aea osce booklet 2012

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Members:D J Taylor (Btech EMC), M J Taylor (A11SA)

Human Emergency Life Programme (Gauteng) cc

Human Emergency Life Programme

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Human Emergency Life ProgrammeGAUTENG Reg. No. CK 1996/019225/23VAT Reg. No. 4530226622

AMBULANCE EMERGENCY ASSISTANT COURSE

OSCE SKILL SHEETS

There will be eight random OSCE skill stations in your final examinations. Those eight will come from the OSCE

skills contained in this booklet.

The pass mark for the practical component of the AEA course is 100%. This means that you are not able to be

assessed as “NOT YET COMPETENT” for any of the OSCE skills. Should you not attain 100% for your OSCE

skills, you will not gain entrance into your final patient simulation examination.

There are thirty-four OSCE skills in this booklet, and they are, in order:

1) Suctioning of the Mouth and Pharynx

2) Use of an Oxygen Cylinder

3) OP Tube and BVM Ventilation

4) Nebulisation

5) Use of ENTONOX

6) Vital Signs: Pulse, Respirations and BP

7) Determination of Blood Glucose Levels

8) Examination of an Unconscious Patient – Medical

9) Examination of an Unconscious Patient – Trauma

10) Application of a Field Dressing

11) Use of Pressure Points

12) Application of a Padded Board Splint – Arm Fracture

13) Application of a Padded Board Splint – Leg Fracture

14) Trauma Traction Splint

15) Log-roll of a Patient onto a Long Spine Board

16) Extrication of a Patient from a Vehicle

17) Normal Vaginal Delivery

18) Breech Delivery

19) Intravenous Therapy

20) Administration of 50% Dextrose

21) Use of an ECG Monitor

22) Use of a Pulse Oximeter

23) Defibrillation

24) Needle Cricothyrotomy

25) Upper Airway Obstruction – with Equipment

26) Needle Thoracentesis

27) Pneumatic Anti-Shock Garment (MAST Suit)

28) One-Man Megacode

29) Adult 1-Rescuer CPR

30) Adult 2-Rescuer CPR

31) Adult FBAO in Responsive Patient (and Responsive Patient who becomes Unresponsive)

32) Child 1-Rescuer CPR

33) Integrated Child FBAO (Responsive and Unresponsive Patient; CPR and Rescue Breathing)

34) Infant 1-Rescuer CPR

35) Integrated Infant FBAO (Responsive and Unresponsive Patient; CPR and Rescue Breathing)

36) CPR and the Use of an AED

H.E.L.P. EMERGENCY MEDICAL TRAINING

CANDIDATE EXAM NUMBER: _____________________ DATE: _____________________

COURSE: FULL TIME _______ PART TIME _______

INTERMEDIATE LIFE SUPPORT – SUCTIONING OF THE MOUTH AND PHARYNX

ACTIVITY

CRITICAL PERFORMANCE

DONE/

NOT

DONE

SAFETY Candidate assesses the area with regards to scene safety. *

AIRWAY Candidate assesses patient’s responsiveness *

Candidate ensures an open, maintained and protected

airway. *

BREATHING

Candidate:

- Assesses patient’s respiratory status

- Administers oxygen as necessary.

*

*

CIRCULATION

Candidate:

- Assesses patient’s pulse and perfusion.

- Arrests life-threatening haemorrhage.

*

*

Candidate establishes IV access. *

Candidate attaches ECG monitor to patient. *

PREPARATION Candidate ensures that the patient is in the lateral

position. *

Candidate prepares all required equipment:

- Suction Unit

- Suction tubing

- Suction catheter (yankauer)

*

*

*

Candidate turns suction unit on, blocks the flow to check

suction pressure, and turns the unit off. *

Candidate connects suction catheter to suction tubing,

ensuring that it is kept clean. *

SUCTIONING Candidate turns the suction unit on. *

Candidate inserts catheter correct distance into the

oropharynx (only as far as candidate can see). *

Candidate blocks the suction catheter opening at the

coupling member. *

Candidate ensures that airway is suctioned clear – while

avoiding hypoxic delay. *

ACTIVITY


DONE/

NOT

DONE

SUCTIONING

CONT. Candidate only suctions on the way out. *

Candidate ensures that patient is placed back on oxygen

after the airway is clear. *

Candidate flushes suction unit system after use. *

* If a critical point is omitted, the final result is automatically not yet competent!

FINAL RESULT: COMPETENT ______ NOT YET COMPETENT ______

COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

___________________________________

Examiner One: Examiner Two:

Name: _________________ Name: ____________________

Qualific: ____________________ Qualific: ____________________

Signature: ____________________ Signature: ____________________


CANDIDATE EXAM NUMBER: _____________________ DATE:

_____________________


INTERMEDIATE LIFE SUPPORT – USE OF AN OXYGEN CYLINDER

ACTIVITY


DONE/

NOT

DONE

PREPARATION OF

O2 CYLINDER

Candidate opens the main valve slowly until an audible

rush of oxygen is heard. *

Candidate closes the main valve rapidly *

APPLICATION OF

THE REGULATOR

Candidate checks that the regulator is the correct one for

the cylinder and that the O-ring seal is present. *

Candidate applies the regulator correctly. *

Candidate opens the cylinder valve slowly, keeping

his/her face clear of the gauges. *

Candidate listens for and notes any leaks.

CONNECTION OF

DELIVERY

DEVICE

Candidate selects the correct oxygen delivery device.

Candidate connects oxygen tubing to the cylinder and to

the delivery device.

*

FLOW

ADJUSTMENT

Candidate opens the flow regulator *

Candidate selects the correct flow rate for the chosen

delivery device *

Candidate correctly applies the delivery device to the

patient, after explaining the procedure. *

TERMINATION OF

O2 THERAPY

Candidate removes the delivery device from the patient.

Candidate turns off the flow meter *

Candidate closes the main cylinder valve. *

Candidate opens the flow meter to bleed the system of

trapped oxygen. *

ACTIVITY


DONE/

NOT

DONE

TERMINATION OF

O2 THERAPY

CONT…

Candidate closes the flow meter



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

____________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – OP TUBE and BVM VENTILATION

ACTIVITY


DONE/

NOT

DONE


AIRWAY Candidate assesses patient’s responsiveness. *


airway. *

BREATHING

Candidate:


- Ensures that adequate ventilation and

oxygenation are in progress.

*

*

CIRCULATION

Candidate:



*

*



OP TUBE

INSERTION

Candidate measures airway from the corner of the mouth

to the angle of the jaw. *

Candidate opens the patient’s mouth. *

Candidate depresses patient’s tongue with tongue

depressor. *

Candidate inserts airway with tip facing downward, and

slides it over the tongue. *

Candidate ensures that the patient’s tongue is not

displaced posteriorly into the oropharynx. *

Candidate ensures that the flange of the OPT is against

the patient’s lips. *

Candidate removes tongue depressor. *

If a gag reflex is present, candidate does not re-insert OP

tube. *

If patient rejects the OP tube, candidate does not re-insert

it. *

VENTILATION Candidate correctly checks and assembles BVMR

Candidate correctly and snugly fits mask to patient’s

face. *

Candidate ventilates patient until chest rises. *

ACTIVITY


DONE/

NOT

DONE

OXYGEN Candidate attaches O2 tubing to O2 cylinder. *

Candidate attaches O2 tubing to BVMR. *

Candidate opens O2 cylinder and adjusts flow rate to 12-

15 litres/min. *

Candidate resumes ventilations. *



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

___________________________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – NEBULISATION

ACTIVITY


DONE/

NOT

DONE




airway. *

BREATHING

Candidate:


- Ensures adequate oxygenation.

