DIRECTIONS for Skills Testing - ACLS-PALS-BLS.com...The test administrator, examiner, will read the...
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© 2019 United Medical Education 1 DIRECTIONS for Skills Testing: The test administrator, examiner, will read the case scenarios to the student and follow the checklists, marking each step Completed as the student works through each scenario. In order to have a step marked complete the student must demonstrate a solid grasp of BLS/ACLS concepts and mechanics. The test administrator should not provide guidance to the student but may answer questions given the information provided in the scenario. Each scenario should take approximately 10 minutes to complete. In the event the administrator must guide the student through a step, the step must be counted as incomplete and the student should repeat the skills checklist. The student should receive feedback on areas needing improvement before retesting skills. *DISCLAIMER: Only a current certified ACLS provider can administer test.
Transcript of DIRECTIONS for Skills Testing - ACLS-PALS-BLS.com...The test administrator, examiner, will read the...
© 2019 United Medical Education 1
DIRECTIONSforSkillsTesting:Thetestadministrator,examiner,willreadthecasescenariostothestudentandfollowthechecklists,markingeachstepCompletedasthestudentworksthrougheachscenario.InordertohaveastepmarkedcompletethestudentmustdemonstrateasolidgraspofBLS/ACLSconceptsandmechanics.Thetestadministratorshouldnotprovideguidancetothestudentbutmayanswerquestionsgiventheinformationprovidedinthescenario.Eachscenarioshouldtakeapproximately10minutestocomplete.Intheeventtheadministratormustguidethestudentthroughastep,thestepmustbecountedasincompleteandthestudentshouldrepeattheskillschecklist.Thestudentshouldreceivefeedbackonareasneedingimprovementbeforeretestingskills.*DISCLAIMER:OnlyacurrentcertifiedACLSprovidercanadministertest.
© 2019 United Medical Education 2
BLSSCENARIO(Testadministratordialogueprovidedinitalics)Youareatthegymrunningonthetreadmillwhenyounoticesomeonenearbyyellingforhelp.Anothergymgoerhascollapsedtotheground.
1. Theexamineeshouldsecurethescene.(Sceneissafe)
2. Assessespatientresponsiveness.(Nopulsepresent,nobreathsobserved)
3. DirectssomeonetocallforhelpandgettheAED.(Bystandershavegonetocall911andgettheAED)
4. DemonstratescorrectCPRhandplacementandbodypositioningoverpatient.
5. Demonstratescorrectcompressionrateanddepth,andallowsforcompletechestrecoil.
6. Demonstratesopeningtheairway,giveseffectivebreaths,andobservesvisiblechestrise.
7. HaveexamineeperformasecondroundofCPR.(AEDhasarrived,switchprovidersgivingcompressions)
8. DemonstratescorrectplacementofAED,withoutinterruptingCPR.(AEDanalyzesrhythm)
9. Examineeclearspatientforrhythmcheckandshock.(Shockdelivered)
10. ExamineeimmediatelyreturnstoCPRaftershockdelivered.
BLS Skills Verification Checklist
Skill Tested
Completed
Yes No
Establish scene safety
Assess patient responsiveness (check for pulse/breathing, no longer than 10 sec)
Activates emergency response (calls for help/AED)
Correct CPR hand placement and positioning
Correct CPR rate (100-120/min.) and depth (2 inches)
Allows for complete recoil of chest between compressions
Airway opened appropriately (head tilt/chin lift, jaw thrust)
Delivers 2 breaths (each over 1 second) with visible chest rise
Correct AED placement without disrupting compressions
Clear of patient for rhythm analysis and shock
Compressions immediately resumed after shock
© 2019 United Medical Education 3
AIRWAYMANAGEMENTSCENARIO(Testadministratordialogueprovidedinitalics)YouareanurseintheERexamininga20-year-oldfemalepatientwhopresentswithshortnessofbreath.Thepatientstatesbetweenbreathsshehasahistoryofasthmaandfeelslikeshecan’tbreathe.
