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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
Second Year Checklists
Paramedic Program Scenario CHECKLIST
Student Name:
Scenario Content AOCP NOCP Attempts Initials
Instructor Signature
Cardiovascular system Assessment and Management
E-3 H-4
4.3 c 6.1 a
Neurological system Assessment and Management
E-1 H-2
4.3 d 6.1 b
Respiratory system Assessment and Management
E-2 H-3
4.3 e 6.1 c
Obstetrics Assessment and Management
D-4 H-12
4.3 f 6.1 q
Gastrointestinal Assessment and Management
E-4 H-5
4.3 g 6.1 e
Genitourinary system Assessment and Management
E-4 H-5
4.3 h 6.1 d
Integumentary system Assessment and Management
E-5 H-8
4.3 i 6.1 f
Musculoskeletal system Assessment and Management
E-6 H-6
4.3 j 6.1 g
Immune system Assessment and Management
H-7
4.3 k 6.1 h
Endocrine system Assessment and Management
H-7 4.3 l 6.1 i
Eyes, Ears, Nose, Throat Assessment and Management
E-5-2 H-2-3
4.3 m 6.1 j
Psychiatric Assessment and Management
D-8 H-12
4.3 p 6.1 p
Patient care- extremes of temperature or environments
H-10 6.1 n
Patient care for terminal illness 6.1 m Provide care for physically challenged patients
H-16 6.2 d
Provide care for mentally challenged patients
H-17 6.2 e
Patient care for poisoning/Overdose H-9 6.1 k Patient care for non-urgent medical problem
H-1 6.1 l
Neonatal Assessment and Management
D-5 H-13
4.3 o 6.2 a
Pediatric Assessment and Management
H-14 6.2 b
Geriatric Assessment and Management
H-15 6.2 c
Trauma Assessment and Management
H-1 6.1 o
Students must pass the scenario in order to receive an instructor’s signature. This tracking form is intended to be used as a tool for students and instructors to help identify areas that may need improvement. The final scenarios at the end of each year may contain content from any of the above areas.
Paramedic Program SKILL CHECKLIST
Rapid Sequence Intubation Course Name: PARA 200 Competency Number: AOCP I-1-2 Student Name: NOCP 5.1h Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Confirm the need for RSI
Prepare equipment and medications *
Preoxygenate the patient *
Pretreatment (L.O.A.D.)
Paralysis with induction
Protection with Sellicks maneuver
Position airway aligning the 3 axis
Introduce Laryngoscope and visualize glottic opening
Place the Endotracheal tube and inflate the balloon
Confirm placement with auscultation (5 points)
Postintubation management
Consider long term sedation, analgesia and paralytics
Record procedure
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Synchronized Cardioversion
Course Name: PARA 200 Competency Number: AOCP I-11-3 Student Name: NOCP 5.5k Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Turn the monitor on and apply the pads to patient Confirms the dysrhythmia* Sedate the patient if time permits Ensure that the “SYNC” button is pressed. And there are markers on the R waves* Select appropriate cardioversion dose (monitor specific) State, “stand clear, charging pads* Charge the defibrillator Check personal, state all clear and do a visual check and reconfirm rhythm* Deliver the energy Check pulse and reassess the patient If there is no change than continue with the appropriate protocol Record the procedure
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Topical Medication Administration Course Name: PARA 200 Competency Number: AOCP G-7 Student Name: NOCP 5.8i Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Recognizes the indication for topical medication or reviews the order from a physician
Reviews 5 rights
Dons BSI*
Gathers all equipment needed
Exposes area for application
Inspects skin and clears away dirt/debris
Applies appropriate dose (Topical agent / Patch)
Reviews action and potential side effects with patient
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Tracheal Suctioning
Course Name: PARA 200 Competency Number: AOCP I-1-2 Student Name: NOCP 5.1c Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Prepare patient
Select and prepare equipment
Turn on suction
Insert catheter without suction to the level of the carina. (noted by coughing, bucking or resistance is met
Cover side port with finger while withdrawing, and rotate the catheter.