*

*

CIRCULATION

Candidate:



*

*

COMPLETION OF

RESPIRATORY

ASSESSMENT

Candidate determines the need for B2 Stimulant

nebulisation and rules out contra-indications. *

PREPARATION

Candidate correctly checks and assembles all equipment

required for nebulisation:

- Nebuliser

- Oxygen with tubing

- Syringe and needle

- B2 Stimulants

*

*

*

*

Candidate checks drug for:

- Correct drug

- Expiry date

- Cloudiness and leaks

- Dosage of drug.

*

*

*

*

Candidate calculates dose required. *

Candidate injects required drug/s into nebuliser and

connects to oxygen source. *

ACTIVITY


DONE/

NOT

DONE

NEBULISATION Candidate connects nebuliser to oxygen source. *

Candidate selects an oxygen flow rate of 4-6 litres/min

and ensures that the nebuliser mask is misting

appropriately.

*

Candidate securely fits nebuliser mask to patient’s face. *

Candidate instructs patient to take slow, deep breaths. *

REASSESSMENT Candidate assesses the patient for effectiveness or side-

effects of nebulisation. *

Candidate monitors the patient’s vital signs, including

noting the patient’s blood sugar level 5 minutes post

nebulisation.

*

Candidate records drug administration correctly. *

Candidate repeats administration of B2 stimulant

nebulisation as required, and as per protocol. *



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

___________________________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – USE OF ENTONOX

ACTIVITY


DONE/

NOT

DONE

PREPARATION OF

ENTONOX

CYLINDER

Candidate opens the main valve slowly until an audible

rush of ENTONOX is heard. *

Candidate closes the main valve rapidly *

APPLICATION OF

THE REGULATOR

Candidate checks that the regulator is the correct one for

the cylinder and that the O-ring seal is present. *

Candidate applies the regulator correctly. *

Candidate opens the cylinder valve slowly, keeping

his/her face clear of the gauges. *

Candidate listens for and notes any leaks.

EXPLANATION OF

PROCEDURE

Candidate ensures that the patient understands how to

use the ENTONOX by demonstrating the procedure and

ensuring that the demand valve is functional

*

Candidate ensures that the face-mask fits the patient

snugly. *

Candidate indicates that the ENTONOX will produce its

peak effect in 3 to 4 minutes *

TERMINATION OF

ENTONOX

THERAPY

Candidate removes the delivery device from the patient.

*

Candidate turns off the flow meter *

Candidate closes the main cylinder valve. *

Candidate presses the orange purge button to bleed the

system of trapped ENTONOX. *



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

____________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – VITAL SIGNS: PULSE, RESPIRATIONS and BP

ACTIVITY


DONE/

NOT

DONE

PULSE

MEASUREMENT

Candidate correctly locates a palpable pulse at the radial

artery. *

Candidate palpates pulse with fingertips and not with the

thumb. *

Using a watch with a second hand, or with a countdown

display, candidate times the pulse for 15 or 30 seconds. *

Candidate reports the pulse rate, rhythm and strength. *

Candidate is accurate in his/her assessment of the pulse

(examiner please to check) *

RESPIRATION

MEASUREMENT

Candidate observes the rise and fall of the patient’s chest

(may do so while holding the patient’s arm to their chest) *

Using a watch with a second hand, or with a countdown

display, candidate times the respirations for 30 seconds. *

Candidate reports the respiratory rate, rhythm and depth. *

Candidate is accurate in his/her assessment of the

respirations (examiner please to check) *

BLOOD PRESSURE

MEASUREMENT

Candidate explains the procedure to the patient

Candidate snugly attaches the BP cuff in the correct

position *

Candidate inflates the cuff to just above the point at

which the radial pulse disappears (systolic BP) or

approximately 160mmHg.

*

Candidate places the diaphragm of the stethoscope over

the brachial artery (medial aspect of the arm) *

Candidate slowly deflates the cuff, observing the gauge

and listening for Korotkoff sounds. *

Candidate is accurate in his/her assessment of the BP

(examiner please to chech – within 10mmHg either side

of the actual measurement)

*



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

____________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – DETERMINATION OF BLOOD GLUCOSE LEVELS

ACTIVITY


DONE/

NOT

DONE

EXAMINER STATES THAT THE PRIMARY AND

SECONDARY SURVEYS HAVE BEEN

PERFORMED

PREPARATION

Candidate selects the correct equipment for the

procedure:

* Glucose test strips

* Blood Lancets

*Gauze swabs

* Watch with second hand/countdown display

* Gloves

* Alcohol swab (not essential)

*

*

*

*

*

Candidate checks the expiry date of the glucose test

strips. *

PROCEDURE Candidate selects a glucose test strip and closes the

container lid soon after removing the strip. *

Candidate explains the procedure to the patient.. *

Candidate safely, and ensuring sterility, opens the blood

lancet. *

Candidate milks the finger chosen for finger-prick.

Candidate pricks the finger at the tip and on the side of

the chosen finger – squeezing the finger at the same

time.

*

Candidate obtains a suitably sized drop of blood. *

Candidate places the drop of blood on the reagent strip of

the glucose test strip without touching the patient’s

finger excessively on the reagent strip.

EVALUATION Candidate waits 60 seconds *

Candidate blots the blood carefully, yet firmly off the

test strip. *

Candidate waits a further 60 seconds. *

ACTIVITY


DONE/

NOT

DONE

EVALUATION

CONTINUED…

Candidate compares the colour reagent strip to the colour

blocks on the test strip bottle. *

Candidate obtains a reading in mg/% or mmol/L. *

Candidate is accurate in his/her assessment of the HGT

(examiner please to check) *



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

___________________________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – EXAMINATION OF AN UNCONSCIOUS PATIENT

(Medical)

ACTIVITY


DONE/

NOT

DONE


AIRWAY Candidate determines that the patient is unresponsive. *


airway. *

BREATHING

Candidate:

- Checks patient’s mouth for foreign material



*

*

*

CIRCULATION

Candidate:



*

*



GENERAL

APPEARANCE

Candidate assesses patient’s skin colour, temperature and

condition. *

HEAD-TO-TOE

SURVEY Candidate assesses for facial symmetry. *

Candidate checks patient’s pupils for size, equality and

reaction to light. *

Candidate examines the patient’s neck for distended

neck veins. *

Candidate examines for use of accessory muscles of

breathing. *

Candidate observes patient’s respiratory excursion, and

auscultates for equal air entry and breath sounds. *

Candidate examines patient’s chest for any implantable

devices. *

Candidate examines patient’s chest for any unusual

markings or bruising – including surgical scars. *

ACTIVITY


DONE/

NOT

DONE

HEAD-TO-TOE

SURVEY CONT.

Candidate palpates the patient’s abdomen, and examines

for distension, tenderness, guarding and rigidity. *

Candidate examines patient’s abdomen for any unusual


Candidate examines patient for signs of incontinence. *

Candidate inspects the patient’s torso for signs of

oedema. *

Candidate examines the patient’s limbs for signs of

oedema. *

Candidate examines patient’s limbs for neurovascular

patency. *

Candidate checks motor function in the patient’s limbs. *

Candidate inspects patient for presence of medical

identification. *

Candidate turns the patient and examines the patient’s

back for any unusual markings or bruising – including

surgical scars.

*



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

____________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – EXAMINATION OF AN UNCONSCIOUS PATIENT

(Trauma)

ACTIVITY


DONE/

NOT

DONE


AIRWAY Candidate determines that the patient is unresponsive. *

Candidate ensures an open airway – using the head-tilt

chin-lift or jaw thrust techniques. *

BREATHING

Candidate:

- Checks patient’s mouth for foreign material

- Look, listen and feel for breathing

*

*

If breathing is absent or inadequate, candidate gives the patient 2 slow breaths (2 seconds

per breath), ensuring that there is adequate chest rise, and that he allows for exhalation

between breaths.

