EMF Procedural Checklists (2021-2022)

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154 EM Fundamentals Facilitator Guide
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Mastery (Advancement) Standard

In this procedural assessment series, mastery is defined as a performance without
any threats to patient or provider safety and suggesting a high likelihood of success
in completing the procedure on a low complexity patient without guidance, assistance,
or advice.
Note
This simulation is designed to teach and assess the knowledge and skills required to perform rapid se-
quence endotracheal intubation using direct or video laryngoscopy on a patient with respiratory fail-
ure. The emphasis in this simulation is on equipment and mechanics; this simulation is not designed to
teach or assess the medical management of peri-intubation patients, pre-intubation airway assessment,
post-intubation patient management, or pharmacology.
Scenario
A 65-year-old 70kg patient (BMI 24) presents with shortness of breath and is diagnosed with bilateral
pneumonia. Despite medical management including a non-rebreather mask, the patient remains hypox-
emic with labored breathing. You and your attending physician decide to intubate the patient using ket-
amine and rocuronium. You are asked to verbalize your plan for intubation, gather the necessary supplies,
and intubate the patient.
Action Rating
1 Verbalize planned approach to intubation Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
2 Verbalize donning gloves, mask with face shield Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
3 Verbalize approach to pre-oxygenation Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Verbalize, gather, and check required equipment:
• Preoxygenation device
• Bag valve mask
• ET tube (6.5 to 8.0), stylet, syringe to inflate
• Check cuff
4 • Laryngoscope blade (mac 3-4 or similar) Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
• Check light
• End-tidal CO2 detector
• Bougie
• Backup airway (e.g., supraglottic device)
• Cric equipment (minimum: bougie, scalpel)
Position patient (bed height; ear to sternal notch
5
using, e.g., towel rolls) Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Verbalize timing of medication administration,

6 when intubation attempt will begin relative to Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
medications
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7 Scissor open mouth, insert laryngoscope Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Advance laryngoscope to visualize epiglottis
8
and verbalize visualization Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Advance and lift laryngoscope to visualize lar-
9
ynx; verbalize grade of laryngeal view Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
While maintaining visualization of larynx, insert
10 endotracheal tube through the vocal cords, Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
remove stylet, and inflate cuff
Measure and verbalize tube depth from front
11
teeth Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Verbalize confirmation of tube placement via

12 waveform capnography and auscultation of epi- Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
gastrium, bilateral lung fields
Verbalize securing of tube with tape or tube
13
holder Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Any additional actions threatening patient safety or otherwise suggesting advancement criteria
not met?
ЃYes, additional concerning actions noted ЃNo
If yes, please describe:
Resident: __________________________ Date: ______________
Faculty: __________________________ Pass/Fail: ______________

