FOOTHILL COLLEGE EMT PROGRAM

EMT 1

SKILLS COMPETENCY EXAMINATION

TRAUMA PATIENT ASSESSMENT

WITH MANAGEMENT AND CONTROL OF BLEEDING
PERFORMANCE OBJECTIVE

Student Name: ___________________

Student will demonstrate their ability to perform a Trauma Patient Assessment/Management,

and Control of Bleeding.
This Skill Test Must Be Completed Within 15 Minutes.
Taking More than 15 minutes is a FAIL for This Skill.

CONDITIONS
The patient is conscious, laying on the ground (supine), with a minor injury to an extremity.
Patient will remove their Shoes and Socks before assessment is started.
EQUIPMENT
EMS Jump Bag
Pen light
Gloves
Stethoscope
Goggles
Blood pressure cuff (sphygmomanometer)
Pen/pencil and blank paper
STANDARDS
The standards are incorporated into the checklist to be used by the scorer. All key points are
indicated by a point value of 10, 20, or 30. This is a SKILL test, requiring the student to
perform the appropriate actions and state relevant information (where designated).
A Total Deduction of Fewer than 30 points is Required to Pass This Skill.
SCORER INSTRUCTIONS
1. Some assessment sequences are secondary to the information obtained. Points will not
be subtracted for asking LOC or SAMPLE questions in a different order - as long as all
necessary information is obtained.
2. Scorer will take and document Patients Vital Signs simultaneously with the student.
3. Vital signs can be taken at any time during the skill. If vital signs are taken initially, be
certain to determine the area injured first, so as not to place BP cuff on injured arm.
4. The sentences in quotations are merely examples of ways to state the information
desired or obtained. Different, equivalent, wording is permitted.

SUMMER - 2014

TRAUMA PATIENT ASSESSMENT &

MANAGEMENT WITH CONTROL OF BLEEDING

PAGE: 1 OF 11

FOOTHILL COLLEGE EMT PROGRAM

EMT 1

SKILLS COMPETENCY EXAMINATION

TRAUMA PATIENT ASSESSMENT

WITH MANAGEMENT AND CONTROL OF BLEEDING
This skill must be completed within 15 minutes.

Start Time: ____________

SCORER STATES: PLEASE DEMONSTRATE A TRAUMA ASSESSMENT

OF A PATIENT WITH A MINOR INJURY.
EXAMINATION STEPS
I)

States: I would utilize appropriate

personal protective equipment (PPE).

SCORE

POINT
VALUE

COMMENTS

20

SCENE SIZE UP
II)

Scene Safety
A) States: I would assess the scene for:
1) Environmental Hazards,
2) Biological Hazards,
3) Human Hazards.
B) I would determine the Mechanism of
Injury (MOI).
C) I would determine the number of
patients.
D) I would determine the need for
additional resources.
E) I would consider stabilization of the
spine. (C-spine - Depends on
MOI)

10
10
10
10
10
10
10

INITIAL ASSESSMENT
III) Performs General Impression
States: Patient appears stable
IV) Places hand on forehead to discourage
patient movement of head and neck
A) Introduces self
States: Hello, my name is _______,
Im an EMT. I'm going to help you.
B) States: Please do not attempt to
move your head or neck while
answering my questions or at any
time during the exam.
C) States: I would have another
person maintain head and neck
immobilization, if possible, during
the exam.
PC = Performed Correctly
PI = Performed Incorrectly
NP = Not Performed
SUMMER - 2014

