Raven EMS Education Program ManualTrauma Epistaxis Evaluation Form
Date:
Student name:
Evaluator name:
Steps:
Take BSI precautions.
Explain the procedure to the patient (if conscious).
Sit the patient down and lean the patient forward.
Pinch the nostrils together with your fingers or a nose clamp.
Apply an icepack to the nose.
Treat for shock as needed (supine, high-flow oxygen, keep warm, rapid transport).
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.
Did not take BSI precautions.
Did not explain and reassure the patient to allow informed consent.
Fails to properly pinch nostrils or apply nose clamp.