Notes / Performance Dimension Training

1. Plan should include equipment and approach for initial and back-up airway management options.
For example, an acceptable plan would be:
“My first attempt will be direct laryngoscopy with a mac 3. If this view is inadequate or the
attempt to pass the tube is unsuccessful, the next attempt will be video laryngoscopy using
a <manufacturer> size 3 blade. If these attempts are unsuccessful, we will place a <supra-
glottic airway>. If at any time the patient desaturates, we will abort the attempt and bag the
patient. If at any time we encounter a ‘cannot intubate, cannot oxygenate’ scenario, I will
perform a cricothyroidotomy using a scalpel and bougie.”
4. Similar blades may include direct or video laryngoscopy equipment. For example, for a 70kg
adult with a normal body mass index, a macintosh 3, miller 3, Glidescope 3, and C-MAC 3 would
all be considered similar. Each of these blades in size 4 would also be acceptable for the pur-
poses of this simulation. The description or use of a size 2 blade in this case is inappropriate
and non-passable.
6. Timing should include the order and time between administration of each medication. Doses
need not be mentioned. Given the typical onset of ketamine within 30 seconds and the typical
onset of intubation-dose rocuronium of approximately 60 seconds, an appropriate plan would
be:
“Now that the patient is preoxygenated, optimally positioned, and we have all our equipment,
we are now ready for intubation. The ketamine should be administered first, followed imme-
diately by the rocuronium. I will wait approximately 45 seconds for the medication to take
effect prior to my intubation attempt.”
6LPXODWLRQ&KHFNOLVWV&ULFRWK\URWRP\ EM Fundamentals 157
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or advice.
Note
This simulation is designed to teach and assess the knowledge and skills required to perform a crico-
thyrotomy using the scalpel-bougie technique. This simulation is not designed to teach or assess other
techniques for this procedure (e.g., use of trach kit with hook).
Action Rating
Verbalize donning mask; don mock-sterile
1
gloves Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Verbalize and gather the necessary equipment
for the procedure
• Scalpel
2 • Bougie Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
• Endotracheal (ET) tube (including size)
• Syringe
• Bag valve mask attached to oxygen
3 Identify and verbalize landmarks Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
4 Verbalize cleansing of the skin Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Make vertical incision through skin and subcuta-
5
neous tissue over the cricothyroid membrane Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Palpate the cricothyroid membrane with
6
non-dominant hand Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Make horizontal incision through the cricothy-
7
roid membrane and into the trachea Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Maintaining patency of the incision with finger
8 or scalpel, pass bougie through incision into the Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
trachea.
Place cuffed ET tube over bougie and into tra-
9
chea Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
10 Inflate cuff Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Verbalize confirmation of placement with wave-
11
form capnography, bilateral breath sounds Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
12 Verbalize securing the tube in place Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
not met?
Resident: __________________________ Date: ______________

6LPXODWLRQ&KHFNOLVWV&ULFRWK\URWRP\ EM Fundamentals 159

5. Landmarks should include the thyroid cartilage and cricothyroid membrane.
12. Tube may be secured in place with sutures, tape, or commercial device.
Additional Notes
• “Peeking” by lifting the artificial skin or otherwise attempting to obtain a view/obtain
information that is not typically available in the clinical setting is a non-passable action.
• A dropped piece of equipment does not automatically preempt a passing score, as long
as the action: (1) does not compromise patient or provider safety, (2) does not suggest a
likely problematic lack of facility with the procedural equipment, and (3) if the equipment
should be sterile and is dropped in a way that compromises sterility, the learner verbalizes
that a new piece of equipment would be obtained and that the contaminated equipment
would not be used.
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or advice.
Note
This simulation is designed to teach and assess the knowledge and skills required to perform a tube
thoracostomy on a stable patient with a traumatic hemothorax. This is not a simulation of a “crash” tube
thoracostomy.
Action Rating
Verbalize informed consent including listing the
1
risks of the procedure (see notes) Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
2 Verbalize washing hands Ѓ Verbalized Ѓ Not done
3 Verbalize patient positioning Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
4 Verbalize and identify landmarks, mark site Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Perform time out (including name, DOB, proce-
5
dure, site) Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
6 Open kit in sterile fashion Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Verbalize donning mask with face shield, sterile
7
gown; don mock-sterile gloves Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
8 Mock sterile skin prep Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
9 Apply mock-sterile drape Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
10 Mock local anesthetic: skin wheel / superficial Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
11 Mock local anesthetic: deep tissue Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Make appropriately-sized vertical incision
12
(~3.5cm) Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Advance Kelly clamp over rib using two-handed
13 technique to maintain control while puncturing Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
then spreading pleura
Place finger into tract prior to removing the
Kelly clamp; confirm intrapleural placement via
14
palpation and leave finger in tract as Kelly clamp Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
is removed
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Using the Kelly clamp as a guide, pass the chest

15 tube into the thoracic cavity so that all holes are Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
within pleural space
Verbalize attaching the tube to collection cham-
16
ber Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
17 Suture the tube in place Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
not met?
Resident: __________________________ Date: ______________


