EMT-Advanced Airway Assist Psychomotor Exam Checklist

1.

Takes of verbalizes appropriate body substance isolation precautions

2.Checks for presence of all __________ sizes (2.0 – 9.0) and supraglottic devices

Checks for presence of all endotracheal tube sizes (2.0 – 9.0) and supraglottic devices

3.Checks for presence of adult/ pediatric/ infant______

Checks for presence of adult/ pediatric/ infant Stylet

4.Checks for presence of ____ ________and bacterial/ viral _______

Checks for presence of tube extension and bacterial/ viral filter

5.Checks for presence of _________ ___________ device

Checks for presence of waveform capnometry device

6.Checks for presence of tube _________ ________

Checks for presence of tube securing device

7.Checks for presence of adult and pediatric ______ ________

Checks for presence of adult and pediatric Magill’s forceps

8.Checks for presence of _____ ______, trash bag, and _______ jelly

Checks for presence of 10cc syringe, trash bag, and lidocaine jelly

9.Demonstrates how to properly check intubation _______ and _____.

Demonstrates how to properly check intubation blades and handle.

10.

READ: You are dispatched to an unresponsive adult. Upon assessment, your medic instructs you to prepare for endotracheal intubation of the patient. The medic asks you to prepare a Mac-4 blade.

11.Assures readiness of BVM and prepares to ________ and _________the patient

Assures readiness of BVM and prepares to preoxygenate and ventilate the patient

12.Checks _______ and for presence of _______ _______ suction catheters.

Checks suction and for presence of rigid soft suction catheters.

13.

Inserts and shapes stylet into endotracheal tube

14.

Attaches air-filled 10cc syringe onto endotracheal tube and checks cuff integrity

15.

Connects tube extension, filter, and capnometry device to BVM

16.

Places assembled endotracheal tube next to patient’s head

17.

Places prepared securing device next to patient’s head

18.

Places assembled intubation handle and blade next to patient’s head

19.

READ: The medic has completed the intubation and asks for your assistance in assuring the patence of the airway and then securing it.

20.

Auscultates for negative gastric sounds and positive = lung sounds

21.

Attaches end-tidal carbon dioxide monitor

22.

Identifies depth of tube at teeth, secures tube and considers/ applies cervical collar