs Cincinnati Prehospital Stroke Scale (facial droop, arm drift and slurred speech)
Obtains second set of vital signs and compares to baseline ASSESSMENT (IMPRESSION)
…Verbalizes impression
Determines if ALS is needed — states rationale ___________________________________________
PLAN (TREATMENT)
CRITICAL (FAIL) CRITERIA
…Indicates need for ALS and/or
…Considers Index of Suspicion
immediate transport (SICK)
DID NOT…
…Administers appropriate rate and …Glucometry/oximetry …Take/verbalize BSI
delivery of oxygen (as indicated)
Initiates proper transportation
…Properly positions patient
and notification for a stroke
…Performs Cincinnati Stroke
Scale (interprets findings)
_____________________________(additional) …Monitors patient’s vital signs
…_____________________________(additional) delivery of oxygen
…Indicate need for ALS and/or
immediate transport (SICK)
COMMUNICATION AND DOCUMENTATION
MEETS STANDARDS (RECERT) __(o
Delivers timely and effective short report
2nd ATTEMPT
Completes SOAP narrative portion of incident response form 2006 CBT/OTEP 445 Head/Spine Injuries
SKILLS CHECKLIST
Objective: Given a partner, proper equipment and a patient with a head/spine injury, demonstrate appropriate
assessment and treatment as outlined in CBT/OTEP 445 and EMT Patient Care Guidelines.
SCENE SIZE-UP (must verbalize)
…Additional Resources Inju
INITIAL ASSESSMENT (must verbalize)
SUBJECTIVE (FOCUSED HISTORY)
Establishes rapport with patient (reassures and calms) and obtains consent to treat (implied/actual)
Determines patient’s chief complaint
…Follows SAMPLE and OPQRST investigation (if possible)
Obtains names/dosages of current medications (if possible)
OBJECTIVE (PHYSICAL EXAM)
…Records and documents baseline vital signs
Performs appropriate medical / trauma exam - exposes/checks for bleeding and/or injuries
…Notes/records any neurologic deficits
Obtains second set of vital signs and compares to baseline ASSESSMENT (IMPRESSION)
Verbalizes impression
…Determines if ALS is needed — states rationale ___________________________________________
PLAN (TREATMENT)
GENERAL CARE (Check all that apply) CRITICAL (FAIL) CRITERIA
Indicates need for ALS and/or
…Performs proper spinal
immediate transport (SICK)
immobilization
DID NOT…
…Immediately stabilizes the head …Initiates steps to prevent heat
…Take/verbalize BSI
in a neutral in-line position
Administers appropriate rate and …Monitors patient vital signs
delivery of oxygen (as indicated)
…Considers Index of Suspicion
Applies dressing/bandage to
delivery of oxygen
Properly positions patient
_____________________________(additional) …Indicate need for ALS and/or
immediate transport
COMMUNICATION AND DOCUMENTATION
MEETS STANDARDS (RECERT) ___(o
…Delivers timely and effective short report
2nd ATTEMPT
Completes SOAP narrative portion of incident response form 2006 CBT/OTEP 450 Diabetes
SKILLS CHECKLIST
Objective: Given a partner, appropriate equipment and a patient with a diabetic condition, demonstrate
appropriate assessment and treatment as outlined in CBT/OTEP 450 and EMT Patient Care Guidelines.
SCENE SIZE-UP
INITIAL ASSESSMENT
SUBJECTIVE
Establishes rapport with patient (reassures and calms) and obtains consent to treat (implied/actual)
…Determines patient’s chief complaint and follows SAMPLE and OPQRST investigation
Determines time of onset of complaint, signs or symptoms
…Obtains names/dosages of current medications and were any taken
OBJECTIVE
Records and documents baseline vital signs - confirms patient’s ability to swallow (as indicated)
…Performs appropriate medical / trauma exam – exposes/checks for bleeding and/or injuries
Performs blood glucometry and records findings (if trained to do so)
…Obtains second set of vital signs and compares to baseline ASSESSMENT (IMPRESSION)
Verbalizes impression
…Determines if ALS is needed — states rationale
___________________________________________ PLAN (TREATMENT)
CRITICAL (FAIL) CRITERIA
…Indicates need for ALS and/or
…Monitors patient vital signs
immediate transport (SICK)
Considers Index of Suspicion
DID NOT…
…Administers appropriate rate and …Performs ongoing assessment …Take/verbalize BSI
delivery of oxygen (as indicated)
…Properly positions patient
…Follows proper “after-care”
…Performs blood glucometry
_____________________________(additional) …Provides oral glucose
_____________________________(additional) delivery of oxygen
…Indicate need for ALS and/or
immediate transport (SICK)
COMMUNICATION AND DOCUMENTATION
MEETS STANDARDS (RECERT) __(o
Delivers timely and effective short report
2nd ATTEMPT
Completes SOAP narrative portion of incident response form 2006 CBT/OTEP 930 Death and Dying
CHECKLIST
Objective: In a “roundtable” discussion group and given POLST, DNR orders or advanced directives, EMS
providers will discuss and demonstrate appropriate assessment, treatment and interaction given at least three death and dying scenarios (to include compelling reasons, if applicable), applying the guidelines outlined in CBT/OTEP 930 and EMT Patient Care Guidelines. Roundtable Exercise
…This exercise for CBT/OTEP 930 Death and Dying course with a roundtable discussion panel …The above individual met standards regarding specific knowledge of: The exercise contained:
…A general explanation of the physiology of death (as covered in CBT/OTEP 930) …An explanation/discussion regarding (as covered in CBT/OTEP 930) Legal/ethical concerns (as covered in CBT/OTEP 930) This exercise/review evaluation fulfills the practical requirements for this course.
COMMUNICATION AND DOCUMENTATION
MEETS STANDARDS (RECERT)
Delivers timely and effective short report
2nd ATTEMPT
INFECTIOUS DISEASE
2006 CBT/OTEP 620 Infectious Disease
PROGRAM REVIEW
Objective: To fulfill the requirements of WAC 296-305-0251 which states “All firefighter/EMTs shall be required
to annually review the infectious disease information, updates, protocols, and equipment used in their
department’s infectious disease plan. Additional specific training requirements are outlined in WAC 296-823-
12005.”
…The CBT/OTEP 620 Infectious Disease course was completed and the “written” exam was completed with a score greater than 70%.
…The person who conducted the required review of the department’s infectious disease policy is knowledgeable about the program and its contents. The review contained:
…A general explanation of the epidemiology, symptoms and transmission of infectious diseases.
…An explanation of the department’s exposure control plan …Information about available personal protective equipment (PPE) …Information pertaining to the reporting of an exposure …Information about post exposure evaluation and follow-up procedures following an exposure This review fulfills the requirements set forth in WAC 296-305-0251 and WAC 296-823-12005 (It is advised that the above WACs are reviewed to assure compliance with Washington State law.) COMMUNICATION AND DOCUMENTATION
MEETS STANDARDS (RECERT)
…Delivers timely and effective short report
2nd ATTEMPT
Completes SOAP narrative portion of incident response form

Source: http://www1.seatacfire.us/firedpt/training/Forms%20and%20Documents/EMS/2006-CBTSkills-ChecksheetsRevD.pdf