1. Risks of the procedure should include infection, bleeding, and damage to adjacent structures
(including nerves and possible solid organs (e.g., spleen, liver)).
2. Hand washing need only be verbalized. Both hand sanitizer and soap-and-water are accept-
able methods of hand washing.
3. Patient positioning should include placing or securing of the ipsilateral arm above the head.
4. Landmarks should include anchors in both the transverse axis (i.e., 4th or 5th intercostal
space, which may be estimated by use of the nipple line) and coronal axis (i.e., mid-axillary line).
Mention of trajectory over superior aspect of rib must also be verbalized either here or else-
where during the simulation (e.g., steps 10-13).
5. Timing of the time out is flexible but must occur after the site is marked and before the skin
is broken. The time out should be verbalized, specifically including:
a. Correct procedure
b. Correct patient (identified by name, date of birth, medical record number)
c. Correct site
8. Gloves are required. Jewelry and watches should be removed and sleeves rolled up (if ap-
plicable). Bouffant caps and sterile gowns are not required for the attempt, but should be used
in practice and therefore must be verbalized. For the sake of cost, regular exam gloves may
be used in lieu of sterile gloves. Regular gloves should still be treated as sterile, however (e.g.,
touching non-sterile equipment should be considered contamination and prompt re-gloving).
Contamination should only be considered a failing action if the trainee does not correct for it by
removing the contaminated supplies and replacing those supplies in a sterile fashion.
9. Betadine swabs or chlorhexidine may be used. Swabs/prep sticks should be disposed of away
from the sterile field so as to avoid contamination.
11. Motions of needle manipulation should be made (including breaking the skin); however, train-
ees should not inject air or fluid into the model (in order to preserve the integrity of the simu-
lator). Note that in practice, aspiration before injection is not required for the initial skin wheel.
15. The chest tube should be directed posteriorly, medially and superiorly as it enters the chest
cavity.
Additional Notes
• If the sterile field is broken but no contaminated equipment has been used on the patient,
the trainee may verbalize gathering a new kit/equipment and re-prepping/draping and still
be considered eligible for a passing performance. Use of any contaminated equipment
and failure to recognize contamination are non-passable actions.
• Safe needle handling is required at all times during the performance. Needlesticks are
6LPXODWLRQ&KHFNOLVWV&KHVW7XEH EM Fundamentals 163
non-passable. Recapping needles is only permissible with the “scooping” technique

where the cap is gripped at the base after being “scooped up” with the needle. The hand
should never hold portions of the cap that are distal to the needle tip.
• “Peeking” by looking behind the artificial skin or otherwise attempting to obtain a view or
information that is not typically available in the clinical setting is a non-passable action.
should be sterile and is dropped in a way that compromises sterility, the trainee verbalizes
would not be used.
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or advice.
Action Rating
1
3 Verbalize and identify landmarks Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Identify internal jugular vein on ultrasound and
4
mark site Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
5
Verbalize donning mask with face shield, bouf-
7
fant cap, sterile gown, and sterile gloves. Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
8 Verbalize positioning patient in Trendelenburg Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
9 Mock cleanse skin with chlorhexidine swab Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
10 Verbalize sterile draping Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Verbalize application of sterile ultrasound probe
11
cover Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Apply occlusive caps to ports, flush ports with
12
saline Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
13 Re-identify internal jugular vein on ultrasound Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
14 Mock local anesthetic Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Advance the needle under ultrasound guidance,
15
aspirating while advancing Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Confirm intravenous placement of needle via
16
ultrasound and aspiration of blood Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
17 Holding the needle securely, remove the syringe Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
6LPXODWLRQ&KHFNOLVWV&HQWUDO9HQRXV$FFHVV EM Fundamentals 165
Insert guide wire through the needle, confirm

18 intravenous placement via ultrasound, then re- Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
move needle without disturbing the guidewire
Thread the flexible catheter over the wire and
into the vein, remove the wire without disturbing
19 the catheter, then connect the catheter to trans- Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
duction tubing to confirm venous placement (if
available)
Insert guide wire through the catheter, re-con-
firm intravenous placement via ultrasound, then
20
remove catheter without disturbing the guide- Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
wire
21 Nick skin at wire entry site using scalpel Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Maintaining control of wire at all times, advance
22
dilator over wire into vein, then withdraw dilator Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Maintaining control of wire at all times, advance
23
triple-lumen catheter over guidewire Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
24 Remove guidewire Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
25 Aspirate for blood return and flush each port Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Verbalize placement of bio-patch, suturing line
26 in place, and placement of sterile occlusive Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
dressing
27 Verbalize disposing of sharps Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
not met?
Resident: __________________________ Date: ______________


