STUDENT CLINICAL BOOK

STUDENT CLINICAL BOOK 10/29/2013

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 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. Palm Beach State College Paramedic Program 1 Student Clinical Book

Palm Beach State College Paramedic Program 2 Student Clinical Book

Paramedic Clinical CLASS SHIFT: BOOK ATTESTATION PAGE 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 3 Student Clinical Book

Palm Beach State College PARAMEDIC PROGRAM STUDENT CLINICAL MANUAL EMS 2664, 2665, 2658, 2659 STUDENT NAME CLINICAL INSTRUCTOR FIRE RESCUE INSTRUCTOR CLASSROOM INSTRUCTOR Palm Beach State College Paramedic Program 4 Student Clinical Book

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 5 Student Clinical Book

Palm Beach State College Paramedic Program CLINICAL EVALUATION PROGRESS REPORT EMS 2664 CLINICAL 1 EMS 2658 CLINICAL 3 EMS 2665 CLINICAL 2 Class: EMS 2659 Internship 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 6 Student Clinical Book

Palm Beach State College Paramedic Program CLINICAL EVALUATION - COVER FOR LONG FORM EMS 2664 CLINICAL 1 EMS 2658 CLINICAL 3 EMS 2665 CLINICAL 2 EMS 2659 Internship CLASS: Date Student Name Instructor Name Instructor Signature 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: Competent Not Competent 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: Palm Beach State College Paramedic Program 7 Student Clinical Book

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 Paramedic Program 8 Student Clinical Book

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 Palm Beach State College Paramedic Program 9 Student Clinical Book

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 Paramedic Program 10 Student Clinical Book

PALM BEACH STATE COLLEGE EMT/Paramedic Program PATIENT CARE REPORT Student: EMT Paramedic Date: / / Time of Call: I accompanied this patient to the hospital during transport. Instructor/Preceptor Name: ETHNICITY M F Hospital/Agency: Age: Chief MEDICAL COMPLAINT Instructor/Preceptor Signature: Unit: Chief TRAUMA COMPLAINT African American American Indian Asian Caucasian Hispanic Abdominal Cardiac CVA Diabetic OB/GYN OD-Poison Psychiatric Respiratory Seizure Sepsis Abdomen Chest Extrem. Muscular Neck/Back Pelvic Head/Face Multisystem Other: Other Other MECHANISM OF INJURY None Driver MVA Passenger MVA Auto-Pedestrian Motorcycle Fall/Jump Airbag Seatbelt Entrapment Ejection Rollover Blunt Penetrating Injury Type: ALLERGIES: MEDICATIONS: Other: 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 Palm Beach State College Paramedic Program 11 Student Clinical Book

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: ELECTRICAL THERAPY MANUAL DEFIBRILLATION ENERGY LEVELS Success: N Y Site: Gauge: Solution: OBS. PERF. EKG INTERPRETATION OBS PERF Rhythm 1: SYNCHRONIZED CARDIOVERSION Rhythm 2: TRANSCUTANEOUS PACING Rhythm 3: PHTLS CARE BLS CARE OBS PERF OBS PERF PATIENT INTERVIEW VITAL SIGNS WITNESSED ARREST SUCTION 0 2 ADMINISTRATION CHEST COMPRESSIONS BANDAGING VENTILATIONS TRACTION SPLINT BLS airway adjunct C-SPINE IMMOBILIZATION LONG BACKBOARD LONG BONE IMOBILIZATION AIRWAY ADJUNCT TYPE: ALS CARE OTHER DESCRIBE # PERFORMED Obs Per STUDENT PHYSICALLY INVOLVED IN LIFTING PATIENT YES NO CHEST DECOMPRESSION CRICOTHYROIDOTOMY 12 LEAD ECG PULSE OXIMETRY BLOOD GLUCOSE Palm Beach State College Paramedic Program 12 Student Clinical Book

SOAP NARRATIVE Subjective: Objective: Assessment: Procedures/Response to Procedures: Palm Beach State College Paramedic Program 13 Student Clinical Book

SKILLS SIGN OFF Name: Instructor: Date: Clinical Location: Patient Age: Patient Gender: Skill Performed Successful: Initials: Student Signature: Date: Instructor Signature: Date: Palm Beach State College Paramedic Program 14 Student Clinical Book

STUDENT EQUIPMENT COMPETENCY CHECK LIST - LP Student Name: Station/Shift: School / Institution: The student will locate and show knowledge of the CPAP The student can identify the location of the CPAP The student can identify the location of all accessories for equipment The student can show and apply the proper procedure for the CPAP The student will locate and show knowledge of the Carevent The student can identify the location of the CAREVENT The student can identify the location of all accessories for equipment The student can show and apply the proper procedure for the CAREVENT The student will locate and show knowledge of the Suction Unit The student can identify the location of the Suction Unit The student can identify the location of all accessories for equipment The student can show and apply the proper procedure for the Suction Unit The student will identify the location of items in the LifePack 15 The student can identify the location of the LifePack 15 The student can identify the location of all accessories for equipment The student can show and apply the proper procedures for the LifePack 15 Palm Beach State College Paramedic Program 15 Student Clinical Book

STUDENT EQUIPMENT COMPETENCY CHECK LIST MED BAG Student Name: Station/Shift: School / Institution: The student will identify the location of items in the Blue Med Bag The student can identify the location of all Medications The student can identify the location of all IV equipment The student can identify the location of all Fluids The student can identify the location of all PPE/BIO bags The student will identify the location of items in the Airway Bag The student can identify the Airway Roll and items inside The 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 The student can identify the location of all IV equipment The student can identify the location of all Fluids The student can identify the location of all PPE The student can identify the location of BLS/ALS Trauma equipment The student will identify the location of items in the Pedi Box The student can identify the location of all Medications The student can identify the location of all IV equipment The student can identify the location of all Fluids The student can identify the location of all PPE/BIO bags The student can identify the location of BLS/ALS equipment Palm Beach State College Paramedic Program 16 Student Clinical Book

STUDENT EQUIPMENT COMPETENCY CHECK LIST - STRETCHER Student Name: Station/Shift: School / Institution: The student will display knowledge & demonstrate how to operate the stair chair The student can identify the location of all handles The student can identify the location of all levers The student can identify the location of all straps The student can demonstrate how to fold and unfold chair The student will demonstrate correct way to move patient The student will display knowledge & demonstrate the operation of the either PBCFR stretchers The student can identify the location of all handles The student can identify the location of all levers The student can identify the location of all straps The student will demonstrate raising and lowering feet/head The student will identify the location and use of the Pedi, Miller, BackBoards & Scoop stretcher The student can identify the location of all Boards The student can identify the location of extra straps The student can identify the location of the decon spray The student can demonstrate how to correctly use straps The student can correctly use above equipment Palm Beach State College Paramedic Program 17 Student Clinical Book

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: Palm Beach State College Paramedic Program 18 Student Clinical Book