student clinical book - palm beach state college beach state college – paramedic program student...

STUDENT CLINICAL BOOK

10/29/2013

Palm Beach State College – Paramedic Program Student Clinical Book

Table of Contents

STUDENT CLINICAL BOOK REQUIREMENTS: ...................................... 1

BOOK ATTESTATION PAGE ............................................................... 3

STUDENT CLINICAL MANUAL ........................................................... 4

CLINICAL SIGN IN SHEET ................................................................. 5

CLINICAL EVALUATION – PROGRESS REPORT .................................. 6

CLINICAL EVALUATION - COVER FOR LONG FORM ............................ 7

MANDATORY PARAMEDIC DRUGS .................................................... 8

REPORT WRITING NARRATIVE REQUIREMENTS ................................. 9

MANDATORY DRUGS ..................................................................... 10

PATIENT CARE REPORT ................................................................. 11

SKILLS SIGN OFF .......................................................................... 14

STUDENT EQUIPMENT COMPETENCY CHECK LIST - LP .................... 15

STUDENT EQUIPMENT COMPETENCY CHECK LIST – MED BAG ........ 16

STUDENT EQUIPMENT COMPETENCY CHECK LIST - STRETCHER ....... 17

SKILLS PERFORMED WORKSHEET.................................................. 18

Palm Beach State College – Paramedic Program 1 Student Clinical Book

Palm Beach State College Paramedic Program

STUDENT CLINICAL BOOK REQUIREMENTS:

To be assembled with tabs

If clinical rotation has not happened yet – keep blank forms out of book. ** Outside Cover is the Attestation Page**

1. Front Page – Name Page

2. Clinical Sign In Sheet 3. Drug Card Check Off Sheet (EMS 2664 ONLY)

4. Medical Director Rotation

5. Medical Director Patient Contact Sheet

6. Pediatric Partners 7. Pedi Grand Rounds 8. Trauma Surgeon Documentation Forms

9. Healey Rehab 10. Cottages 11. Humane Society Form 12. O.R. Intubation rotation

13. Midterm and Final Evaluation, Cover Sheet for Long Form 14. Preceptor Objective Worksheet

15. Preceptor Feedback Tool 16. Patient Care Reports One Tab for Hospital Reports. 17. PCR’s from Fire Rescue

**Binder clipped when turned in with labeled tabs.


Paramedic Clinical BOOK ATTESTATION PAGE

CLASS SHIFT: ____________

I hereby attest that the reports and documentation contained within this Student Clinical Book for:

Are complete, accurate, have been reviewed by the student and myself, verified with our signatures, and reflect the student’s

TYPHON entries.

Clinical Instructor Printed Name: _______________________________________________

Clinical Instructor Signature: _______________________________________________

Date of Submission: _______________________________________________

□ EMS 2664 – CLINICAL 1 □ EMS 2658 – CLINICAL 3

□ EMS 2665 – CLINICAL 2 □ EMS 2659 – Internship


Palm Beach State College PARAMEDIC PROGRAM

STUDENT CLINICAL MANUAL

EMS 2664, 2665, 2658, 2659

STUDENT NAME________________________________

CLINICAL INSTRUCTOR__________________________

FIRE RESCUE INSTRUCTOR______________________

CLASSROOM INSTRUCTOR______________________


CLINICAL INSTRUCTOR_______________________________ FIRE RESCUE INSTRUCTOR____________________________ INSTRUCTOR PHONE # ________________________________ Clinical Shift ___________ Class Shift _____________

PALM BEACH STATE COLLEGE PARAMEDIC STUDENT

CLINICAL SIGN IN SHEET STUDENT: Fill out this sheet every time you attend a clinical function. Fill out the dates you are absent.