10
30
5

20

10

Total Points Missed This Page ______

TRAUMA PATIENT ASSESSMENT &

MANAGEMENT WITH CONTROL OF BLEEDING

PAGE: 2 OF 11

FOOTHILL COLLEGE EMT PROGRAM

EMT 1

SKILLS COMPETENCY EXAMINATION

TRAUMA PATIENT ASSESSMENT

WITH MANAGEMENT AND CONTROL OF BLEEDING
POINT
EXAMINATION STEPS
SCORE
COMMENTS
VALUE
V) Primary (Chief) Complaint
10
Asks: Where do you hurt?
VI) Determines Level of Orientation
a) Orientation to Person
10
Asks: What is your name?
b) Orientation to Place
10
Asks: Tell me where you are.
c) Orientation to Time
10
Asks: What time of day is it?
d) Orientation to Purpose (This will also
tell you the Mechanism of Injury)
10
Asks: What happened?
VII) Determines Loss of Consciousness
10
Asks: Did you lose consciousness (black out)?
VII) Determines Patients
10
Transport Priority
States: Transport Priority Code is 2
IX) Administers O2 Therapy.
States: I would place this patient on O2
30
using a NRM at 10 to 15 liters per minute.
X) Age
5
Asks: How old are you?
XI) Obtains SAMPLE Information:
Signs and Symptoms (S) and Event (E)
States: The S and E of SAMPLE is
10
information that will be gathered throughout
the exam.
a) Allergies (A):
10
Asks: Are you allergic to anything?
b)
Current Medications (M)
10
Asks: What medications do you take?
c) Past Medical History (P)
Asks: Are you under a doctors care
10
for any medical problems
d) Last Oral Intake (L)
Asks: When was the last time you had
10
anything to eat or drink? What did you
have?
PC = Performed Correctly
PI = Performed Incorrectly
NP = Not Performed

SUMMER - 2014

Total Points Missed This Page ______

TRAUMA PATIENT ASSESSMENT &

MANAGEMENT WITH CONTROL OF BLEEDING

PAGE: 3 OF 11

FOOTHILL COLLEGE EMT PROGRAM

EMT 1

SKILLS COMPETENCY EXAMINATION

TRAUMA PATIENT ASSESSMENT

WITH MANAGEMENT AND CONTROL OF BLEEDING
EXAMINATION STEPS
XII) Prepares for the Exam
e) States: Im going to start my examination
now to see if you are injured anywhere else.
f) Asks: Tell me any places that hurt when I
Touch them.
g) States: Remember, Do not move your head
or neck.
XIII) Assesses Skin Signs
(Using Forearm or Hand)

a)

Color (normal, pale, flushed, cyanotic,

jaundice)
b)
Temperature (cool, warm, hot)
c)
Moisture (wet, dry)
States: Skin color is normal.
Skin is warm and dry.

SCORE

PONT
VALUE

COMMENTS

5
5
10

10
10
10

XIV) Takes Vital Signs

a)

Pulse
Takes pulse with index and middle
fingers over the radial pulse
ii)
For at least 15 seconds
iii) Does not use thumb to palpate pulse.
i)

iv)

b)

Reports pulse rate to scorer.

(must be within a 10 point margin)

Respirations
i)
Counts respirations as radial pulse is
palpated.

10
10
10
Student:_______
20
Proctor:_______

10

ii)

Watches for rise and fall of abdomen.

10

iii)

Reports Respiration Rate to scorer.

(must be within 4 point margin)

20

PC = Performed Correctly
PI = Performed Incorrectly
NP = Not Performed

SUMMER - 2014

Student:_______
Proctor:_______
Total Points Missed On This Page ______

TRAUMA PATIENT ASSESSMENT &

MANAGEMENT WITH CONTROL OF BLEEDING

PAGE: 4 OF 11

FOOTHILL COLLEGE EMT PROGRAM

EMT 1

SKILLS COMPETENCY EXAMINATION

TRAUMA PATIENT ASSESSMENT

WITH MANAGEMENT AND CONTROL OF BLEEDING
EXAMINATION STEPS
c)

Blood Pressure (Palpated)

i) Places Cuff 1 above antecubital space.
ii) Does not place Cuff over clothing.
iii)
Assures Cuff fits snugly.
iv) Centers bladder of cuff over brachial
artery.
v) Assures Tubing is distal to cuff.

SCORE

POINT
VALUE
5
5
5
5
5

vi)

Palpates Radial or Brachial pulse.

10

vii)

Keeps Fingers on pulse point.

10

viii)

Inflates Cuff at least 30 points above

point at which pulse is no longer felt.

10

ix)

Deflates Cuff slowly.

x)

Determines Palpable blood pressure.