CIRCULATION

Candidate:



*

*



GENERAL

APPEARANCE

Candidate assesses patient’s skin colour, temperature and

condition. *

HEAD-TO-TOE

SURVEY Candidate notices obvious wounds and deformities. *

Candidate examines patient’s scalp for injury and

bruising. *

Candidate checks the patient’s nose and ears for injury

and discharge. *

Candidate examines the patient’s eyes for signs of injury. *

Candidate checks patient’s pupil size, equality and

reaction to light. *

Candidate examines patient’s facial bones and jaw for

deformity and stability. *

Candidate smells patients breathe for abnormal odours. *

Candidate examines the patient’s neck for wounds and

deformity. *

ACTIVITY


DONE/

NOT

DONE

Candidate checks for tracheal deviation and distended

neck veins. *

Candidate correctly applies a cervical collar *

Candidate examines patient’s chest for wounds and

stability. *

Candidate observes patient’s respiratory excursion, and

auscultates for equal air entry and breath sounds. *

Candidate examines patient’s chest for any implantable

devices. *

Candidate examines patient’s chest for any unusual


Candidate palpates the patient’s abdomen, and examines

for wounds, distension, tenderness, guarding and

rigidity.

*

Candidate examines patient’s abdomen for any unusual


Candidate examines patient’s pelvis for wounds,

stability, signs of incontinence, and priapism (in males). *

Candidate examines the patient’s limbs for wounds and

deformity. *

Candidate examines patient’s limbs for neurovascular

patency. *

Candidate checks motor function in the patient’s limbs. *

Candidate inspects patient for presence of medical

identification. *

Candidate logrolls the patient and examines his back for

wounds and deformity.

Candidate examines the patient’s back for any unusual




COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

__________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – APPLICATION OF A FIELD DRESSING

ACTIVITY


DONE/

NOT

DONE

The Examiner states that the patient is conscious and has a wound – Examiner to point out

the wound site

PATIENT

ASSESSMENT 1O

SURVEY

Candidate verbally indicates that a primary survey

should be done.

If profuse bleeding is present, Candidate is to state that

immediate direct pressure needs to be applied.

Candidate verbally indicates that a secondary survey

should be done.

Candidate checks pulse distal to the wound. IF the

wound is to a limb (preferred site) *

WOUND CARE Candidate checks the wound for presence of foreign

bodies. *

OPENING OF

DRESSING

Candidate opens the dressing packaging without causing

contamination and removes the dressing. *

Candidate unrolls the short end of the bandage until the

dressing is free.

Candidate keeps the wound contact service of the

dressing folded-in on itself. *

APPLICATION OF

THE DRESSING

Candidate opens the wound contact surface of the

dressing and immediately applies it to the wound. *

Candidate uses the bandage to secure the dressing in

place. *

Candidate covers both open ends of the dressing. *

Candidate ensures that the dressing is not so tight as to

restrict circulation. *

Candidate checks pulses distal to the wound. *

Candidate evaluates the injured part where possible.

Candidate assesses whether or not the bleeding is

controlled. *



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

_____________________________________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – USE OF PRESSURE POINTS

ACTIVITY


DONE/

NOT

DONE




airway. *

BREATHING

Candidate:



*

*

CIRCULATION

Candidate:



*

*

Candidate establishes IV access.

Candidate attaches ECG monitor to patient

PATIENT

ASSESSMENT

Candidate indicates that primary and secondary surveys

have been performed. *

The Examiner is to state which pressure point is to be used by giving examples of bleeding

sites

TEMPORAL Candidate correctly locates pulse point *

Candidate uses the side of his/her thumb to compress the

artery *

Candidate assesses whether or not indirect pressure is

successful (checks distal pulse or assesses for

slowing/stopping of bleeding)

*

FACIAL Candidate correctly locates pulse point *

Candidate uses the side of his/her thumb to compress the

artery *




*

ACTIVITY


DONE/

NOT

DONE

BRACHIAL Candidate correctly locates pulse point *

Candidate uses his/her fingertips to compress the artery *




*

FEMORAL Candidate correctly locates pulse point *

Candidate sits at the patients’ side opposite to the side of

the injury *

Candidate places his/her fist on the artery (on the injured

side) and uses his/her body weight to compress the artery *




*



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

_________________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – APPLICATION OF A PADDED BOARD SPLINT

(ARM FRACTURE)

ACTIVITY


DONE/

NOT

DONE




airway. *

BREATHING

Candidate:



*

*

CIRCULATION

Candidate:



*

*

PATIENT

ASSESSMENT



Candidate exposes arm with suspected fracture without

unnecessary movement. *

Candidate assesses:

- Radial pulse

- Movement in limb

- Sensation in limb

- Skin colour, temperature and condition in limb

- Capillary refill

*

*

*

*

*

Candidate assesses wrists, elbow and shoulder for

associated injuries.

SPLINTING Candidate explains the procedure to the patient. *

Candidate requests that partner applies steady

longitudinal traction and realign the limb as necessary.

Candidate evaluates for the presence of a radial pulse

following the application of longitudinal traction.

Candidate aligns a padded board splint under or

alongside the injured limb. *

ACTIVITY


DONE/

NOT

DONE

SPLINTING CONT. Candidate ensures that the padded splint extends from

the hand to the mid-humerus. *

Candidate ensures that any natural hollows between the

splint and the patients’ limb are filled with gauze or

similar material.

Candidate secures the padded splint to the patients’ arm

with roller bandages, ensuring to cover the entire length

of the splint.

*

Candidate performs the splinting procedure with minimal

movement of the injured limb. *

Candidate requests that partner releases longitudinal

traction if applied.

Candidate re-assesses:

- Radial pulse

- Movement in limb

- Sensation in limb


- Capillary refill

*

*

*

*

*

Candidate elevates the splinted arm.



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

____________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – APPLICATION OF A PADDED BOARD SPLINT

(LEG FRACTURE)

ACTIVITY


DONE/

NOT

DONE




airway. *

BREATHING

Candidate:



*

*

CIRCULATION

Candidate:



*

*

PATIENT

ASSESSMENT



Candidate exposes leg with suspected fracture without


Candidate assesses:

- Pedal pulse

- Movement in limb

- Sensation in limb


- Capillary refill

*

*

*

*

*

Candidate assesses ankle, knee and hip for associated

injuries.


Candidate requests that partner applies steady

longitudinal traction and realign the limb as necessary.

Candidate evaluates for the presence of a pedal pulse

following the application of longitudinal traction.

Candidate aligns a padded board splint under or

alongside the injured limb. *

ACTIVITY


DONE/

NOT

DONE

SPLINTING CONT. Candidate ensures that the padded splint extends from

the foot to the mid-thigh. *

Candidate ensures that any natural hollows between the

splint and the patients’ limb are filled with gauze or

similar material.

Candidate secures the padded splint to the patients’ leg

with roller bandages, ensuring to cover the entire length

of the splint.

*

Candidate performs the splinting procedure with minimal

movement of the injured limb. *

Candidate requests that partner releases longitudinal

traction if applied.


- Pedal pulse

- Movement in limb

- Sensation in limb


- Capillary refill

*

*

*

*

*

Candidate elevates the splinted leg.



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

____________________


Name: ____________________ Name: ____________________



H.E.L.P.


