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EMT student ID’s are usually in this format: 123456FT-01. For refresher or skills only, place “CE” in this field.

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Military Time Only (example: 1523)

Skills Section

Action

Points Possible

Points Awarded

Dons or verbalizes appropriate PPE for skill.

1

Assesses mental status of patient and explains procedure.

1

Assesses respiratory status and confirms appropriateness of intervention.

1

Note: Examiner states: “Patient is responsive, tachypneic, and has a pulse of 92/minute.”

Verbalizes obtaining medical direction for assisting with inhaler use.

1

Verifies that the inhaler is not expired.

1

Verbalizes and ensures the “5 Rights” of medication administration are present.

1

Confirm that the patient has not already taken a dose of the inhaler recently.

1

Note: Examiner states: “Medical direction has approved the use of the inhaler.”

Shakes metered-dose inhaler for 30 seconds prior to use.

1

Instructs patient to exhale.

1

Instruct patient to place mouthpiece in mouth past their teeth, and above the tongue.

1

Instructs patient to activate inhaler once while initiating a slow deep breath.

1

Instructs patient to hold their breath 5-10 seconds to allow medication absorption.

1

Resume oxygen therapy as appropriate.

1

Verbalizes waiting 15-30 seconds to repeat dose if approved by medical direction.

1

Reassesses patient’s respiratory status for effectiveness.

1

Identifies/Verbalizes how to properly chart medication administration in PCR.

1

Military Time Only (example: 1523)

Critical Criteria Section

Critical Criteria

Administrative Section

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