(When pulse is first felt to return)

20

xi)

Reports Palpated blood pressure to

scorer.
(Must be within a 10 point margin)

20

d)

COMMENTS

Student:

/P

Proctor:

/P

Blood Pressure (Auscultated)

i)

Places Cuff 1 above the antecubital

space.

ii)

Does not place Cuff over clothing.

iii)
iv)

Assures Cuff fits snugly.

Centers bladder of cuff over brachial
artery.

v)

Assures Tubing is distal to cuff.

vi)
vii)

Palpates Brachial Artery.

Places Stethoscope diaphragm over
brachial artery.

10

PC = Performed Correctly
PI = Performed Incorrectly
NP = Not Performed

SUMMER - 2014

10
Total Points Missed This Page ______

TRAUMA PATIENT ASSESSMENT &

MANAGEMENT WITH CONTROL OF BLEEDING

PAGE: 5 OF 11

FOOTHILL COLLEGE EMT PROGRAM

EMT 1

SKILLS COMPETENCY EXAMINATION

TRAUMA PATIENT ASSESSMENT

WITH MANAGEMENT AND CONTROL OF BLEEDING
EXAMINATION STEPS

SCORE

POINT
VALUE

i) Inflates Cuff to at least 30 points above

palpated BP, or 30 points above the
pressure noted when the pulse is no longer
heard, while inflating the cuff.

10

ii) Deflates Cuff slowly.

iii) Determines both Systolic and Diastolic

sounds.
iv) Reports Systolic blood pressure to Scorer.
(Must be within a 10 point margin)
v) Reports Diastolic blood pressure to Scorer.
(Must be within a 10 point margin)
XV)

Begins Head to Toe Survey

COMMENTS

20
20
20

Student:

Proctor:

(reports all findings to scorer)

a)

Palpates scalp with both hands for:

i) Active Bleeding (Checks Gloves)
ii) Deformities
States: No Active bleeding or deformities
found.
b) Observes eyes for:
i) Ability to open (spontaneous, to
voice, or to pain)
States: Spontaneous eye opening noticed.
ii) Foreign bodies and prosthesis.
States: No foreign bodies or prosthesis
noticed.
iii) Diameter of each pupil (normal,
dilated, constricted, or pinpoint)
States: Pupils are ______mm in size
iv) Reaction to light,
(Moves penlight lateral to medial)
v) Notes equality of reaction time to
light and pupil diameter.
States: Pupils are equal and react to light.
PC = Performed Correctly
PI = Performed Incorrectly
NP = Not Performed

SUMMER - 2014

5
5

10
R-10
L-10
R-10
L-10
R-10
L-10
R-10
L-10
Total Points Missed This Page ______

TRAUMA PATIENT ASSESSMENT &

MANAGEMENT WITH CONTROL OF BLEEDING

PAGE: 6 OF 11

FOOTHILL COLLEGE EMT PROGRAM

EMT 1

SKILLS COMPETENCY EXAMINATION

TRAUMA PATIENT ASSESSMENT

WITH MANAGEMENT AND CONTROL OF BLEEDING
EXAMINATION STEPS
XVI) Observes lower eyelid for color
Gently Pulls either eyelid down, looks for
pinkness or paleness.
States: Lower eyelid is pink
XVII) Observes Ears
Looks into both ears for blood or clear
fluid (CSF).
States: No blood or clear fluid (CSF) in ears.
XVIII) Observes Nose
Looks into nose for blood or clear fluid (CSF)
States: No blood or clear fluid (CSF) in nose
XIX) Observes Mouth
Looks into mouth for possible airway
obstruction and/or trauma.
States: No trauma or obstruction noticed.
XII) Exposes Chest & Abdomen
States: Before assessing the neck, chest and
abdomen I would remove all clothing.
XIII) Observes Front of Neck for:
i. Trachea deviation
States: No tracheal deviation noticed.
ii. Accessory muscle use in neck
States: No accessory muscle use noticed
iii. Neck vein distention
States: No neck vein distention noticed
iv. Surgical Airway
States: No Stoma noticed.
v. Medical Alert necklace
States: No med-alert noticed.
XIV) Palpates back of neck (cervical spine)
for mid-line point tenderness.
States: No cervical spine tenderness noted.
XV) Observe both Clavicles for Deformities
XVI) Palpates both Clavicles for Deformities
States: No deformities noticed.
PC = Performed Correctly
PI = Performed Incorrectly
NP = Not Performed

