Download Clinical Objectives Manual

Critical Care Flight Paramedic Program
Clinical Handbook
Leslie Hernandez, MAEd, NRP, FP-C
Program Coordinator
hernandezlp@uthscsa.edu
(210) 567-7576
Dr. Craig O. Manifold
Medical Director
manifold@uthscsa.edu
1
1. Purpose: The purpose of the Critical Care clinical rotation is to enable students to observe and participate in the
clinical assessment and intervention for critically ill or injured patients, while considering the implications of
such assessment and care during transport. These rotations are also designed to expose students to lowoccurrence events (such as Intra Aortic Balloon Pump therapy and delivering high risk neonates).
2. Goal: The overall goal of this experience is to enable the student to adjust treatment modalities, equipment,
pharmacological interventions, and sustained management techniques to meet the needs of the individual patient
and accompanying pathologies that may complicate patient presentation.
3. Execution: This experience shall be facilitated by the clinical coordinator with student oversight from a
designated representative within each clinical service. Each student will be exposed to the patient throughout the
care continuum and allowed to verbalize proposed care plans according to diagnostic results and patient
response. The student will maximize the learning experience by (1) observing comprehensive patient care of
designated patients and (2) verbalizing the effect of various treatment modalities on observed patients and (3)
receiving feedback from such interactions.
4. Scope of Practice: No more than 3 students will be placed with one area representative. Students may perform
prescribed procedures or interventions under the direct supervision of a physician, registered nurse of associated
professionals licensed to practice in the assigned clinical facility.
5. Procedure for reporting to assigned unit: Students will report to designated meeting area each morning before
reporting to the assigned area. The student will then report to the area representative at the assigned place, date
and time as coordinated through the program clinical coordinator. If the preceptor fails to report, the student will
notify the clinical coordinator for further instructions. The preceptor will be provided a copy of the Critical Care
Clinical Handbook.
5. Behavioral Objectives:
The student will:
A. Actively listen to patient reports that may occur during their rotation (shift reports, physician to physician
reports, interdisciplinary care plan, etc.).
B. Perform patient assessments consistent with patient condition.
C. Review, interpret and discuss patient information including laboratory, radiology and other diagnostic results.
D. Review care history and discuss possible reasoning for chosen plan of care.
E. Observe and discuss effect of treatment and/or care interventions.
F. Discuss Pre-Hospital care that may have affected current treatment choices.
G. Be active in discussing patient assessment and management.
The Preceptor (assigned physician/provider) will:
A. Give the student a brief history of each patient on service.
B. Review student clinical objectives.
C. Be familiar with Skills Checklist.
D. Assist the student in gaining clinical expertise by involving in procedures, treatments and discussion.
E. Serve as a source of reference in answering questions and points of discussion.
F. Challenge the student by asking questions about treatment and care options.
6. Evaluations:
A. Students will be generally evaluated by the instructor for integration within the care team, quality of input,
interpretation of diagnostic tests and performance of skills.
B. Providers will be evaluated for:
a. Inclusion of student in patient discussions, treatments and interventions.
b. Providing skills opportunities.
c. Providing feedback to student and program staff as necessary.
d. Challenging the student on patient assessment, and treatment options.
C. Students will choose one patient during each ICU rotation and L&D rotation, and be prepared to
present and discuss in an end of day peer forum. Student will provide patient history, interventions,
response, adjusted interventions, current management and response of treatment of diagnostic tests.
Student will be able to discuss patient considerations during transport as the patient now presents.
2
Course Clinical Objectives
1. Occupational Health and Safety: Displaying safety consciousness with patients, self, other personnel,
equipment; compliance with infection control principles, including appropriate use of standard
precautions and aseptic technique; using proper body mechanics when handling patients and equipment;
demonstrating understanding of psychological hazards of emergency/critical care environments of
techniques for stress recognition and management.
2. Psychomotor Skills: It is the intent of this course to provide the student opportunities to build the
psychomotor skills necessary to provide a foundation for further performance. While performing most
high-risk, low occurrence procedures on real patients may not be possible, several simulated patients
will provide a number of opportunities to begin the process of muscle memory. A few skills to be
performed are listed below, with a more detailed list found in the skills checklists.
a. Vascular access- Demonstrating ability to safely and effectively access the venous circulation of
patients from all age groups.
b. Medication administration- Demonstrating ability to safely and effectively give medications by
the intravenous push, intravenous continuous infusion, intramuscular, subcutaneous, and
nebulized routes.
c. Bag-Mask ventilation- Demonstrating the ability to safely and effectively ventilate unintubated
patients from all age groups.
d. Endotracheal intubation- Demonstrating the ability to safely and effectively perform
endotracheal intubation.
