Great Lakes EMS Academy (2016) Name ___________________ EMT-Basic Psychomotor Skills Manual (2017) Great Lakes EMS Academy 1001 South Division Grand Rapids, MI 49507 Phone: 616 459 1736 0 www.GreatLakesEMS.com Great Lakes EMS Academy (2016) Name ___________________ Page left Blank 0 EMT-Basic Psychomotor Skills Manual (2017) Table of Contents Page Introduction 2 Mid-Term and Final Testing 2 To Be Successful 4 2015 AHA BLS Recommendations 5 Cardiac Arrest-ADULT 7 CPR and AED 8 Cardiac Arrest-CHILD 9 Cardiac Arrest-INFANT 10 Choking Patient (FBOA) 11 Learning Checklist for Airway and Ventilation 12 Airway, Oxygen, Suctioning and Ventilation 13 Adult Ventilation – Supraglottic Airway 14 Bleeding Control and Shock 16 Learning Checklist for Musculoskeletal Injuries 17 Splinting - Joint Injury 18 Splinting- Long Bone Injury 19 Femur Fracture Traction Splint 20 Spinal Immobilization Seated Patient (KED) 21 Spinal Immobilization Supine Patient 22 Patient Assessment/Management –TRAUMA 23 Patient Assessment/Management –MEDICAL 25 CPAP 28 Nebulized Albuterol 29 IM Epinephrine (EpiPen) Admin 30 Naloxone (Narcan) Administration (MAD) 31 Assess Vital Signs 32 Blood Glucose Measurement 33 Lifting and Moving with Stretcher 34 NREMT Skill Sheets (Summative Evaluations) 35-47 1 Great Lakes EMS Academy Name ___________________ Introduction This is the Great lakes EMS Academy EMT-Basic Skills Manual. This book is part of the student’s permanent record. The student will have possession of this book throughout the EMT Course. The student should bring this to class every day you never know when there may be time during class to run through some skills or scenarios. We try to teach skills within the first days of class. We follow short discussion on skills with demonstration and then practice…practice…practice. Following practice, the student will go through skills evaluation. During evaluation, a passing score is determined by how many points the student receives from the skill sheet. The minimal score for successful completion is found on the bottom of each of the skill sheets. In traditional EMS classes, students are taught various skills. Then the students practice under the watchful eye of instructors and then test out at the end of class. The Academy has evolved to a different pattern of practice and evaluation. We start testing on skills within a few weeks after the start of class. This allows the student and faculty to see progression in skills proficiency. EMT-Basic students are required to successfully test out several times for each of the skills. The opportunity to test will begin within the first few weeks of class. As adult learners, we all need to be challenged and see progress. Students who fail skills testing will have an opportunity to retest. If the student fails to successfully complete basic skills evaluation after three attempts, they are required to attend a remedial education opportunity within one week of the failed skills evaluation and then be given two more attempts to pass the skills evaluation. The student needs to successfully complete the retest within two weeks of the failed skills evaluation. The remedial education and retest will be scheduled outside of the regularly scheduled class time. At the mid-term and end of class, the faculty will be reviewing the student’s practical skill sheets to assure that the students have passed all the required skills and scenario testing. If there is a problem with the student’s documentation for skills evaluation, the student will be required to show competency in that skill. The Academy purposefully leaves equipment out and available for the students to use outside of class-time to practice. The EMT-Basic student learns skills that can mean life or death for future patients. It is important for the student to not only know how to perform various skills, but to also have the confidence to use the skills when they are needed in the dynamic setting of pre-hospital medicine. The student needs to practice until the skill is as natural as riding a bike. Mid-Term Testing At mid-term testing, the students are tested on the skills that have been learned during the first months of class. At this time, the testing is more formal and the instructors will be using the GLEMSA skill sheets that we use during the normal class sessions. All students are required to pass the following skills1: 1. CPR and AED (random between adult, child and infant) 2. Airway, Oxygenation, Suction and Ventilation 3. Splinting (random between traction, long bone or joint) 4. Trauma Assessment/Management During the Trauma Assessment/Management skills station, the students are placed into groups of three (3). The student being tested will be required to lead his team members through the testing scenario. The station will involve the management of one patient who has sustained one the following injuries/traumatic events: 1. Head Injury 7. Open chest wound 2. Neurogenic (spinal) shock 8. Hemothorax 3. Hemorrhagic shock 9. Amputation 4. Multiple extremity fractures 10. Impaled object 5. Major bleeding 11. Femur fracture 6. Evisceration Attendance on the day of practical testing at the mid-term is mandatory. If a student is absent on the day of testing, the student must plan with faculty to be tested on the skill within two weeks of the missed evaluation. This will be completed outside of the scheduled class time and will cost the student $50.00/hour for as long as testing takes to complete the testing. That could be 3-4 hours at the end of the course. 