1. Examineeperformsprimaryassessment:assessingairway,breathing,andcirculation.(Airwayispatent;patientisbreathingrapidly,30RR;wheezingheardbilaterallyonauscultation;88%O2saturation;115HR;130/84BP)
2. Activatesemergencyresponse.(Respiratorytherapisthasbeencalledandisontheirway)
3. Providessupplementaloxygentopatient.(Askexamineewhatisappropriateoxygenationlevel?)Examineestates94%orgreater.
Youadministersupplementaloxygentothepatientbutoxygensaturationisnotimproving.Respiratorytherapyarrivesandadministersalbuteroltreatment.Thereisnomarkedimprovementinpatient’sconditionandvitalsignsbegintodeteriorate.Patientisgaspingforair.4. Demonstrateseffectiveventilationusingbag-mask.Askexamineewhatiscorrect
ventilationrateandspeed?Onebreathevery6seconds,over1secondeach.
5. Examineerecognizestheneedforanadvancedairwayandplacesone.
ACLS Skills Verification Checklist - Airway Management
Skill Tested
Completed
Yes No
Performs primary assessment:
Assesses airway, breathing and circulation
Activates emergency response (calls for help)
Administers supplemental oxygen (maintains oxygen saturation 94% or higher)
Performs effective bag-mask ventilation (once every 6 seconds, given over 1 sec)
Recognizes need for an advanced airway
© 2019 United Medical Education 4
TACHYARRHYTHMIAMEGACODESCENARIO(Testadministratordialogueprovidedinitalics.Rhythmstripsattachedtodocument.)YouareanERphysicianexamininga50-year-oldmalethatpresentstotheERcomplainingoflight-headednessandshortnessofbreath.
1. Examineeassessesairway,breathing,andcirculation.(Airwayispatent;24RR;154HR;90%O2Sat;120/84BP)
2. Examineeinitiatesappropriateinterventions:maintainsopenairwayandoxygenation,placesIV,placescardiacmonitor,andmonitorspatient’sBP.
3. ShowexamineerhythmstripforSVT.Examineecorrectlyidentifiesrhythm.
4. Examineeperformsvagalmaneuvers.(Nochangeinpatientcondition.)
5. ExamineeadministersAdenosine,initialdose6mg.(NochangeafterinitialdoseofAdenosine.PatientremainsinSVT.)
6. ExamineeadministersseconddoseofAdenosine,dose12mg.(Patient’sconditionhasnot
improved.PatientremainsinSVT)
7. Examineeshouldmoveontocardioversion.Haveexamineestatedose,100J.(Aftersynchronizedcardioversionpatientgoesunconscious.)
8. Examineeassessesforpulse,breathing.(Patientdoesnothaveapulse.Themonitorshows
thefollowingrhythm)ShowexamineerhythmstripforVT;havethemidentify.
9. ExamineerecognizesVTasashockablerhythm.Defibrillatespatient.CommencesCPR.
10. Atrhythmcheck(2minmark)showexamineerhythmstripforPEA;havethemidentify.
11. ExamineeshouldcontinueCPR.Administer1mgepinephrine.ConsiderH&T’s.
PatienthasROSC.
12. Examineeshouldidentifypost-cardiacarrestcaremeasures.
© 2019 United Medical Education 5
ACLS Skills Verification Checklist- Tachyarrhythmia Megacode
Skill Tested
Completed
Yes No
Performs primary assessment:
Assesses airway, breathing and circulation
Implements appropriate initial interventions for tachyarrhythmia:
Maintain airway, supplemental oxygen, cardiac monitor, BP, place IV
Correctly identifies cardiac rhythm
a.) Performs vagal maneuvers
b.) Administers adenosine and identifies correct doses
c.) Performs cardioversion
Performs BLS assessment:
Circulation, airway, breathing
Correctly identifies cardiac rhythm as shockable. Delivers shock.
Continues CPR immediately after shock delivered.