Keep this sheet in your Clinical Book. Student Name Date Time In Time Out Site Instructor Printed Name Instructor Signature Calls Reports


Palm Beach State College – Paramedic Program CLINICAL EVALUATION – PROGRESS REPORT


□ EMS 2665 – CLINICAL 2 □ EMS 2659 – Internship Class:

Date Student Name

Instructor Name Instructor Signature

Indicate how the student is progressing toward competency by rating the student on a scale of 1-5. A “1” or “2” rating indicates that immediate remedial work is indicated. A “5” indicates superior performance. Cognitive Domain (Knowledge Base) 5 4 3 2* 1*

Psychomotor Domain (Clinical Proficiency) 5 4 3 2* 1*

Affective Domain (Behavioral Skills) 5 4 3 2* 1*

Documentation (FISDAP/Typhon) 5 4 3 2* 1*

Comments:

*Grades of 1 or 2 require comments, an Assistance Lab referral form, and Clinical Coordinator notification. Student Signature:


Palm Beach State College – Paramedic Program

CLINICAL EVALUATION - COVER FOR LONG FORM


□ EMS 2665 – CLINICAL 2 □ EMS 2659 – Internship CLASS: _______________

Date Student Name

Instructor Name Instructor Signature

Competent Not Competent Cognitive Domain (Knowledge Base) Minimum Score: 24

Psychomotor Domain (Clinical Proficiency) Minimum Score: 16

Affective Domain (Behavioral Skills) Minimum Score: 36

Documentation (Typhon) Minimum Score: 12 Comments: In any given semester, a Competent score is required in the Psychomotor domain in order to receive a course satisfactory grade (S). In EMS2664, EMS2665 and EMS2658, other than the above mentioned requirement, the student may receive only one Not Competent and still receive a course grade of satisfactory (S). In EMS2659, a Final Evaluation of Competent must be received in ALL categories to earn a satisfactory grade (S).

CURRENT GRADE: Satisfactory Unsatisfactory*

*Requires immediate Clinical Coordinator notification Student Signature:


MANDATORY PARAMEDIC DRUGS 1) Adenocard

2) Albuterol

3) Amiodarone

4) Amyl Nitrite

5) Aspirin

6) Atropine

7) Calcium Chloride

8) Dexamethasone

9) Dextrose 50%

10) Diazepam

11) Digoxin

12) Diltiazem

13) Diphenhydramine

14) Dopamine

15) Epinephrine 1:1,000

16) Epinephrine 1:10,000

17) Etomidate

18) Flumazenil

19) Furosemide

20) Glucagon

21) Ipratropium

22) Labetalol

23) Levalbuterol

24) Lidocaine

25) Lorazepam

26) Magnesium Sulfate

27) Mannitol

28) Methylprednisone

29) Midazolam

30) Morphine

31) Naloxone

32) Nitroglycerine

33) Nitrous Oxide

34) Oxygen

35) Oxytocin

36) Pralidoxime

37) Procainamide

38) Prochlorperazine

39) Promethazine

40) Proventil

41) Salbutamol

42) Sodium Bicarbonate

43) Sodium Nitrite

44) Sodium Thiosulfate

45) Succinylcholine

46) Terbutaline

47) Tetracaine

48) Thiamine

49) Vasopressin

50) Verapamil


PALM BEACH STATE COLLEGE

EMS Academy - Paramedic Program

DATE: August 2010

PATH: REPORT WRITING NARRATIVE REQUIREMENTS

Excellent report writing and documentation skills are paramount for paramedic students to master. These skills require much diligence and patience in order to achieve excellence. Therefore, all paramedic students are required to use the following narrative styles in each subsequent semester. Templates and examples for each can be found on Typhon. Semester 1: Students will write narratives in the CHARTE format. Semester 2: Students will write narratives in the SOAP format. Semester 3 and Internship: Students will write narratives in the Descriptive Narrative format


MANDATORY DRUGS

1. These are mandatory for student drug cards. Instructors may also add additional drugs as they see fit.

2. All drug cards are to be hand written and turned into the Clinical Lead Instructor by the end of EMS 2664.

3. The Clinical Lead Instructor will check each box once they see and approve each drug card. □ 1) Adenocard □ 2) Albuterol □ 3) Amiodarone □ 4) Amyl Nitrite □ 5) Aspirin □ 6) Atropine □ 7) Calcium Chloride □ 8) Dexamethasone □ 9) Dextrose 50% □ 10) Diazepam □ 11) Digoxin □ 12) Diltiazem □ 13) Diphenhydramine □ 14) Dopamine □ 15) Epinephrine 1:1,000 □ 16) Epinephrine 1:10,000 □ 17) Etomidate □ 18) Flumazenil □ 19) Furosemide □ 20) Glucagon □ 21) Ipratropium □ 22) Labetalol □ 23) Levalbuterol □ 24) Lidocaine □ 25) Lorazepam