_____________________


INTERMEDIATE LIFE SUPPORT – TRAUMA TRACTION SPLINT

ACTIVITY


DONE/

NOT

DONE




airway. *

BREATHING

Candidate:



*

*

CIRCULATION

Candidate:



*

*



PATIENT

ASSESSMENT



Candidate exposes leg with suspected fracture without


Candidate removes the patient’s shoes and socks. *

Candidate assesses:

- Pedal pulse

- Movement in limb

- Sensation in limb


- Capillary refill

*

*

*

*

*


Candidate fastens ankle stirrup strap. *

Candidate correctly measures traction splint against

patient’s uninjured leg. *

Candidate requests partner to grasp the patient’s ankle

and apply gentle longitudinal traction. *

Candidate slides traction splint into position. *

ACTIVITY


DONE/

NOT

DONE

SPLINTING CONT.

Candidate ensures that the splint is seated correctly

against the ischial tuberosity, and ensures that the splint

is not pressing against the patient’s genitals.

*

Candidate secures the ischial strap of the splint. *

Candidate attaches ankle strap to traction mechanism,

and starts pulling mechanical traction. *

Candidate requests that partner releases his grip slowly

as the traction splint takes over traction. *


- Pedal pulse

- Movement in limb

- Sensation in limb


- Capillary refill

*

*

*

*

*

Candidate adjusts traction as necessary. *

Candidate secures traction splint to patient’s leg –

ensuring not to strap over the fracture site. *

Candidate elevates the foot of the splint. *

* If a critical point is omitted, the final result is automatically unsatisfactory!

FINAL RESULT: SATISFACTORY ______ UNSATISFACTORY ______

COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

____________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – LOGROLL OF A PATIENT ONTO A LONG SPINE

BOARD

ACTIVITY


DONE/

NOT

DONE




airway. *

BREATHING

Candidate:



*

*

CIRCULATION

Candidate:



*

*

C-SPINE

IMMOBILISATION Candidate instructs the patient not to move. *

Candidate requests partner to place himself at the

patients’ head.

Candidate explains procedure to the patient. *

Candidate requests that partner maintains support of the

patient’s head and neck in alignment with the patient’s

body.

*

Candidate correctly applies a cervical collar and

instructs partner to maintain manual stabilisation of the

patient’s head and neck.

*

PREPARATION

FOR LOGROLL

Candidate prepares equipment:

- Spine Board

- Base Plate

- Head Blocks

- Spider Harness/straps

Candidate positions him/herself at the patients’ side,

kneeling at the patients’ shoulders.

Candidate requests a third persons to kneel at the

patients’ buttocks on the same side

ACTIVITY


DONE/

NOT

DONE

PREPARATION

FOR LOGROLL

CONT.

Candidate ensures that he/she has a proper grasp by

placing one hand on the patients’ furthermost shoulder

and another hand at the patients’ hip.

Candidate ensures that third person places one hand at

the patients’ buttocks and the other hand at the patients’

mid-thigh.

LOGROLL

Candidate instructs the person maintaining manual

stabilisation of the patients’ head to be in control of the

logroll procedure.

*

On the count of the person at the patients’ head, the

patient is rolled onto his/her side as a unit whilst the

patients’ head and neck remains in alignment with the

rest of the patients’ body.

*

Candidate requests that spine board is pulled under and

aligned with the patient. *

On the count of the person at the patients’ head, the

patient is lowered, as a unit, onto the spine board. *

SECURING THE

PATIENT TO THE

SPINE BOARD

Candidate adequately secures the patient to the spine

board by placing straps over the patients’ chest, thighs

and knees (or by securing a full spider harness over the

patient).

*



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

____________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – EXTRICATION OF A PATIENT FROM VEHICLE

ACTIVITY


DONE/

NOT

DONE




airway. *

BREATHING

Candidate:



*

*

CIRCULATION

Candidate:



*

*



C-SPINE

IMMOBILISATION

Candidate requests partner to place himself behind the

patient. *

Candidate explains procedure to the patient. *

Candidate requests that partner maintains support of the

patient’s head and neck in alignment with the patient’s

body.

*

Candidate correctly applies a cervical collar and

instructs partner to maintain manual stabilisation of the

patient’s head and neck.

*

HEAD-TO-TOE

SURVEY Examiner states that there are no obvious injuries.

Candidate states that vital signs would also be checked. *

PREPARATION

FOR EXTRICATION

Candidate correctly positions extrication device behind

patient. *

Candidate correctly secures patient to extrication device. *

ACTIVITY


DONE/

NOT

DONE

PREPARATION

FOR

EXTRICATION

CONT.

Candidate places padding between the patient’s neck and

the extrication device – as required.

Candidate secures the patient’s head to the extrication

device. *

Candidate requests that partner release manual

stabilisation of the patient’s head and neck. *

EXTRICATION Candidate supervises partner to assist him in positioning

the patient onto a long spine board. *

Candidate, with assistance, places the spine board onto

the ground.

Candidate secures patient to spine board. *

Candidate removes patient, on spine board, to a safe

place. *

SECONDARY

SURVEY

Candidate performs a full secondary survey on the

patient, and re-records a full set of vital signs. *



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

____________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – NORMAL VAGINAL DELIVERY

ACTIVITY


DONE/

NOT

DONE




airway. *

BREATHING

Candidate:



*

*

CIRCULATION

Candidate:



*

*



PREPARATION Candidate positions mother with buttocks at the edge of

the bed with knees flexed. *

Candidate prepares all required equipment:

- Cord clamps.

- Scissors/blade

- Pads

- Warm blanket

- Mucous extractor

- Resuscitation equipment

*

*

*

*

*

*

DELIVERY Candidate places gentle pressure on the baby’s head to

prevent it from delivering too quickly. *

Candidate protects the perineum from tearing. *

ACTIVITY


DONE/

NOT

DONE

DELIVERY CONT.

Once the baby’s head is delivered, candidate removes

mucous and blood from the baby’s mouth and nose, and

suctions gently if necessary.

*

Candidate checks for the umbilical cord around the

baby’s neck:

a. If present, slip it over the baby’s head.

b. If it is too tight to slip over the baby’s head, it

must be double clamped and cut between the

clamps.

*

*

Candidate allows restitution to take place. *

Candidate places palms on either cheek to apply gentle

downward traction to deliver the anterior shoulder. *

Candidate applies gentle upward traction on the head to

deliver the posterior shoulders. *

Candidate grasps the baby firmly as it delivers. *

Candidate holds the infant’s head down to allow fluid to

drain from its airway. *

Candidate places the infant in the lateral position and

clears the airway if necessary. *

Candidate double clamps the umbilical cord and cuts the

cord between the clamps. *

Candidate cleans and dries the infant. *

Candidate takes the APGAR score one minute after birth

of the infant. *

Candidate inspects the cord for bleeding. *

Candidate wraps the infant in a warm blanket and gives

it to the mother. *

DELIVER OF THE

PLACENTA

Candidate applies gentle pressure over, and massages the

uterus. *

Candidate encourages the mother to push. *

Candidate does not pull on the umbilical cord. *

When the placenta delivers, candidate places it in a

plastic bag and takes it with to hospital. *

ACTIVITY


DONE/

NOT

DONE

DELIVER OF THE

PLACENTA CONT.

Candidate continues to massage the uterus. *

Candidate allows only 20 minutes for the delivery of the

placenta.

Candidate cleans the mother appropriately.

Candidate notes time of delivery of baby and placenta.

Candidate administers post natal care to the mother and

baby. *



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

___________________________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – BREECH DELIVERY

ACTIVITY


DONE/

NOT

DONE




airway. *

BREATHING

Candidate:



*

*

CIRCULATION

Candidate:



*

*



PREPARATION Candidate positions mother with buttocks at the edge of

the bed with knees flexed. *

Candidate prepares neonatal resuscitation equipment. *

Candidate allows the foetus’ legs, buttocks and trunk to

deliver spontaneously (don’t pull!). *

Candidate supports baby’s weight on left forearm.