Suction for less than 15 seconds
If dysrhythmias or bradycardias occur, suction stops and hyperoxygenate the patient
Resume oxygenation and adequate ventilations
Rinse catheter in sterile saline or water
Reassess respiratory status
Repeat procedure if necessary
Record procedure
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Noninvasive Transcutaneous Cardiac Pacing
Course Name: PARA 200 Competency Number: AOCP I-12-1 Student Name: NOCP 5.5 l Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Assess the patient for the need of pacing
Gather the appropriate equipment
Explain the procedure to the patient including pain and discomfort
Sedate if necessary
Obtain rhythm strip 3 lead and 12 lead
Assess and record baseline vitals
Apply the pacing pads
Turn the pacer on
Assure that the monitor can sense all intrinsic QRS complexes
Select appropriate pacing rate 60 – 80 bpm
Select initial current setting
Increase pacer in 20 milliamps until capture
Observe electrical capture (pacer spike followed by wide QRS and discordant T wave)
Observe for mechanical capture (palpable pulse, ^ in BP, ^LOC)
Obtain rhythm strip and record vital signs, reassess patient and record procedure
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
URINARY CATHETERIZATION Course Name: Para 200 Student Name: _____________________________ Competency: AOCP I-14, I-15 NOCP 5.5o, 5.5u The student must demonstrate all steps for successful evaluation by the instructor
Date of Attempt
Instructor Evaluation
Explains the indications for catheterization
Explains procedure to patient and maintain privacy
Positions patient appropriately
Selects appropriate size of catheter
Opens and places tray maintaining sterile field
Places on sterile gloves
Cleans area properly, allowing solution to dry
Picks up catheter 3-5 cm from tip and lubricates tip
Instructs the patient to take a deep breath and advance catheter
Advance catheter gently but steadily and not forcing it
Confirm placement of catheter with urine out put from catheter into collecting tray
Inflates balloon and withdraws until resistance if felt
Attach catheter collection bag and anchors to patient
Reassess the patient and documents procedure
Student Evaluator Initials:
Instructor Initials: Comments:
Paramedic Program SKILL CHECKLIST
Foreign Body Removal
Course Name: PARA 200 Competency Number: AOPC I-1-2 Student Name: NOCP 5.1 j Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Patient preparation
Put patient in a sniffing position
Open pt’s mouth and ensure the upper lip is pulled back from the laryngoscope blade
Insert blade
Lift blade, expose a visualize
Visualize and remove the foreign body with magill forceps *
Reattempt to ventilate the patient *
Continue with primary survey and re-evaluate airway as indicated
If not able to remove the obstruction or can’t visualize it consider cricothyrotomy or PTTV
Record the procedure
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Oral and Nasal Gastric Tube Insertion Course Name: PARA 200 Competency Number: AOCP 1-15 Student Name: NOCP 5.5 t Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Prepare equipment
Don appropriate BSI precautions
Explain procedure to patient
If possible position patient in high fowlers position
Examine nose for (nasal) mouth for (oral) insertion
Measure tubing to appropriate length and mark tubing or note the distance
Lubricate 5-10 cm of catheter (2% Xylocaine gelly)
If insertion is through the nostril ensure that the leading edge of bevel is away from the septum (Avoid Kiesselbach’s plexus)
If patient is alert instruct patient to swallow as the tube is passed into the esophagus. Sipping on water way help
If resistance is met rotate slightly while advancing DO NOT FORCE THE TUBE!
Advance tube until mark has been reached
Confirm tube placement
Document Procedure
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Manual Defibrillation
Course Name: PARA 200 Competency Number: AOCP I-11-2 Student Name: NOCP 5.5 j Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Recognizes the need for defibrillation
Ensures quality CPR is being performed while preparing monitor
Attaches Pads appropriately
Places monitor in Paddles or attaches ECG cables
Recognizes Dysrhythmia
Charges Defibrillator to appropriate dose (Monitor specific) Compressions may continue throughout charge
Clear the patient and remove oxygen
Delivers appropriate defibrillation dose
Immediately resumes CPR starting with compressions
CPR consists of 30:2 for 2 minutes or compressions at 100/min while delivering breaths once every 8 seconds if advanced airway insitu.