1. Risks of the procedure should include common complications (e.g., pain), uncommon but se-
vere complications (e.g., pneumothorax, arterial injury), infection, and bleeding.
c. Correct site (it should also be explicitly noted here that the site is marked)
Contamination should only be considered a failing action if the learner does not correct for it by
16. Puncture of the carotid artery is a non-passable action.
Additional Notes
the trainee may verbalize gathering a new kit/equipment and re-prepping/draping and still
and failure to recognize contamination are non-passable.
• “Peeking” by looking down the open end of the model or otherwise attempting to obtain
a view/information that is not typically available in the clinical setting is a non-passable
action.
• A dropped piece of equipment does not automatically preempt a passing score, so long
would not be used.
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or advice.
Action Rating
1
Identify radial artery on ultrasound and mark
4
site Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
5 Verbalize Allen’s test Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
6
8 Mock cleanse skin with chlorhexidine swab Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
9 Don mock-sterile gloves Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
10 Verbalize applying sterile drape or sterile towels Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Verbalize applying sterile ultrasound probe
11
cover Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
12 Re-identify radial artery location on ultrasound Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
13 Advance needle into radial artery Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
14 Advance wire, then advance catheter over wire Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Remove needle and wire without disrupting the
15
catheter Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Hold pressure proximal to catheter to prevent
16
leakage Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
17 Attach arterial catheter to transducer tubing Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Verbalize confirming placement with arterial
18
waveform on monitor Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
19 Verbalize securing line with sterile dressing Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
not met?
Resident: __________________________ Date: ______________

6LPXODWLRQ&KHFNOLVWV5DGLDO$UWHU\/LQH EM Fundamentals 169

1. Risks of the procedure should include common complications (e.g., pain at the site), uncom-
mon but severe complications (e.g., vascular injury), as well as infection and bleeding.
Contamination should only be considered a failing action if the learner does not correct for it by
Additional Notes
the learner may verbalize gathering a new kit/equipment and re-prepping/draping and still
• “Peeking” by looking down the open end of the model or otherwise attempting to obtain
action.
• A dropped piece of equipment does not automatically preempt a passing score, so long
would not be used.
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or advice.
Action Rating
1
3 Verbalize patient positioning Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
5 Mark site (pressure marking) Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
6
Verbalize donning mask; don mock-sterile
8
gloves Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Organize supplies in sterile fashion (tubes, col-
9
umn) Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Mock cleanse skin with betadine (circular, out-
10
ward) Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
11 Apply sterile drape Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
12 Mock local anesthetic: skin wheel Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
13 Mock local anesthetic: deep tissue Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
14 Verbalize spinal needle position (L3-4, L4-5) Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
15 Verbalize spinal needle angle (at umbilicus) Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
16 Verbalize spinal needle orientation (bevel lateral) Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
17 Measure opening pressure Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
Collect CSF in tubes (collect and verbalize vol-
18
ume) Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
19 Replace stylet prior to needle removal Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
20 Pressure applied with sterile dressing Ѓ Done correctly Ѓ Done incorrectly Ѓ Not done
6LPXODWLRQ&KHFNOLVWV/XPEDU3XQFWXUH EM Fundamentals 171
not met?
Resident: __________________________ Date: ______________