Candidate checks for the umbilical cord around the

baby’s neck. *

LOVESET

MANOEUVRE Candidate grasps baby’s pelvis with both hands. *

Candidate rotates baby 90o until anterior arm is freed. *

If arm not free, locate arm and free it from under the

symphysis pubis, by gently pulling down across the face

and the chest.

*

Candidate gently rotates baby to the opposite side. *

Candidate re-performs steps of Loveset manoeuvre to

free second arm. *

ACTIVITY


DONE/

NOT

DONE

MAURICEAU-

SMELLIE-VEIT

MANOEUVRE

Candidate straddles baby on left forearm, with palm

facing upward. *

Candidate inserts middle finger on baby’s occiput. *

Candidate places index and ring finger on either side of

the baby’s neck. *

Candidate lifts the baby’s body upwards. *

Candidate flexes baby’s head by applying traction on jaw

and pressure on occiput. *

Candidate slowly extracts baby’s head upward when

fully flexed. *

Candidate checks for umbilical cord around baby’s neck

and removes if present. *

Candidate administers post natal care to the mother and

baby. *



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

___________________________________


Name: ____________________ Name: ____________________



H.E.L.P.


_____________________


INTERMEDIATE LIFE SUPPORT – INTRAVENOUS THERAPY

ACTIVITY


DONE/

NOT

DONE




airway. *

BREATHING

Candidate:



*

*

If the patient is not breathing adequately, or is not breathing at all, the candidate is to give

2 slow breaths using an appropriate device (BVM).

CIRCULATION

Candidate:



*

*

DETERMINE NEED

FOR IV THERAPY

Candidate obtains the patient’s vital signs and

determines the need for IV therapy.

PREPARATION Candidate explains the procedure to the patient.

Candidate selects appropriate fluid. *

Candidate checks vacolitre for cloudiness, leaks and

expiry date. *

Candidate selects correct administration set and attaches

correctly to vacolitre. *

Candidate fills the administration set chamber halfway

and flushes the tubing, ensuring the line is free of air. *

Candidate closes the line clamp and recovers the tubing

tip. *

Candidate selects correct cannula. *

Candidate places BP cuff on patient’s arm and inflates to

just below the systolic BP. *

ACTIVITY


DONE/

NOT

DONE

VENIPUNCTURE Candidate selects suitable vein and cleans site with

alcohol swab.

Candidate stabilises vein with non-dominant hand.

Candidate inserts needle through the skin, bevel facing

upward, into a vein. *

Candidate advances needle until backflow is seen. *

Candidate slides the catheter over the needle into the

vein and withdraws the needle. *

Candidate attaches IV administration set to catheter and

deflates the BP cuff. *

Candidate opens the flow clamp wide open, and checks

the placement and checks the patient’s arm for swelling

indicating infiltration of the tissue.

*

Candidate adjusts the flow rate as desired. *

Candidate secures cannula and tubing with appropriate

strapping. *



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

___________________________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – ADMINISTRATION OF 50% DEXTROSE

ACTIVITY


DONE/

NOT

DONE




airway. *

BREATHING

Candidate:



*

*



CIRCULATION

Candidate:



*

*

COMPLETION OF

SECONDARY

SURVEY

Candidate determines the need for 50% dextrose

administration and rules our contra-indications. *

PREPARATION

Candidate checks drug for:

- Correct drug

- Expiry date

- Cloudiness and leaks

- Dosage of drug.

*

*

*

*

Candidate calculates dose required. *

Candidate draws up correct dose into syringe and

eliminates excess air. *

ADMINISTRATION Candidate establishes IV access. *

Candidate cleans the administration site with alcohol

swab. *

Candidate ensures a free-flowing IV line. *

Candidate slowly administers desired dose of 50%

dextrose. *

ACTIVITY


DONE/

NOT

DONE

REASSESSMENT Candidate assesses the patient for effectiveness or side-

effects of 50% dextrose administration. *

Candidate monitors the patient’s vital signs, especially

noting the patient’s blood sugar level 5 minutes post

dextrose administration.

*

Candidate records drug administration correctly. *

Candidate repeats administration of 50% dextrose as

required, and as per protocol. *



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

___________________________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – USE OF AN ECG MONITOR

ACTIVITY


DONE/

NOT

DONE




airway. *

BREATHING

Candidate:



*

*



CIRCULATION

Candidate:



*

*

COMPLETION OF

PRIMARY SURVEY

Candidate determines the need for ECG monitoring. *

PREPARATION

Candidate checks patient for:

- Dry skin for application of ECG electrodes

- Skin area free of excess hair for application of

ECG electrodes (shaves if necessary)

Candidate prepares the following equipment:

- Appropriate number of ECG electrodes (for

monitor)

- ECG electrode wires CONNECTED to ECG

monitor

- Pre-placement of ECG electrodes onto ECG

electrode wires.

*

*

*

*

*

ACTIVITY


DONE/

NOT

DONE

APPLICATION

(EUROPEAN ECG

MONITOR)

Candidate places ECG electrodes as follows:

- Red electrode to the right shoulder (infra-

clavicular)

- Yellow electrode to the left shoulder (infra-

clavicular)

- Green electrode to the left mid-axillary line at

base of costal margin.

If black electrode present:

- Black electrode to the right mid-axillary line at


*

*

*

*

APPLICATION

(AMERICAN ECG

MONITOR)

Candidate places ECG electrodes as follows:

- White electrode to the right shoulder (infra-

clavicular)

- Black electrode to the left shoulder (infra-

clavicular)

- Red electrode to the left mid-axillary line at base

of costal margin.

If green electrode present:

- Green electrode to the right mid-axillary line at


*

*

*

*

Candidate ensures that the monitor is turned to “lead II”

for monitoring purposes. *

INTERPRETATION Candidate prints a six second (30 big block) strip of

“lead II”. *

Candidate assesses the rhythm strip and accurately notes

the following features:

- Rhythm (in terms of regularity)

- Rate (as calculated from the strip and not

monitor)

- ECG diagnosis (as per ILS rhythm strips)

*

*

*



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

____________________________________________________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – USE OF A PULSE OXIMETER

ACTIVITY


DONE/

NOT

DONE




airway. *

BREATHING

Candidate:



*

*



CIRCULATION

Candidate:



*

*

COMPLETION OF

PRIMARY SURVEY

Candidate determines the need for pulse oximetry. *

PREPARATION

Candidate checks patient for:

- Signs and symptoms of profound shock

- Pulse/ perfusion on the limb being used

- Clean finger (for finger probe)

- Presence of nail varnish (even clear coat)

- Recent use of intravenous dyes (methylene blue,

etc)

- Cold extremities

- History of Sickle Cell Disease (underestimate

SaO2 by 8%)

- Toxic Inhalations (carboxyhaemoglobinaemia &

methaemglobinaemia)

*

*

*

*

*

*

*

*

APPLICATION Candidate places finger probe snugly over the patient’s

finger. *

Candidate ensures that there is not excessive ambient

light affecting the probe (may show “poor signal”) *

Candidate ensures that patient is not excessively moving

his/her hand with probe attached to finger. *

ACTIVITY


DONE/

NOT

DONE

ASSESSMENT Candidate checks that pulse oximeter shows adequate

signal generation. *

Candidate checks that an adequate waveform is seen on

pulse oximeter screen (if available).

