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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:


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



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



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



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



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:


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



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



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



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


Students Initials



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



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



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


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



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


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




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



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



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


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




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



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


Students Initials



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



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



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



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



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



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