1 Failure of practical testing will mean failure of the module. The student will not continue with the course. 2 EMT-Basic Psychomotor Skills Manual (2017) Final Testing At the end of the course, practical skills testing is much like the mid-term. However, during the final practical testing we will use the NREMT skill sheets. This testing is the NREMT Practical Skills Evaluation that is mandated as part of the testing process for the National Registry. The students are tested on all the skills that have learned during the entire course. All students are required to pass the following skills2: 1. CPR 2. Bag-Valve-Mask Ventilation 3. Supplemental Oxygen Administration 4. Supraglottic Airway 5. Patient Assessment/Management - Medical 6. Bleeding Control/Shock Management 7. Long Bone Fracture Immobilization 8. Joint Injury Immobilization 9. Traction Splint 10. Spinal Immobilization (Seated Patient) 11. Spinal Immobilization (Supine Patient) 12. Patient Assessment/Management - Trauma The students evaluated on their performance in a trauma and medical assessment / management scenario. The trauma scenario will involve the management of one patient who has sustained one of the injuries listed above and a medical patient with one of the problems/complaints listed below: 1. Shortness of breath (asthma) 8. Anaphylaxis (bee sting) 2. Shortness of breath (pulmonary edema) 9. O.B. / childbirth (normal) 3. Chest pain (cardiac) 10. O.B. / childbirth (breech) 4. Altered mental status (stroke) 11. Hypothermia 5. Altered mental status (low blood sugar) 12. Heat Exhaustion 6. Altered mental status (high blood sugar) 13. Pediatric asthma 7. Altered mental status (status seizure) 14. Pediatric dehydration Attendance on the day of practical testing at the end of class is a big deal. If a student is absent on the day of testing, the student must make arrangements with faculty to be tested on the skill within two weeks of the missed evaluation. This will be completed outside of the scheduled class time and will cost the student $50.00/hour for as long as testing takes to complete the testing. That could be 3-4 hours at the end of the course. 2 Failure of practical testing will mean failure of the course. 3 Great Lakes EMS Academy Name ___________________ To be Successful To pass each practical skill, the student must obtain a score that is at least as high as the minimum score designated at the bottom of the skill sheet and must not violate any of the critical criteria. The student must physically go through all the steps on each practical skill to sufficiently learn it. Simply repeating what is printed on the practical skill sheet is not sufficient, and the student will fail the examination if he or she does that. The student must demonstrate that he or she is capable of physically performing the practical skill, not simply repeating printed lines of text. Each skill must be practiced several times to sufficiently learn it. Simply watching an instructor demonstrate the skill or watching other students practice the skill is not sufficient. The student must physically practice the skill themselves several times to sufficiently learn it. “Standard Precautions” is the first step on each practical skill, and failure to take appropriate standard precautions is a critical failure on many practical skills. Therefore, the student should form the habit of always taking standard precautions before every practical skill. Many steps must be performed in a specific manner to obtain the corresponding point or to avoid violating critical criteria. Alternatively, many steps can be successfully completed in a variety of manners, and instructors practice different styles of demonstrating these steps. Students are responsible for understanding what constitutes critical criteria and which procedures are open to personal variation in style. Some steps must be performed at specific points during the practical skills while others can be performed at points other than the ones printed on the practical skill sheets. Students are responsible for knowing which procedures must be performed at specific points in the practical skills. The most common reason that the student fails a practical skill is because of anxiety. Stay calm and go through the practical skill at a comfortable pace.