Raven EMS Education Program ManualAssessment Primary Evaluation Form
Date:
Student name:
Evaluator name:
Size-Up Steps:
PPE/Take or verbalize infection control precautions (self and crew).
Environmental hazards/dangers.
Number of patients.
MOI/NOI/IOS.
Additional resources required/extrication.
Need for c-spine.
Primary Assessment Steps:
Verbalize the general impression (sick versus not sick) of the patient. Consider the patient’s level of distress, positioning, surroundings, environment, and family members.
Determine the patient’s level of consciousness (AVPU).
Determine the patient’s chief complaint and establish rapport.
Reason 9-1-1 was called.
Patient’s name, age, and weight (gather for reporting information).
Assess for a patent airway.
Open and patent: head tilt–chin lift or jaw-thrust maneuver.
Need for suctioning or Magill forceps.
Need for adjuncts (OPA/NPA).
Assess breathing for rate, rhythm, tidal volume, chest rise, and equality.
Bare the chest.
Palpate the chest.
Auscultate lung sounds.
Administer oxygen as needed (nasal cannula, nonrebreathing mask, bag-mask device).
Assess circulation for rate, rhythm, regularity, and quality.
Check pulse (peripheral and central).
Evaluate skin signs: color, temperature, and moisture.
Control any major bleeding.
Check capillary refill (≤6 years old).
Treat for shock as needed (place in supine position, keep warm, administer high-flow oxygen, and provide rapid transport).
Determine disability/deficits/deformities.
Check pupils.
Determine GCS score (eyes 4, verbal 5, motor 6).
Determine if the patient is alert and oriented to person, place, time, and event.
Check for CMS, posturing, and gross deformities.
Expose the patient.
Perform a rapid trauma assessment as needed (only for major trauma or an unresponsive medical patient).
Find and treat life threats not initially found during the primary assessment; note any additional injuries and pertinent negatives.
Decide appropriate assessment and transport.
Stay and play or load and go.
Packaging/transport method.
Report your findings: name, age, weight, LOC, ABCs, C/C.
Transition Steps - Prep for the secondary assessment (on scene or en route) and delegate vital signs and diagnostic tools:
BP,
HR,
RR,
SpO2,
blood glucose,
ECG,
12-lead
Pain scale (1–10) or Wong-Baker FACES scale
Affective:
Accepts evaluation and criticism professionally.
Shows willingness to learn/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.
Fails to take or verbalize infection control precautions prior to performing assessment.
Fails to determine scene safety before approaching the patient.
Did not explain and reassure the patient to allow informed consent.
Fails to provide spinal protection when indicated.
Fails to find or appropriately manage issues associated with airway, breathing, and circulation.
Fails to provide appropriate oxygen therapy within 3 minutes of starting the scenario.
Improperly assesses the patient’s condition or priority level.