Candidate notes pulse oximeter reading. *

Candidate is aware of the difference between a “false

positive” and “false negative” pulse oximetry reading,

and the causes thereof.

*



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

___________________________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – DEFIBRILLATION

ACTIVITY


DONE/

NOT

DONE



Candidate opens patient airway (Head-Tilt/Chin Lift or

Jaw Thrust) *

BREATHING Candidate assesses patient’s breathing for maximum of

10 seconds. *



CIRCULATION Candidate assesses patient’s carotid pulse for a

maximum of 10 seconds. *

If the arrest was not witnessed, candidate is to perform 2 minutes (5 cycles) of CPR prior to

defibrillation. If the collapse was witnessed, immediate defibrillation is to be done.

PREPARATION Set monitor to 360 Joules (monophasic) or to 150/200

Joules (biphasic) (adult) or 2J/kg (child) *

Ensure “Sync” button switched off

DEFIBRILLATION Defibrillator gel to be placed on paddles. *

Determine correct paddle position and press down with

at least 20kg force to reduce trans-thoracic impedance. *

Check rhythm on monitor (Quick Look Paddles or lead

II) *

If Ventricular Fibrillation or Pulseless Ventricular Tachycardia present, continue with

defibrillation.

Charge monitor to 360 Joules (monophasic) or to

150/200 Joules (biphasic) (adult) or 2J/kg (child) *

Ensure that all persons are clear of the patient (I’m

Clear, You’re Clear, Oxygen clear, Everybody’s Clear). *

1 Candidate depresses both discharge buttons at the same

time to deliver shock, and observes ECG rhythm. *

After defibrillation, the candidate is to proceed with CPR starting with chest compressions.

Candidate performs 2 minutes (5 cycles) or CPR,

pushing hard and fast at a rate of at least 100

compressions a minute using the 30:2 compression-to-

ventilation ratio.

*

ACTIVITY


DONE/

NOT

DONE

ALS ASSISTANCE Candidate establishes ALS back-up.

DEFIBRILLATION

CONTINUED…

Candidate assesses cardiac rhythm through paddles. If

the rhythm remains unchanged, candidate is to continue

with defibrillation.

Candidate is only to check the patient’s pulse if the rhythm displayed on paddle check is an

organised rhythm. If the presenting rhythm is not organised and not shockable, the

candidate is to continue with CPR.

Charge monitor to 360 Joules (monophasic) or to 150

Joules (biphasic) (adult) or 4J/kg (child) *

Ensure that all persons are clear of the patient (I’m

Clear, You’re Clear, Oxygen clear, Everybody’s Clear). *

2 Candidate depresses both discharge buttons at the same

time to deliver shock. *

After defibrillation, the candidate is to proceed with CPR starting with chest compressions.

Candidate performs 2 minutes (5 cycles) or CPR,

pushing hard and fast at a rate of at least 100

compressions a minute using the 30:2 compression-to-

ventilation ratio.

*

Candidate repeats cycles of defibrillation and CPR as

necessary and continues until ALS arrives, or until

return of spontaneous circulation.



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

____________________


Name: __________________ Name: _________________

Qualific: _____________________ Qualific: ____________________

Signature: _____________________ Signature: ____________________



_____________________


INTERMEDIATE LIFE SUPPORT – NEEDLE CRICOTHYROTOMY

ACTIVITY


DONE/

NOT

DONE

SAFETY Candidate assesses the area with regards to scene

safety. *



airway. *

BREATHING Candidate:


*

*

CIRCULATION Candidate:


*

*

VENTILATION Candidate attempts to ventilate the patient. *

Candidate repositions the patient’s airway and

reattempts ventilation. *

All other methods (e.g. abdominal thrust) fail to remove

obstruction. *

CRICOTHYROTOMY Candidate correctly assembles and checks equipment.

Candidate places the patient in a supine position. *

Candidate cleans the anterior neck with alcohol swab.

Candidate correctly locates the cricothyroid membrane. *

Candidate stabilises the thyroid cartilage. *

Candidate punctures the skin midline directly above the

cricothyroid membrane with a 14G Jelco with a 20mL

syringe attached (saline in syringe for bubbling to

occur).

*

Candidate inserts needle into cricothyroid membrane

and directs needle 45o caudally, applying a negative

pressure to the syringe, and advancing until air is

aspirated.

*

Candidate withdraws the needle while simultaneously

advancing the 14G cannula into position. *

ACTIVITY


DONE/

NOT

DONE

VENTILATION

Candidate attaches a 3-way tap to oxygen tubing, as well

as to the cannula:

a. Open all taps in all directions on the 3-way tap.

b. Set oxygen flow rate at 1 lire per minute per year

of age (up to a maximum of 8 litres/minute).

c. Occlude the open 3-way tap hole for 1 second,

and release (open) it for 4 seconds.

d. Watch for chest rise.

*

Candidate secures the cannula and tap to the patient’s

neck. *

Candidate ventilates the patient, auscultates the chest and

epigastrium for adequate ventilation. *

IF A CRITICAL POINT IS OMITTED, THE FINAL RESULT IS AUTOMATICALLY NOT YET

COMPETENT!


COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – UPPER AIRWAY OBSTRUCTION (with equipment)

ACTIVITY


DONE/

NOT

DONE


AIRWAY Candidate assesses patient’s responsiveness. *

Candidate opens the patient’s airway. *

BREATHING

Candidate:


- Attempts finger sweep if obstruction visible.

*

*

VENTILATION Candidate attempts ventilation. *

Candidate repositions the patient’s airway and re-

attempts ventilation. *

If obstruction still visible and not removed by finger

sweep, candidate prepares equipment:

- Tongue depressor

- Magills forceps

*

*

REMOVAL OF

OBSTRUCTION

Candidate depresses patient’s tongue with tongue

depressor. *

Under direct vision, candidate inserts Magills forceps

into patient’s airway and removes obstruction. *

If obstruction can not be removed, attempt manual

manoeuvres. *

MANUAL

MANOEUVRES

For adults, children and infants, perform 2 minutes (5

cycles) of CPR using the appropriate compression-to-

ventilation ratio

*

*

Candidate re-attempts removal of obstruction with

Magills forceps under direct visualisation. *

If still unsuccessful after 2 attempts, candidate performs

needle cricothyroidotomy in the adult patient.

In the child or infant patient, candidate is to continue

with CPR and removal attempts.

*

ACTIVITY


DONE/

NOT

DONE

If effective, candidate assesses patient’s circulation. *

Candidate resumes ventilations as necessary. *



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

___________________________________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – NEEDLE THORACENTESIS

ACTIVITY


DONE/

NOT

DONE


HELLO Candidate assesses patient’s responsiveness *

ABC

Only if the candidate suspects the patient to be clinically

dead:

A- Open

B- Look, listen and feel

C- Pulse check

*

PATIENT

ASSESSMENT


airway. *

BREATHING

Candidate:

a. Administers high flow O2 prn

b. Assesses respiratory status e.g. trachea, neck

veins, breath sounds

c. Diagnoses tension pneumothorax

*

*

*

ACTIVITY


DONE/

NOT

DONE

DECOMPRESSION

Candidate prepares equipment:

a. 14G IV cannula

b. Alcohol swab

c. Syringe with saline and air-space (for air

bubbling)

Candidate locates 2

nd intercostals space, mid-clavicular

line on the side of the tension pneumothorax *

Candidate cleans the intended area of centesis.

Candidate inserts the 14G IV cannula just over the 3

rd

rib. *

Candidate punctures the parietal pleura. *

Candidate watches for air bubbles in saline.

Candidate removes syringe and listens for sudden

escape of air-relief from tension pneumothorax. *

Using the Seldinger technique, candidate fully advances

the catheter to the hub and then removes the needle. *

Candidate leaves the catheter in place as a marker.