Identifies cardiac rhythm as unshockable. Continues CPR.
Administers 1 mg epinephrine.
Identifies ROSC post-arrest care: Optimize ventilation/oxygenation (maintain O2
Sat >94%), treat hypotension (fluids), STEMI / MI considerations (coronary
perfusion), Temperature management (Neuro), transfer to ICU
© 2019 United Medical Education 6
BRADYARRHYTHMIAMEGACODESCENARIO(Testadministratordialogueprovidedinitalics.Rhythmstripsattachedtodocument.)67year-oldmalepresentstotheERforalteredmentalstatus.Patientreportsfeelingtiredandhiswifestateshehashadsomeconfusion.
1. Examineeassessesairway,breathing,andcirculation.(Noairwaycompromise;18RRbreathsoundsclear;42HR;90%O2Sat;80/56BP)
2. Examineeinitiatesappropriateinterventions:maintainairwayandoxygenation,placesIV,placescardiacmonitor,monitorspatient’sBPandECG.
3. Showexamineerhythmstripforsinusbradycardia;havethemidentify.
4. Examineerecognizesneedtoadministeratropine,initialdose0.5mgbolus.(Threeminuteslateryouadministeraseconddoseaswellwithnochangeinpatientcondition.)
5. Examineeshouldmoveontotranscutaneouspacing.(Thepatientsuddenlygoes
unconscious.)
6. Examineeassessesforpulseandbreathing.(Patientdoesnothaveapulse.Themonitorshowsthefollowingrhythm)ShowexamineerhythmstripforVT;havethemidentify.
7. ExamineerecognizesVTasshockablerhythm.Defibrillatespatient.CommencesCPR.
8. Atrhythmcheck(2minmark)showexamineerhythmstripforPEA;havethemidentify.
9. ExamineeshouldcontinueCPR.Administer1mgepinephrine.ConsiderH&T’s.
PatienthasROSC.
10. Examineeshouldidentifypost-cardiacarrestcaremeasures.
© 2019 United Medical Education 7
ACLS Skills Verification Checklist- Bradyarrhythmia Megacode
Skill Tested
Completed
Yes No
Performs primary assessment:
Assess airway, breathing and circulation
Implements appropriate initial interventions for bradyarrhythmia:
Maintain airway, oxygen, cardiac monitor, BP, IV, ECG
Correctly identifies cardiac rhythm.
Administers correct dose of atropine 0.5 mg.
Performs transcutaneous pacing.
Performs BLS assessment:
Circulation, airway, breathing
Correctly Identifies cardiac rhythm as shockable. Delivers shock.
Continues CPR immediately after shock delivery.
Identifies cardiac rhythm as unshockable. Continues CPR.
Administers 1 mg epinephrine.
Identifies ROSC post-arrest care: Optimize ventilation/oxygenation (maintain O2
Sat >94%), treat hypotension (fluids), STEMI/ MI considerations (coronary
perfusion), Temperature management (Neuro), transfer to ICU
© 2019 United Medical Education 8
MEGACODERHYTHMSTRIPS(Key is on the next page.) 1.
2.
3.
4.
© 2019 United Medical Education 9
MEGACODERHYTHMSTRIPSKEY:
1. Supraventricular Tachycardia (SVT) 2. Ventricular Tachycardia – Monomorphic (VT) 3. Pulseless Electrical Activity (PEA) 4. Sinus Bradycardia
© 2019 United Medical Education 10
I, __________________________, the examiner, attest that I am currently certified in Advanced Cardiovascular Life support (ACLS), and that the examinee has successfully completed all aspects of the ACLS live skills test as provided by United Medical Education, in accordance with the current international CPR and ECC guidelines. Examinee Name: _______________________ Examinee Signature: __________________________ Date Signed: ______________ Examiner Name: ________________________ Examiner Signature: __________________________ Date Signed: ______________ Corresponding Provider Card Verification Number (VN): _____________________ This sheet is to be kept with the corresponding ACLS provider card of the examinee.