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Medication Administration - ET Course Name: PARA 200 Competency Number: AOCP G-9 Student Name: NOCP 5.8g Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Prepares the necessary equipment
Examines the medication for discolouration, particles, expiration
Assembles the syringe
Hyperoxgenate the patient in anticipation of administration
Removes the BVM and administers the medication (epinephrine, Lidocaine, atropine and naloxone)
Replaces the BVM and resumes ventilations
Monitors the patient for the desired effect
Record the procedure
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Medication administration - Rectal
Course Name: PARA 200 Competency Number: AOCP G-12 Student Name: NOCP 5.8k Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Confirm indications and contraindications
Use appropriate BSI
Confirm the 5 rights of the medication *
Draw the correct quantity of medication into the syringe
Place the hub of a 14g Teflon catheter (removed from the angiocath) on the end of a needleless syringe
Insert the Teflon catheter into the patient’s rectum and inject the medication. Try to keep the medication on the lower part of the rectum. *
With draw the catheter and hold the patient’s buttocks together, thus permitting retention and absorption
Record procedure
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Orotracheal intubation Course Name: PARA 200 Competency Number: AOCP I-1-2 Student Name: NOCP 5.1h Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Confirm need for intubation
Test and prepare equipment have backup equipment ready
Hyperoxygenate patient *
Position airway align the 3 axis
Insert laryngoscope properly
Visualize vocal cords *
Inserts appropriate size ET tube
Maintains visualization as tube passes the cords
Checks tube placement *
Inflates the cuff with the appropriate amount of air
Auscultate the epigastric area and the chest *
Perform secondary confirmation (CO2 or esophageal detection)
Secures the tube
Record the procedure appropriately
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Ostomy drainage system care
Course Name: PARA 200 Competency Number: AOCP 1-20 Student Name: NOCP 5.5p Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Assess integrity of pouching system
Assess stoma size color and protrusion
Assess peristomal skin for signs of infection/irritation
Ask patient about ostomy output (amount, consistency, color, odor and flatulence)
If system needs draining give patient opportunity and privacy to complete the task on their own
If patient needs assistance for drainage of pouch complete the following…
Gather equipment
Don appropriate BSI precautions
Fill syringe with warm water
Remove rubber band or open drainage device and empty contents into diaper or basin
Flush bag with warm water and drain contents
Secure bag with band or clamp
Document procedure
Students Initials
Instructor Initials
Paramedic Program SKILL CHECKLIST
Nasotracheal Intubation
Course Name: PARA Competency Number: AOCP I-1-2 Student Name: NOCP 5.1f Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Confirms indications for nasotracheal intubation
Assemble and prepare equipment
Hyperoxygenate the patient *
Has suction ready *
Selects the appropriate size ET tube*
Inserts tube through the unobstructed nare with bevel towards septum *
Passes the tube past vocal cords while listening for air movement
Feels tube pass the vocal cords
Auscultates the epigastric region and the chest *
Secures the tube
Ventilates with the BVM
Records the procedure
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
SUTURING
Student Name: _____________________________ Course Name: Para 220 Competency: AOCP I-6-2 The student must demonstrate all steps for successful evaluation by the instructor
Date of Attempt
Instructor Evaluation
Assesses wound for appropriateness of suturing
Assembles equipment and explains procedure to patient
Cleans wound site
Maintains sterile field
Selects sutures
Draws up local anesthetic
Sutures wound
Applies appropriate tension
Ties required knot
Places sterile dressing over wound
Ensure appropriate tetanus vaccination
Considers and explains risk of infection to patient
Student Evaluator Initials:
Instructor Initials: Comments:
Paramedic Program SKILL CHECKLIST
Administer Volume Expanders
Course Name: PARA 220 Competency Number: AOCP I-10-3 Student Name: NOCP 5.5g Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Recognize the indications for volume expansion
Ensure patency of large bore IV
Review 5 rights
Identify solution (Pentaspan) and expiration date
Inspect that the solution is clear and intact
Remove overwrap and attach drip set using aseptic technique
Initiate infusion at appropriate dosage
Monitor for signs of Hypersensitivity
Monitor hemodynamics
Document procedure
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Basic Extrication
Course Name: PARA 220 Competency Number: AOCP B-6-1, A-9 Student Name: NOCP 3.3 c, 1.5c Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Ensure scene safety*
Ensure personnel is wearing protective equipment *
Works collaboratively with other emergency response agencies (Fire, Police)*
Secure C-spine
Assess LOC, airway, breathing and circulation
Recognizes rapid extrication is not needed for this patient*
Works with Fire department in deciding safest means of extrication in a timely manner
Safely extricates patient ensuring spinal motion restriction
Immobilizes patient appropriately for condition
Conducts neurological assessment before and after movement*
Documents procedure
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
CHEST TUBE MONITORING
Course Name: Para 220 Student Name: _____________________________ Competency: AOCP I -19, NOCP 5.5 r The student must demonstrate all steps for successful evaluation by instructor
Date of Attempt
STEPS
Instructor Evaluation
Explains the procedure to the patient and indications
Confirms connection of the drainage system with the patient
Fills with water as required
Connects suction device
Positions drainage system appropriate to the patient
Checks for kinks and obstructions in the tubing
Ensures tubing is not clamped
Acts appropriately if the chest tube become dislodged from the patient
Acts appropriately if the chest drainage system breaks or cracks
Demonstrates steps in correcting a problem with the suction control
Demonstrates steps in correcting a problem with the water seal
