CA Skills – PENETRATING CHEST INJURY – Emergency Medical Services University, LLC

Please enable JavaScript in your browser to complete this form.

Student ID:

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

Note: Validation of a Student ID may take up to 30 seconds to complete. You may continue filling out this form while validation is in progress.

Date:

Actual Time Started:

Military Time Only (example: 1523)

Skills Section

Section Critical Number:

Action

Points Possible

Points Awarded

Takes appropriate PPE precautions

Point 1

Ensures the scene is safe

Point 2

Covers the open wound with a gloved hand

Point 3

Listens to Lung Sounds

Point 4

Places an appropriate chest seal such as occlusive dressing with 3 taped sides

Point 5

Consider priority (immediate) transport to a trauma facility

Point 6

Initiates steps to prevent heat loss from the patient

Point 7

Properly positions the patient

Point 8

Administers high concentration Oxygen

Point 9

Total Points (Out of 9)

Actual Time Ended:

Military Time Only (example: 1523)

Critical Criteria Section

Critical Criteria

Failure to take appropriate PPE precautions
Failure to administer high concentration oxygen
Failure to seal wound using correct procedures in a timely manner
Failure to indicate the need for immediate transportation
Failure to manage the patient as a competent EMT
Uses or orders a dangerous or inappropriate intervention
Failure to transport within 10 minutes

Notes

Administrative Section

Note: EMT Student Candidate Name (Not Refresher) will populate automatically below. If the name has not been populated or the name is incorrect, contact customer service to get the correct STUDENT ID NUMBER.

Candidate:

First

Last

Examiner:

First

Last

Instructor State

Exam Location:

Instructor Certification Number:

Attempt 1 Result

Attempt 2 Result

Attempt 3 Result

Instructor Signature

Clear Signature

By clicking the submit button below, I hereby agree to make an electronic copy of the form contained here.

EMS University

Note: Validation of a Student ID may take up to 30 seconds to complete. You may continue filling out this form while validation is in progress.

Skills Section

Critical Criteria Section

Administrative Section

Helpful guidance on your EMT Training...