Candidate reassesses the patient’s respiratory status. *

Candidate assesses the patient’s circulation:

- assess pulse and perfusion

- treat accordingly

*

IF A CRITICAL POINT IS OMITTED, THE FINAL RESULT IS AUTOMATICALLY NOT YET

COMPETENT!


COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

__________


Name: ____________________ Name: ____________________





_____________________


INTERMEDIATE LIFE SUPPORT – PASG

ACTIVITY


DONE/

NOT

DONE




airway. *

BREATHING

Candidate:



*

*



CIRCULATION

Candidate:



*

*

DETERMINE NEED

FOR PASG

Candidate obtains the patient’s vital signs and

determines the need for PASG (now or following IV

fluids).

*

PREPARATION Candidate establishes an IV line. *

Candidate attaches the ECG monitor. *

Candidate explains the procedure to patient (if patient

conscious)

Candidate prepares PASG on spineboard.

Candidate attaches the foot-pump and closes the

stopcock valves. *

Candidate places patient onto PASG.

Candidate removes the patient’s shoes and socks.

Candidate removes all objects from the patient’s pockets *

ACTIVITY


DONE/

NOT

DONE

Candidate secures leg and abdominal sections to the

patient by means of Velcro fasteners.

USE OF PASG

If used for haemorrhage control, candidate inflates

required sections sequentially, starting with the legs (legs

only for ILS), to approximately 5mmHg above the

systolic BP, or otherwise inflate to 40mmHg.

*

Candidate closes stopcock valves after successful

inflation of each chosen section. *

Once inflated, do not deflate pre-hospitally unless an

urgent need exists. *

Candidate continually reassesses:

- respiration

- air entry

- pulse

- blood pressure

*

*

*

*

Candidate transports the patient to hospital.



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

___________________________________


Name: ____________________ Name: ____________________




CANDIDATE EXAM NUMBER: _____________________ DATE: __________________


INTERMEDIATE LIFE SUPPORT – ONE MAN MEGACODE

ACTIVITY


DONE/

NOT

DONE


RESPONSE Candidate determines that the patient is unresponsive and

activates the emergency response system. *

Candidate notes absent breathing or breathing which is not

normal (only gasping) *

CIRCULATION

Candidate:

- Checks for carotid pulse, and

- Checks for other signs of circulation. (no longer than

10 seconds)

*

*

If signs of circulation are present, but breathing is absent or inadequate, provide rescue

breathing (1 breath every 5 to 6 seconds, about 10 to 12 breaths/minute)

If no signs of circulation are present, candidate begins 30

chest compressions (rate of at least 100 compressions per

minute)

*

AIRWAY Candidate opens the patient’s airway using the head-tilt chin-

lift manoeuvre (or jaw thrust if trauma) *

BREATHING Candidate delivers 2 breaths over 1 second each – each with

enough volume to make the chest rise. *

Candidate continues with 2 minutes (approximately 5 cycles) of 30 compressions and 2

ventilations – if defibrillator available, use as soon as possible.

DEFIBRILLATION Defibrillator gel to be placed on paddles. *

Determine correct paddle position and press down with at

least 12kg force to reduce trans-thoracic impedance.

*

Check rhythm on monitor (Quick Look Paddles) *

If Ventricular Fibrillation or Pulseless Ventricular Tachycardia present, continue with

defibrillation.

Charge monitor to 360 Joules (monophasic) or to 150 Joules

(biphasic) or 4 J/kg (paediatrics)

*

Ensure that all persons are clear of the patient (I’m Clear,

You’re Clear, Oxygen Clear, Everybody’s Clear).

*

ACTIVITY


DONE/

NOT

DONE

1 Candidate depresses both discharge buttons at the same time

to deliver shock.

*

After defibrillation, the candidate is to immediately resume chest compressions.

ALS ASSISTANCE Candidate establishes ALS back-up while continuing with

CPR.

*

CIRCULATION

After 2 minutes (approximately 5 cycles) of 30:2

compression-to-ventilation CPR, the candidate re-evaluates

presenting rhythm. If the rhythm has not changed then the

candidate continues with defibrillation. Candidate is only to

check for a pulse is the rhythm has changed to one that looks

like an organised cardiac rhythm.

*

If there is a rhythm change to an organised cardiac rhythm, candidate is to check for a

pulse, and continue with the rhythm management as per protocol.

DEFIBRILLATION

CONTINUED…

Charge monitor to 360 Joules (monophasic) or to 150 Joules


*

Determine correct paddle position and press down with at least

12kg force to reduce trans-thoracic impedance.

*


You’re Clear, Oxygen clear, Everybody’s Clear).

*


to deliver shock.

*


CIRCULATION







*

ECG MONITOR Candidate is to place the ECG leads on patient’s chest *

Candidate switches ECG monitor from “Paddles” to “Lead II” *

If there is a rhythm change to an organised cardiac rhythm, candidate is to check for a

pulse, and continue with the rhythm management as per protocol.

DEFIBRILLATION Charge monitor to 360 Joules (monophasic) or to 150 Joules


*

Determine correct paddle position and press down with at least

12kg force to reduce trans-thoracic impedance.

*


You’re Clear, Oxygen clear, Everybody’s Clear).

*


to deliver shock.

*


ACTIVITY


DONE/

NOT

DONE

CIRCULATION







*

If the initial presenting rhythm has not changed (i.e. remained in Ventricular Fibrillation

or Pulseless Ventricular Tachycardia) the candidate is to continue with defibrillation

according to protocol.



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


Name: ____________________ Name: __________________

Qualific: ____________________ Qualific: __________________

Signature: ____________________ Signature: __________________




BASIC LIFE SUPPORT – ADULT 1-RESCUER CPR

ACTIVITY


DONE/

NOT

DONE


RESPONSE Candidate determines that the patient is unresponsive

and activates the emergency response system. *

Candidate notes absent breathing or breathing which is

not normal (only gasping) *

CIRCULATION

Candidate:


- Checks for other signs of circulation. (no longer

than 10 seconds)

*

*





minute)

*

AIRWAY Candidate opens the patient’s airway using the head-tilt

chin-lift manoeuvre (or jaw thrust if trauma) *

BREATHING Candidate delivers 2 breaths over 1 second each – each

with enough volume to make the chest rise. *


ventilations.

PATIENT

REASSESSMENT

After 5 cycles of compressions and ventilations (30:2

ratio, about 2 minutes), candidate rechecks the patient’s

carotid pulse and signs of circulation.

*

If no signs of circulation are present, candidate continues

30:2 cycles of compressions and ventilations, beginning

with chest compressions.

*

If signs of circulation are present, but breathing is absent

or inadequate, candidate continues rescue breathing (1

breath every 5 to 6 seconds or about 10 to 12

breaths/minute).

*

ACTIVITY


DONE/

NOT

DONE

SUCCESSFUL CPR If the patient is breathing, or resumes adequate breathing,

place in recovery position. *



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


Name: ____________________ Name: __________________






INTERMEDIATE LIFE SUPPORT – ADULT 2-RESCUER CPR

ACTIVITY


DONE/

NOT

DONE






CIRCULATION

Candidate 1:


- Checks for other signs of circulation (no more

than 10 seconds)

*

*



If no signs of circulation are present, candidate 2 begins

30 chest compressions (rate of at least 100 compressions

per minute).

*

AIRWAY Candidate 1 opens the patient’s airway using the head-

tilt chin-lift manoeuvre (or jaw thrust if trauma) *

BREATHING Candidate 1 delivers 2 breaths over 1 second each – each


Candidates continue with 2 minutes (approximately 5 cycles) of 30 compressions and 2

ventilations.