Demonstrates steps in correcting problems with the collections chamber
Continually reassesses the patient and documents appropriately
Student Evaluator Initials:
Instructor Initials: Comments:
Paramedic Program SKILL CHECKLIST
Surgical Cricothyrotomy Course Name: PARA 220 Competency Number: AOCP I-1-2 Student Name: NOCP 5.1 l Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Confirm the indication for a surgical airway
Ventilate patient if necessary, inline manual stabilization should be maintained
Gather and prepare equipment
Locate the cricothyroid membrane
Cleanse the area with alcohol or another antiseptic agent
Stabilize thyroid cartilage between thumb and middle finger of one hand
Incises skin over the membrane
Applies skin retractor ( hemostats) if available
Incises cricothyroid membrane *
Enlarges the opening
Inserts the endotracheal tube between the hemostats, just passed the cuff
Inflate the cuff
Connect the BVM with O2 to the ET and ventilate
Confirm the correct tube placement and stabilize the tube
Reassess the patient and record the procedure
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Pleural Decompression Course Name: PARA 220 Competency Number: AOCP I-16 Student Name: NOCP 5.5s Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Ensure airway patency, provide O2, support ventilations if indicated Determine the need for the procedure based on patient’s signs and symptoms* Prepare equipment Locate the insertion site, 2nd intercostal space mid-clavicular line Cleanse the skin with Betadine in a circular motion Attach the selected gauge of intravenous catheter to the syringe Insert the intravenous catheter into the skin and direct the needle Insert the catheter through the parietal pleura until air escapes. It should exit under pressure
Remove the needle stylet from the catheter, advance the catheter and secure in place
Ensure the one-way flutter valve is working Reassess the patient for: improved level of consciousness, improved respiratory effort and improved cardiovascular status
Record the procedure
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Percutaneous Transtracheal Ventilation (PTTV)
Course Name: PARA 220 Competency Number: AOCP I-1-2 Student Name: NOCP 5.1k Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Confirm the indications for a PTTV
Place patient in supine and maintain in-line stabilization
Ventilate if appropriate, use suction if required
Gather and prepare equipment
Locate the cricothyroid membrane
Cleanse the area with alcohol or another antiseptic solution
Insert the needle of the syringe through the midline of the membrane at a 45 degree angle towards the patient’s feet
Advance the catheter over the needle, until the catheter hub comes to rest. Hold the catheter secure, and remove the needle
Secure the catheter appropriately, do not let go
Connect the oxygen to the catheter via the PTTV device hub
Connect the oxygen tubing to the oxygen regulator
Ventilate as per the appropriate guidelines
Watch for chest expansion and auscultate chest for breath sounds
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Rapid/Emergent Extrication
Course Name: PARA 220 Competency Number: NOCP 3.2c Student Name: Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Assesses scene safety and Mechanism of Injury*
Takes control of C-spine if possible
Assesses LOC and airway, breathing and circulation
Recognizes the need for Emergent Extrication*
Acquires access to the patient the fastest and safest way possible
While attempting to control C-spine patient is rapidly removed from vehicle/scene *
Once in a safe area C-spine is controlled and treatment is initiated
Procedure is documented
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Maintain intra-aortic balloon pumps
Course Name: PARA 230 Competency Number: AOCP F-14 Student Name: NOCP 5.5n Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Describes how the IABP functions
Describes who can benefit from this procedure
Before transport review settings and troubleshooting with physician and IABP technician
Ensure battery life and electrical source will be efficient
Ensure that there is enough helium (spare tank)
Ensure communication with transferring or receiving physician can and will be maintained
Before transport review hemodynamics of the patient (LOC, NIBP, arterial BP, pulse, ECG, respiratory status, temp, urine output)
Have inotropic support ready and available
During transport monitor hemodynamics
Notify receiving hospital about patient status and ETA
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Maintaining Transvenous Pacing
Course Name: PARA 230 Competency Number: AOCP I-12-1 Student Name: NOCP 5.5m Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Describe how transvenous Pacemaker functions
Describe who benefits from transvenous pacing
Review equipment and settings with physician
Attach all available monitoring equipment
Attach transcutaneous pacemaker (Physician may order a trial of Pacing to ensure capture if the transvenous pacer fails)
Ensure equipment will function appropriately
Review hemodynamics prior to transport (LOC, NIBP, arterial BP if available, respiratory function, ECG, temp.)
Ensure sedative and analgesic medication is ready and available
Describe what to do for Pacemaker under sensing
Describe what to do for Pacemaker over sensing
Describe what to do for Failure to capture
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Medication administration - IO Course Name: PARA 240 Competency Number: AOCP G-10 Student Name: NOCP 5.8f Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Understands indications and contraindications
Checks IV bag and medications for expiry date
Students Initials
Instructor Initials Comments:
Paramedic Program SKILL CHECKLIST
Intraosseous Course Name: PARA 240 Competency Number: AOCP 1-13 Student Name: NOCP 5.5e Date of Attempt
* Items are critical items. Omission of the step is an automatic failure. Explain the procedure to the patient and family
Identify the site
Assemble the equipment
Prepare the site with Betadine *
Obtain the Intraosseous needle *
Set the needle depth
Insert the needle into bone marrow *
Remove the stylet *
Aspirate the bone marrow
Inject 10ml of normal saline to clear lumen
Attach IV tubing with 3 way stopcock
Secure needle
Infuse fluid and medications
Check for complications *
Record procedure
Students Initials
Instructor Initials Comments:
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