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NAME BLS-2017-Altered Mental States EMERGENCY MEDICAL SERVICES (11/10 MH) Objective: Given a partner, appropriate equipment and an altered mental status, demonstrate appropriate assessment and treatment as outlined in BLS-2017-Altered Mental States and EMT Patient Care Guidelines. SCENE SIZE-UP (must verbalize) BSI Scene Safety Determines NOI/MOI Number of Patients Additional Resources INITIAL ASSESSMENT (must verbalize) Mental Status Chief complaint Airway C-spine SUBJECTIVE (FOCUSED HISTORY) Breathing Circulation Bleeding Body Position Obvious Trauma SICK NOT SICK 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 signs or symptoms (On scene time <15mins for Stroke patients) Obtains names/dosages of current medications OBJECTIVE (PHYSICAL EXAM) Records and documents baseline vital signs (looks for Medical Alert bracelets, anklets, necklaces) Performs appropriate medical/trauma exam exposes/checks for bleeding and/or injuries Checks for neurologic deficits using AVPU (Demonstrates use of noxious stimulus in unresponsive pt.) Demonstrates proper assessment of pupils ASSESSMENT (IMPRESSION) Demonstrates use of the FAST Exam for potential stroke patients Determines if ALS is needed states rationale PLAN (TREATMENT) GENERAL CARE (Check all that apply) Reports At Patient s Side Indicates need for ALS and/or Administers appropriate rate and delivery of oxygen (as indicated) Properly positions patient Monitors patient s vital signs Considers IOS COMMUNICATION AND DOCUMENTATION Performs glucometry (documentation required) Performs pulse oximetry Initiates Code CVA ( On-scene time<15 mins) Appropriate use of the: EMS Sepsis Triangle Contacts receiving hospital Performs pt. reassessment Delivers timely and effective short report (if indicated) Completes SOAP narrative portion of incident response form CRITICAL (FAIL) CRITERIA DID NOT Take/verbalize BSI Appropriately provide/manage airway, breathing, bleeding control, treatment of shock Administer appropriate rate and delivery of oxygen Indicate need for ALS and/or MEETS STANDARDS (RECERT) 2 nd ATTEMPT EVALUATOR SIGN YOUR NAME IF NO EXPLAIN BLS-2017-Altered Mental States Student Name Recert Yes No Date Written Score

TIME Blood Pressure Pulse Rate Respiratory Rate Consciousness ECG Rhythm Oxygen Meds (Pulse Oximetry- SpO2) (Glucometry) Medications taken by patient at home Allergies Chief Complaint Narrative

NAME BLS-2017- Stroke EMERGENCY MEDICAL SERVICES (11/16 JN) Objective: Given a partner, proper equipment and a patient with s/s of a stroke, demonstrate appropriate assessment and treatment as outlined in CBT 2017 Stroke and EMT Patient Care Guidelines. SCENE SIZE-UP (must verbalize) BSI Scene Safety Determines NOI/MOI Number of Patients Additional Resources INITIAL ASSESSMENT (must verbalize) Mental Status Chief complaint Airway C-spine Breathing SUBJECTIVE (FOCUSED HISTORY) Circulation Bleeding Obvious Trauma Body Position SICK NOT SICK 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 the need for rapid transport) 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 the FAST Exam and obtains LAMS Score Obtains second set of vital signs and compares to baseline ASSESSMENT (IMPRESSION) Verbalizes impression (i.e. Acute CVA) Determines if ALS is needed states rationale PLAN (TREATMENT) GENERAL CARE (Check all that apply) Indicates need for ALS and/or Reports APS to Dispatch Administers appropriate rate and delivery of oxygen (as indicated) Considers 95% SpO2 for decision Properly positions patient Performs FAST Exam (interprets) COMMUNICATION AND DOCUMENTATION Obtains LAMS Score Considers Index of Suspicion Glucometry (required for suspected CVA) Oximetry Initiates Code CVA" On-scene time <15 min (when possible) Performs pt. reassessment Early notification to ED Delivers timely and effective short report (if indicated) Completes SOAP narrative portion of incident response form CRITICAL (FAIL) CRITERIA DID NOT Take/verbalize BSI Appropriately provide/manage airway, breathing, bleeding control, treatment of shock Properly administers oxygen Indicate need for ALS and/or MEETS STANDARDS (RECERT) 2 nd ATTEMPT EVALUATOR SIGN YOUR NAME IF NO EXPLAIN BLS-2017-Stroke Student Name Recert Yes No Date Written Score online / other)

TIME Blood Pressure Pulse Rate Respiratory Rate Consciousness ECG Rhythm Oxygen Meds (Pulse Oximetry- SpO2) (Glucometry) Medications taken by patient at home Allergies Chief Complaint Narrative

NAME BLS-2017-Cultural Awareness EMERGENCY MEDICAL SERVICES (12/16 RB) Objective: With a partner or a group, discuss some of the key concepts of cultural awareness as they were presented in the BLS-2017-Cultural Awareness course DISCUSSION QUESTIONS What are some culturally based barriers to treatment that you ve encountered on previous calls? How does your culture influence you on calls? (Focused both on the EMT/Medic culture and their personal culture) What are some techniques you ve used to deal with barriers to treatment in the past? What worked well? What didn t work well? Why do you think they either worked or didn t work? What are some ways that you can leverage each other s cultural backgrounds to help deal with barriers to treatment in the future? If you had to pick one Take away to try and incorporate into your day to day practices, what would it be? How do you see that having a positive impact on calls? BLS-2017-Cultural Awareness Student Name Recert Yes No Date Written Score EVALUATOR SIGN YOUR NAME