1. Risks of the procedure should include common complications (e.g., headache), uncommon
but severe complications (e.g., CSF leak requiring blood patch), as well as infection, bleeding,
and damage to adjacent structures (including nerves).
3. Patient positioning should include description of either the lateral decubitus or sitting posi-
tion. Descriptions (e.g., “patient lying on their side with their knees to their chest”) are accept-
able in lieu of specific terms (e.g., “lateral decubitus”). Note that the learner will be required to
demonstrate measurement of the opening pressure regardless of which position is chosen /
represented by the manikin (i.e., seated or lateral decubitus).
4. Landmarks should include mention of the iliac crests as a guide to the appropriate spinal
level. The anterior superior iliac spine (ASIS) is not a relevant landmark for lumbar puncture and
mention of this landmark as a guide is an unacceptable (non-passable) action.
5. Site should be marked with equipment such as a syringe or cap (this need not be sterile un-
less already prepped). Fingernails and needles are not appropriate tools for marking the site for
the procedure and use of either of these methods constitutes a non-passable action.
plicable). Bouffant caps are not required for the attempt, but should be used in practice and
therefore must be verbalized. Sterile gowns are not required. For the sake of cost, regular exam
gloves may be used in lieu of sterile gloves. Regular gloves should still be treated as sterile,
however (e.g., touching non-sterile equipment should be considered contamination and prompt
re-gloving). Contamination should only be considered a failing action if the learner does not
correct for it by removing the contaminated supplies and replacing those supplies in a sterile
fashion.
9. Supplies should be prepared such that the learner is ready to collect spinal fluid as soon as
the subarachnoid space is accessed. Delay in collection of fluid due to poor preparation is con-
sidered an unacceptable (non-passable) action.
10. Swabs should be used sequentially in an outward circular motion. Swabs should be disposed
of away from the sterile field so as to avoid contamination.
6LPXODWLRQ&KHFNOLVWV/XPEDU3XQFWXUH EM Fundamentals 173
ees should not inject air or fluid into the model (in order to preserve the integrity of the simu-
lator). Note that in practice, aspiration before injection is not required for the initial skin wheel.
ees should not inject air or fluid into the model (in order to preserve the integrity of the simula-
tor). The spinal needle with stylet removed should not be used to inject the deep tissues – lido-
caine possesses antimicrobial properties that may inhibit culture growth. Note that in practice,
aspiration before injection IS required prior to injection of deep local anesthetic.
14. Needle should be inserted at the previously marked site, identified by the landmarks of the
iliac crests. The bevel should be perpendicular to the vertebral column. The stylet need not be
replaced when manipulating spinal needle beyond the initial dermal layers; however, the stylet
must be replaced prior to removal of the needle from the subarachnoid space (Action #17).
15. Note that the learner will be required to demonstrate measurement of the opening pressure
regardless of which position is chosen / represented by the manikin (i.e., seated or lateral de-
cubitus). This step is only meant to evaluate technique in the assembly and attachment of the
manometry equipment. There is no “correct” opening pressure and learners should not receive
“incorrect” scores.
16. During CSF collection, briefly dripping spinal fluid while making purposeful movements is
permissible. Non-deliberate actions (e.g., fumbling with equipment without clear purpose) while
dripping spinal fluid is an unacceptable (non-passable) action.
Additional Notes
the learner may verbalize gathering a new kit/equipment and re-prepping/draping and still
• “Peeking” by looking down the open end of the canal or otherwise attempting to obtain
action.
would not be used.

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6LPXODWLRQ&KHFNOLVWV EM Fundamentals 153

Mastery (Advancement) Standard

Verbalize timing of medication administration,

Verbalize confirmation of tube placement via

If yes, please describe:

Resident: __________________________ Date: ______________

Faculty: __________________________ Pass/Fail: ______________

Notes / Performance Dimension Training

Mastery (Advancement) Standard

If yes, please describe:

Resident: __________________________ Date: ______________

Faculty: __________________________ Pass/Fail: ______________

Notes / Performance Dimension Training

Mastery (Advancement) Standard

Using the Kelly clamp as a guide, pass the chest

If yes, please describe:

Resident: __________________________ Date: ______________

Faculty: __________________________ Pass/Fail: ______________

Notes / Performance Dimension Training

non-passable. Recapping needles is only permissible with the “scooping” technique

Mastery (Advancement) Standard

Insert guide wire through the needle, confirm

If yes, please describe:

Resident: __________________________ Date: ______________

Faculty: __________________________ Pass/Fail: ______________

Notes / Performance Dimension Training

16. Puncture of the carotid artery is a non-passable action.

Mastery (Advancement) Standard

If yes, please describe:

Resident: __________________________ Date: ______________

Faculty: __________________________ Pass/Fail: ______________

Notes / Performance Dimension Training

Mastery (Advancement) Standard

If yes, please describe:

Resident: __________________________ Date: ______________

Faculty: __________________________ Pass/Fail: ______________

Notes / Performance Dimension Training

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