PATIENT

REASSESSMENT

After 5 cycles of compressions and ventilations (30:2

ratio, about 2 minutes), candidate 1 delivers 2 rescue

breaths and rechecks the patient’s carotid pulse and signs

of circulation.

*



with chest compressions, until an AED or EMS team

arrives.

*




breaths/minute).

*

ACTIVITY


DONE/

NOT

DONE





COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


Name: ____________________ Name: __________________






INTERMEDIATE LIFE SUPPORT – ADULT FBAO IN RESPONSIVE PATIENT

(and RESPONSIVE PATIENT WHO BECOMES UNRESPONSIVE)

ACTIVITY


DONE/

NOT

DONE


AIRWAY Candidate determines that the patient is responsive and

indicating universal distress signal. *

ABDOMINAL

THRUSTS

Candidate gives abdominal thrusts with proper hand

position (chest thrusts for patient who is obese or

pregnant), avoiding compressions over the lower

sternum (xiphoid).

*

Candidate repeats thrusts until the object is expelled

(obstruction relieved) or the patient becomes

unresponsive.

*

Adult FBAO – Patient becomes unresponsive

PERFORMANCE Candidate activates the emergency response system. *

Candidate opens the patient’s airway with a tongue-jaw-

lift; & performs a finger sweep if the foreign object is

visible.

*

Candidate opens the patient’s airway and attempts to

ventilate; if it is still obstructed (chest does not rise),

reopen the airway (reposition the head and chin) and try

to ventilate again.

*

If ventilation is unsuccessful, candidate starts CPR by

giving 30 chest compressions on the lower half of the

patient’s sternum in the midline between the nipples.

*

Continue with CPR until ALS arrives or patient begins

breathing normally.

SUCCESSFUL If the patient is breathing normally or resumes adequate

breathing, place the patient in the recovery position.



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


Name: ____________________ Name: __________________






INTERMEDIATE LIFE SUPPORT – CHILD 1-RESCUER CPR

ACTIVITY


DONE/

NOT

DONE






CIRCULATION

Candidate:



than 10 seconds)

*

*



If no signs of circulation are present, or heart rate is less

than 60 bpm with signs of poor perfusion, candidate

begins 30 chest compressions (typically 1-hand

compression technique, rate of at least 100 compressions

per minute)

*






ventilations.

PATIENT

REASSESSMENT

After about two minutes of rescue support, candidate

rechecks the patient’s carotid pulse and signs of

circulation.

*

If candidate is alone, candidate now activates the

emergency response system. *




*

ACTIVITY


DONE/

NOT

DONE

PATIENT

ASSESSMENT

CONT.




breaths/minute).

*





COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


Name: ____________________ Name: __________________






INTERMEDIATE LIFE SUPPORT – INTEGRATED CHILD FBAO

(RESPONSIVE and UNRESPONSIVE PATIENT; CPR and RESCUE BREATHING)

ACTIVITY


DONE/

NOT

DONE


AIRWAY Candidate determines that the patient is responsive and

indicating universal distress signal. *

Candidate asks “Are you choking?” (YES), if yes,

candidate asks “Can you speak?” (NO). If no, candidate

tells the child that he is going to help.

*

ABDOMINAL

THRUSTS

Candidate stands or kneels behind the child, with his

arms encircling the child’s abdomen. *

Candidate gives abdominal thrusts using the proper hand

position (avoid xiphoid) and supports the child’s body. *

Candidate repeats until the object is expelled or the

patient becomes unresponsive.

Child FBAO – Patient becomes unresponsive

PERFORMANCE If a second rescuer is available, candidate sends that

rescuer to activates the emergency response system. *


lift; and removes any foreign objects that can be seen (no

object seen = no finger sweeps).

*




to ventilate again.

*

If ventilation is unsuccessful, candidate starts CPR

beginning with chest compressions *


breathing normally.

ACTIVITY


DONE/

NOT

DONE





COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


Name: ____________________ Name: __________________






INTERMEDIATE LIFE SUPPORT – INFANT 1-RESCUER CPR

ACTIVITY


DONE/

NOT

DONE






CIRCULATION

Candidate:

- Checks for brachial pulse, and


than 10 seconds)

*

*



If no signs of circulation are present, or heart rate is less

than 60 bpm with signs of poor perfusion, candidate

begins 30 chest compressions (typically 2-finger

compression technique, rate of at least 100 compressions

per minute)

*






ventilations.

PATIENT

REASSESSMENT

After about two minutes of rescue support, candidate

rechecks the patient’s carotid pulse and signs of

circulation.

*

If candidate is alone, candidate now activates the

emergency response system. *




*

ACTIVITY


DONE/

NOT

DONE

PATIENT

ASSESSMENT

CONT.




breaths/minute).

*

SUCCESSFUL CPR If the patient is breathing normally, or resumes adequate

breathing, place in recovery position. *



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


Name: ____________________ Name: __________________






INTERMEDIATE LIFE SUPPORT – INTEGRATED INFANT FBAO

(RESPONSIVE and UNRESPONSIVE PATIENT; CPR and RESCUE BREATHING)

ACTIVITY


DONE/

NOT

DONE


AIRWAY Candidate determines that the patient is responsive. *

Candidate confirms severe or complete airway

obstruction (signs of serious breathing difficulty,

ineffective cough, no strong cry).

*

BACK

BLOWS/CHEST

COMPRESSIONS

Candidate gives up to 5 forceful back blows with the

heel of the hand, and 5 forceful chest compressions using

the 2-finger compression technique (no abdominal

thrusts).

*

Candidate repeats until the object is expelled or the

patient becomes unresponsive.

Infant FBAO – Patient becomes unresponsive

PERFORMANCE If a second rescuer is available, candidate sends that

rescuer to activates the emergency response system. *


lift; and removes any foreign objects that can be seen (no

object seen = no finger sweeps).

*




to ventilate again.

*

If ventilation is unsuccessful, candidate starts CPR

beginning with chest compressions *


breathing normally.

ACTIVITY


DONE/

NOT

DONE





COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

_________________________


Name: ____________________ Name: __________________





_____________________


INTERMEDIATE LIFE SUPPORT – CPR AND THE USE OF THE AED

ACTIVITY


DONE/

NOT

DONE


RESPONSE

Candidate determines that the patient is unresponsive

and activates the emergency response system – calling

for an AED

*



CIRCULATION

Candidate:



than 10 seconds)

*

*





minute)

*






ventilations.

AED USE Candidate places the AED next to the patient as soon as

it is available and proceeds with AED use.

Candidate puts the AED on by pushing the “POWER

ON” button *

Candidate attached the electrode pads in the proper

position (as pictured on each of the AED electrodes)

sternum and apex, with proper contact and no

overlapping of the electrodes.

*

Candidate “clears” the patient for analysis (automated) *

The AED will analyse and will advise a shock and will charge the electrodes

ACTIVITY


DONE/

NOT

DONE

AED USE CONT. Candidate “clears” the patient and presses the “SHOCK”

button. *

The AED will only deliver one shock and will then instruct the candidate to continue with

CPR starting with chest compressions. The internal AED timer will now also commence

timing for 2 minutes.

CPR Candidate continues with CPR until ALS arrives or until

the patient begins breathing normally *

Pulse, breathing, coughing and movement are present

PATIENT CARE Candidate continues to monitor breathing and signs of

circulation until ALS arrives. *

If trauma is not suspected, candidate placed the patient in

the recovery position with the AED attached. *



COMMENTS:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

____________________


Name: ____________________ Name: ____________________



aea osce booklet 2012

Documents

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