BLS-2017-High Performance Trauma Management EMERGENCY MEDICAL SERVICES (8/13 JN) NAME Objective: Given a partner, appropriate equipment and a trauma patient, demonstrate appropriate assessment. treatment and management of that patient as outlined in BLS-2017-High Performance Trauma Management. SCENE SIZE-UP (must verbalize) BSI Scene Safety Determines NOI/MOI Number of Patients Additional Resources INITIAL ASSESSMENT (must verbalize) Appearance Chief complaint Airway C-spine Work of Breathing SUBJECTIVE (FOCUSED HISTORY) Circulation Bleeding Obvious Trauma Body Position SICK NOT SICK 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 as appropriate Obtains names/dosages of current medications and were any taken OBJECTIVE (PHYSICAL EXAM) Records and documents baseline vital signs Performs appropriate medical / trauma exam exposes/checks for bleeding and/or injuries 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) Reports At patient s side Indicates need for ALS and/or Performs rapid trauma exam Identifies and treats life threatening bleeding using pressure dressing and/or tourniquet Administers appropriate rate and delivery of oxygen (as indicated) COMMUNICATION AND DOCUMENTATION Performs rapid spinal immobilization Prepares patient for ALS transport Monitors patient vital signs Considers index of suspicion Performs ongoing assessment Performs pulse oximetry Performs glucometry (if trained) (additional) (additional) Delivers timely and effective short report (if indicated) Completes SOAP narrative portion of incident response form CRITICAL (FAIL) CRITERIA DID NOT Take/verbalize BSI Appropriately provide/manage airway, breathing, bleeding control, treatment of shock Administer appropriate rate and delivery of oxygen Indicate need for ALS and/or MEETS STANDARDS (RECERT) 2 nd ATTEMPT EVALUATOR SIGN YOUR NAME IF NO EXPLAIN BLS-2017-High Performance Trauma Management Student Name Recert Yes No Date Written Score

TIME Blood Pressure Pulse Rate Respiratory Rate Consciousness ECG Rhythm Oxygen Meds (Pulse Oximetry- SpO2) (Glucometry) Medications taken by patient at home Allergies Chief Complaint Narrative

NAME BLS-2017-Mental Health EMERGENCY MEDICAL SERVICES (12/16 RB) Objective: With a partner or a group, discuss some of the key concepts of mental health as they were presented in BLS-2017-Mental Health. DISCUSSION QUESTIONS What has been your personal experience with mental health issues? Have you had friends, family or coworkers who have experienced a mental health condition? What steps are you currently taking to maintain balance in your own life? What are some opportunities you have to improve? Describe a time when you were working with someone who was in trouble due to stress or a mental health concern? What were some of the signs and symptoms that you saw? How did you approach the situation? Describe what you might do differently the next time based on your new knowledge and experience. How do you access your agency s Employee Assistance Program and what other resources are available to you through your agency? BLS-2017-Mental Health Student Name Recert Yes No Date Written Score EVALUATOR SIGN YOUR NAME

NAME BLS-2017 OB/GYN Emergencies EMERGENCY MEDICAL SERVICES Objective: Given a partner the EMT will demonstrate his/her competency in dealing with proper assessment and the treatment of the obstetrical patient. As outlined in BLS-2017-OB/GYN Emergencies and EMT Patient Care Guidelines. SCENE SIZE-UP (must verbalize) Safety Precautions (BSI) Scene Safety MOI/NOI Number of Patients INITIAL ASSESSMENT (must verbalize) Mental Status C-Spine SUBJECTIVE (FOCUSED HISTORY) Establishes rapport with patient Permission To Treat SAMPLE/OPQRST OBJECTIVE (PHYSICAL EXAM) Baseline Vital Signs (With Temp) Medical Exam Trauma Exam Skin Signs HEENT ASSESSMENT (IMPRESSION) Must Verbalize Impression PLAN (TREATMENT) Immediate Life Threats Proper Oxygen Therapy Pulse Ox/Glucometry Positioning Patient Consider IOS Transportation Decision CRITICAL FAIL ABC s Bleeding Obvious Injury Body Position Chief Complaint Medications Medical Hx Lung Sounds Para/Grava Neck Veins DCAP/BTLS ALS If Indicated: Why Safety Precautions (BSI)/Scene Safety Appropriately provide/manage airway, breathing, bleeding control, treatment of shock COMMUNICATION AND DOCUMENTATION Written Delivers timely and effective short report (if indicated) Completes SOAP narrative portion of incident response form SICK NOT SICK Proper Bleeding Control Prepare For Birth Hemorrhage Prevent Heat Loss (Mom And Baby) Ongoing Assessment Reports At patient s side Additional Resources CMS/Swelling Crowning Assessment Of Mother Assessment Of Baby Administer O2 Appropriate Rate And Delivery Need For ALS MEETS STANDARDS (RECERT) 2 nd ATTEMPT EVALUATOR SIGN YOUR NAME IF NO EXPLAIN BLS 2017 OB/GYN Emergencies Student Name Meets Standards Yes / No Date: Written Score (online / other)

TIME Blood Pressure Pulse Rate Respiratory Rate Consciousness ECG Rhythm Oxygen Meds (Pulse Oximetry) (Glucometry) Medications taken by patient at home Allergies Chief Complaint Narrative 2017 Seattle/King County EMS