□ 26) Magnesium Sulfate □ 27) Mannitol □ 28) Methylprednisone □ 29) Midazolam □ 30) Morphine □ 31) Naloxone □ 32) Nitroglycerine □ 33) Nitrous Oxide □ 34) Oxygen □ 35) Oxytocin □ 36) Pralidoxime □ 37) Procainamide □ 38) Prochlorperazine □ 39) Promethazine □ 40) Proventil □ 41) Salbutamol □ 42) Sodium Bicarbonate □ 43) Sodium Nitrite □ 44) Sodium Thiosulfate □ 45) Succinylcholine □ 46) Terbutaline □ 47) Tetracaine □ 48) Thiamine □ 49) Vasopressin □ 50) Verapamil

Student Printed Name: _____________________________________ Student Signature: _________________________________________ Clinical Instructor Signature: _________________________________ Date Completed: ___________________________________________


PALM BEACH STATE COLLEGE EMT/Paramedic Program

PATIENT CARE REPORT

Student: _________________________

EMT Paramedic Date: ____/____/_____

Time of Call: _______________ Hospital/Agency: ____________

Age:____

Unit: ____________

□ I accompanied this patient to the hospital during transport.

Instructor/Preceptor Name: ______________________

Instructor/Preceptor Signature: ______________________

ETHNICITY M F

African American

American Indian

Asian

Caucasian

Hispanic

Other: ___________________

Chief MEDICAL COMPLAINT

Abdominal OD-Poison Cardiac Psychiatric CVA Respiratory Diabetic Seizure OB/GYN Sepsis

Other ___________________

Chief TRAUMA COMPLAINT

Abdomen Neck/Back Chest Pelvic Extrem. Head/Face

Muscular Multi-system

Other ___________________

MECHANISM OF INJURY None Driver MVA Passenger MVA Auto-Pedestrian

Motorcycle Fall/Jump Airbag Seatbelt Entrapment Ejection

Rollover Blunt Penetrating Injury – Type: _____________________ Other: ______________________________________

ALLERGIES:

MEDICATIONS:

PAST MEDICAL HX:

Time BP Pulse Resp AVPU Pupils Lungs Drug/Tx Dose Route

Eyes Open→ Spontaneous 4 To Voice 3 To Pain 2 None 1 Glasgow Score = _________ Verbal→ Orient 5 Confused 4 Inappropriate 3 Garbled 2 None 1 Motor→ Obey Com. 6 Pain/Local 5 Pain/Withdraw 4 Pain/Flexion 3 Pain/Ext 2

None 1


BLS AIRWAY NC NRB Nasal airway Oral airway BVM @ ______L/Min

ALS AIRWAY Surgical Nasal ET Oral ET Attempts X: ____ Success Y N ET size: ___

Pulse Ox on room air ⇒ ________ % After O2 ⇒ ________ % Glucometer ⇒ __________

IV / IO Attempts X: _____

Success: Y N

Site: ________ Gauge: ______ Solution: ______

ELECTRICAL THERAPY

ENERGY LEVELS

OBS. PERF. EKG INTERPRETATION OBS PERF

MANUAL DEFIBRILLATION Rhythm 1:

SYNCHRONIZED CARDIOVERSION

Rhythm 2:

TRANSCUTANEOUS PACING

Rhythm 3:

PHTLS CARE BLS CARE

OBS PERF OBS PERF PATIENT INTERVIEW WITNESSED ARREST

VITAL SIGNS SUCTION

02 ADMINISTRATION CHEST COMPRESSIONS

BANDAGING VENTILATIONS TRACTION SPLINT BLS airway adjunct C-SPINE IMMOBILIZATION

AIRWAY ADJUNCT TYPE:

LONG BACKBOARD ALS CARE – OTHER LONG BONE IMOBILIZATION

DESCRIBE # PERFORMED Obs Per

STUDENT PHYSICALLY INVOLVED IN LIFTING PATIENT

YES NO

CHEST DECOMPRESSION CRICOTHYROIDOTOMY

12 LEAD ECG PULSE OXIMETRY BLOOD GLUCOSE


SOAP NARRATIVE Subjective:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Objective:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Assessment:____________________________________________________________________ __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Procedures/Response to Procedures:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


SKILLS SIGN OFF Name: Date: Instructor: Clinical Location: Patient Age: Patient Gender: Skill Performed Successful: Initials: Student Signature: Date: Instructor Signature: Date:


STUDENT EQUIPMENT COMPETENCY CHECK LIST - LP Student Name: Station/Shift:

School / Institution:

The student will locate and show knowledge of the CPAP

Yes No Preceptor DateThe student can identify the location of the CPAPThe student can identify the location of all accessories for equipmentThe student can show and apply the proper procedure for the CPAP

The student will locate and show knowledge of the Carevent

Yes No Preceptor DateThe student can identify the location of the CAREVENTThe student can identify the location of all accessories for equipmentThe student can show and apply the proper procedure for the CAREVENT

The student will locate and show knowledge of the Suction Unit

Yes No Preceptor DateThe student can identify the location of the Suction UnitThe student can identify the location of all accessories for equipmentThe student can show and apply the proper procedure for the Suction Unit

The student will identify the location of items in the LifePack 15

Yes No Preceptor DateThe student can identify the location of the LifePack 15The student can identify the location of all accessories for equipmentThe student can show and apply the proper procedures for the LifePack 15


STUDENT EQUIPMENT COMPETENCY CHECK LIST – MED BAG Student Name: Station/Shift:


The student will identify the location of items in the Blue Med BagYes No Preceptor Date

The student can identify the location of all MedicationsThe student can identify the location of all IV equipment The student can identify the location of all FluidsThe student can identify the location of all PPE/BIO bags

The student will identify the location of items in the Airway Bag

Yes No Preceptor DateThe student can identify the Airway Roll and items insideThe student can identify/ knows how to use ALS-BLS Airway equipment The student can identify the Miscellaneous equipment in Airway bag

The student will identify the location of items in the Trauma Bag

Yes No Preceptor DateThe student can identify the location of all IV equipmentThe student can identify the location of all FluidsThe student can identify the location of all PPEThe student can identify the location of BLS/ALS Trauma equipment

The student will identify the location of items in the Pedi Box

Yes No Preceptor DateThe student can identify the location of all MedicationsThe student can identify the location of all IV equipment The student can identify the location of all FluidsThe student can identify the location of all PPE/BIO bagsThe student can identify the location of BLS/ALS equipment


STUDENT EQUIPMENT COMPETENCY CHECK LIST - STRETCHER Student Name: Station/Shift:


The student will display knowledge & demonstrate how to operate the stair chair

Yes No Preceptor DateThe student can identify the location of all handlesThe student can identify the location of all leversThe student can identify the location of all strapsThe student can demonstrate how to fold and unfold chairThe student will demonstrate correct way to move patient

The student will display knowledge & demonstrate the operation of the either PBCFR stretchers

Yes No Preceptor DateThe student can identify the location of all handlesThe student can identify the location of all leversThe student can identify the location of all strapsThe student will demonstrate raising and lowering feet/head

The student will identify the location and use of the Pedi, Miller, BackBoards & Scoop stretcher

Yes No Preceptor DateThe student can identify the location of all BoardsThe student can identify the location of extra strapsThe student can identify the location of the decon spray The student can demonstrate how to correctly use strapsThe student can correctly use above equipment


Skills Performed Worksheet STUDENT NAME: ____________________________ DATE: ______________________ INSTRUCTOR: _______________________________ CLINICAL LOCATION: ______________________

PATIENT AGE

PATIENT GENDER

SKILL PERFORMED

SUCCESSFUL INITIALS

PRINT NAME: _______________________________________________________

STUDENT SIGNATURE: ______________________________________________ DATE: ____________

PRINT NAME: _______________________________________________________

INSTRUCTOR SIGNATURE: ___________________________________________ DATE: ____________

student clinical book - palm beach state college beach state college – paramedic program student...

Documents