SUMMER - 2014

SCORE

POINT
VALUE

COMMENTS

R - 10
L - 10

10

10

10

10
10
10
10
10
30
R - 10
L - 10
R - 10
L - 10
Total Points Missed This Page ______

TRAUMA PATIENT ASSESSMENT &

MANAGEMENT WITH CONTROL OF BLEEDING

PAGE: 7 OF 11

FOOTHILL COLLEGE EMT PROGRAM

EMT 1

SKILLS COMPETENCY EXAMINATION

TRAUMA PATIENT ASSESSMENT

WITH MANAGEMENT AND CONTROL OF BLEEDING
EXAMINATION STEPS
XVII) Observes Chest for:
i. Bilateral equality of movement
ii. Paradoxical motion

SCORE

POINT
VALUE

COMMENTS

20
5

i. Effort of breathing
20
ii. Sternal or intercostal retractions
States: There is equal bilateral movement of the
20
chest without paradoxical motion or
excessive effort.
iii. Scars and bruises
5
States: No scars or bruises noticed.
XVIII) Auscultates both Lungs for Breath Sounds
(At the intersection of the lateral nipple line and the mid-axillary line.)
Reports Breath Sounds
R-5
States: Breath sounds are present bilaterally.
L-5
XIX) Palpates Chest
iv. Places hands on chest in BarrelHoop
10
test position.
Asks: Please take a deep breath. (enables
5
assessment for bony or soft tissue crepitus.)
v. If no crepitus noticed, compresses chest
firmly for Barrel Hoop test. If no Pain
noticed:
10
States: No pain, bony or soft tissue crepitus
noticed.
XX) Observes Abdomen for:
20
i) Obvious penetrating injuries
ii) Scars
5
iii) Bruises
5
iv) Distention
5
v) Pulsating Mass (es)
States: No penetrating injuries, scars, bruises,
distention, or pulsating mass noticed. If
10
a mass existed, I would not palpate the
abdomen.
PC = Performed Correctly
PI = Performed Incorrectly
NP = Not Performed

SUMMER - 2014

Total Points Missed This Page ______

TRAUMA PATIENT ASSESSMENT &

MANAGEMENT WITH CONTROL OF BLEEDING

PAGE: 8 OF 11

FOOTHILL COLLEGE EMT PROGRAM

EMT 1

SKILLS COMPETENCY EXAMINATION

TRAUMA PATIENT ASSESSMENT

WITH MANAGEMENT AND CONTROL OF BLEEDING
EXAMINATION STEPS

SCORE

a) Palpates Abdomen (in all four quadrants separately)

vi) RUQ
vii) LUQ
viii) LLQ
ix) RLQ
(1) For tenderness,
(2) For rigidity (firmness)
States: No tenderness or rigidity noticed.
a) Palpates Pelvis
Compresses pelvis from the sides (iliac crests)
to test for pelvic fracture (barrel-hoop test).
States: No pain noticed
XXI) Observes Legs and Feet for:
The Clothing has been removed,
Removes Shoes and Socks.
States: I would assess the Legs and Feet for...
i) Needle (track) marks
ii) Shunts
iii) Bleeding
iv) Scars and bruises.

