Raven EMS Education Program ManualTrauma Splint Cervical Spine Blanket Roll Application Evaluation Form
Date:
Student name:
Evaluator name:
Steps:
Take BSI precautions.
Explain the procedure to the patient (if conscious).
Stabilize the head.
Apply a cervical collar.
Place the straps around the backboard and patient.
Insert the blanket roll and roll each side of the blanket snugly against the neck and shoulders.
Tie two cravats around the blanket roll, then two more around the blanket roll and backboard.
Accepts evaluation and criticism professionally.
Shows willingness to learn or asks appropriate questions.
Interacts with simulated patient and other personnel in a professional manner (ie, uses appropriate name, explains procedures, maintains modesty, is courteous to crew, etc).
Passing criteria:
Pass: At least 70% (? of ?) successfully completed above. Currently at 0% completed.
Fail.
Did not explain and reassure the patient to allow informed consent.
Fails to take BSI precautions prior to performing procedure.