POINT
VALUE

COMMENTS

10
10
10
10
5
5

10

10
R-3
L-3
R -3
L-3
R-3
L-3
R-3
L-3

v) Deformities
R-3
States: No track marks, shunts, bleeding, scars
L-3
or deformities noticed.
XXII)
Palpates each Leg for Pain or
R - 10
Deformity
L - 10
States: No pain or deformities noticed.
XXIII) Palpates Foot Pulses (palpate together, using at least two fingers)
XXIV) Palpates either the dorsal pedal or
R - 10
posterior tibial pulse in each foot.
L - 10
States: Pulses present bilaterally.
XXV) Observes Foot Movement
R - 10
(Holds ankle joints)
L - 10
States: Please wiggle your toes.
PC = Performed Correctly
PI = Performed Incorrectly
NP = Not Performed
SUMMER - 2014

Total Points Missed On This Page ______

TRAUMA PATIENT ASSESSMENT &

MANAGEMENT WITH CONTROL OF BLEEDING

PAGE: 9 OF 11

FOOTHILL COLLEGE EMT PROGRAM

EMT 1

SKILLS COMPETENCY EXAMINATION

TRAUMA PATIENT ASSESSMENT

WITH MANAGEMENT AND CONTROL OF BLEEDING
EXAMINATION STEPS
a) Observes Foot Sensation
(Touches either the big toe or the
pinky toe on each foot in turn)
Asks: Which toe am I touching?
b) Observes Arms and Hands for:
i) Needle (track) marks
ii)

Shunts

POINT
VALUE

COMMENTS

R - 10
L - 10
R-3
L-3
R-3
L-3
R-3
L-3

iii) Bleeding
iv) Scars and bruises
v)

SCORE

Deformities

c) Palpates each Arm for Pain or

Deformity

R-3
L-3
R-3
L-3
R - 10
L - 10

d) Palpates Radial Pulses (palpate

R - 10
together)
L - 10
States: Pulses present bilaterally.
e) Observes Hand Movements (holds wrist
R - 10
joints)
L - 10
Asks: Please move your fingers.
f) Observes Hand Sensation (Touches a
R - 10
finger on each hand in turn)
L - 10
Asks: Which finger am I touching?
XXVI) Examination of the Back
Describes the log roll procedure to examine the back and buttocks.
States: I would need at least 2 people, preferably
4 people for the log roll. I would position
the person in charge at the head to
20
immobilize the C-Spine and give
commands, another person at the shoulders,
one at the hips, and one more for the legs.
PC = Performed Correctly
PI = Performed Incorrectly
Total Points Missed This Page _____
NP = Not Performed

SUMMER - 2014

TRAUMA PATIENT ASSESSMENT &

MANAGEMENT WITH CONTROL OF BLEEDING

PAGE: 10 OF 11

FOOTHILL COLLEGE EMT PROGRAM

EMT 1

SKILLS COMPETENCY EXAMINATION

TRAUMA PATIENT ASSESSMENT

WITH MANAGEMENT AND CONTROL OF BLEEDING

EXAMINATION STEPS

SCORE

POINT
VALUE

COMMENTS

XXVII) States: I would Assesses the Back and

Buttocks for bleeding, deformities, scars
20
or bruising.
SCORER STATES: IF YOU HAD FOUND SIGNIFICANT BLEEDING WHEN YOU
ASSESSED THE LOWER RIGHT ARM, WHAT ACTIONS WOULD
YOU NOW TAKE TO CONTROL IT?
I) States: I would place a dry sterile dressing
(DSD) over the wound. If the first
dressing became soaked with blood, I
10
would place another dressing (DSD) over
the first.
II) States: I would apply direct pressure over
30
the wound using the palm of my hand.
III) States: If these measures failed, a
10
Tourniquet would be used.
a) States: The Tourniquet would be
applied 1- 2 proximal to the wound,
not over a joint.
20
b) I would write the time of application on
the Tourniquet.
SKILL COMPLETED IN 15 MINUTES

30

(BOTH TRAUMA ASSESSMENT / MANAGEMENT AND

CONTROL OF BLEEDING)

PC = Performed Correctly
PI = Performed Incorrectly
NP = Not Performed

Total Points Missed This Page ________

Start Time: __________

Finish Time: _________
Cumulative Total Points Missed: _______
Scorers Printed Name: ___________________________
Scorers Signature: _______________________________
FAILED SKILL Student Not Prepared
SUMMER - 2014

TRAUMA PATIENT ASSESSMENT &

MANAGEMENT WITH CONTROL OF BLEEDING

PAGE: 11 OF 11