e. ECG acquisition and interpretation- Demonstrating ability to safely and effectively acquire and
interpret both a monitoring lead and 12-lead ECG.
f. Be aware of different muscles and approaches used with skills when caring for patients in all age
groups.
g. See additional skills in Appendix A – Skills Checklist
3. Patient Assessment and Management: Demonstrate the ability to perform a comprehensive
assessment (including initial assessment, history, and physical exam), develop a differential diagnosis,
formulate, and implement a treatment plan demonstrating a knowledge base and professional judgment
required to care for patients.
a. Describe the normal structure and function of the human body and of each of its major organ
systems across the life span.
i. Describe the normal structure and function of the human body at the cellular, tissue,
organ and body level.
ii. Discuss the normal process of growth in childhood, and maturation through the life-span.
b. Be able to describe the scientific principles underlying laboratory and radiologic diagnostic
methodologies.
i. Discuss the basic scientific principles of radiologic diagnostic tests, and be able to give
examples of how these tests should be used appropriately in patient care.
ii. Discuss how common clinical laboratory tests are used in diagnosis and treatment
monitoring.
c. Explain various causes (genetic, developmental, metabolic, toxic, microbiologic, autoimmune,
neoplastic, degenerative, behavioral, and traumatic) of major diseases and conditions and the
ways in which they operate on the body (pathogenesis).
i. Recognize variations of normal development and function of organs and systems due to
various causes.
d. Apply clinical reasoning and critical thinking skills in developing a differential diagnosis and
management plan.
e. Discuss the impact of patient status, treatments and inventions during transport.
3
4.
5.
6.
7.
i. Describe proper readiness for transport of critical patients in respect to equipment,
interventions, medications, and treatment most likely to maintain or initiate during care.
f. Discuss impact of current assessment and patient management upon transport (critically think
pre-transport interventions such as delay of transport, initiating interventions, discontinuing
interventions, etc).
Psychological: Student must be able to provide care that is compassionate, appropriate, culturally
sensitive and effective for treating health problems and promoting health while understanding the impact
of care on your well-being (also see professional #6).
Record Keeping and Communications:
a. Students must demonstrate interpersonal and communication skills that facilitate effective
interactions with patients and their families and other health professionals, specifically,
i. Develop empathetic, caring relationships with patients.
ii. Communicate effectively with patients’ families, colleagues, and other health care
professionals.
iii. Demonstrate collaborative teamwork skills and the ability to work effectively with other
members of the health care team.
b. Discuss the necessary components needed for thorough documentation before, during and after
transport.
Professionalism: Students must demonstrate a commitment to professional service, adherence to ethical
principles, sensitivity to patients, and maintenance of personal health and well-being, specifically,
a. Demonstrate honesty and integrity in all interactions with patients, their families, and colleagues.
b. Identify and apply theories and principles that govern ethical decision-making.
c. Protect patient privacy and confidentiality.
i. Identify potential breaches to patient privacy and describe strategies to mitigate these
risks.
d. Demonstrate personal accountability and admit professional mistakes openly and honestly with
one’s colleagues and instructors and critically evaluate these mistakes to promote professional
development.
i. Discuss medical errors and their impact on patient care and outcomes.
e. Recognize unprofessional behaviors in self as well as in peers and other health professionals with
whom one interacts and address these in a constructive manner.
i. Identify unprofessional behavior(s) in observed patient interactions.
ii. Provide constructive feedback to peers and instructors in small group settings and
evaluations.
f. Maintain persona health and well-being and achieve a balance between priorities of patient care
and personal and professional development.
g. Actively seek and respond to feedback about professional performance.
Specific topics as outlined under each area heading.
4
Student Name:
PATIENT
SIM
Labor and Delivery
Learning Objectives: Be able to respond appropriately to the
following items
Date/
Initials
1. Identify physiologic changes during pregnancy (cardiovascular,
respiratory, gastrointestinal, renal, and endocrine), what changes are your
patient displaying?
2. Identify dermatologic changes that occur during pregnancy. Are there any
in your patient? Why is this a concern during transport?
3. Discuss the assessment of an obstetrical patient.
4. Describe the management of the pregnant patient who is in cardiac arrest.
5. Identify special areas of concern if you were to transport your patient.
6. Demonstrate understanding of fetal monitoring and how to assess
tracings.
7. Demonstrate the understanding of several methods of fetal monitoring
that you may use during transport of a pregnant patient.
8. Identify complications of pregnancy, including spontaneous abortion and
causes of bleeding.
9. Demonstrate appropriate responses to medical conditions that can exist
during pregnancy and how to manage them during transport.
Pregnancy-induced hypertension
Preeclampsia
Eclampsia
HELLP Syndrome
10. Demonstrate appropriate use of medications used in treating medical
5
Date/ Initials
conditions that can exist during pregnancy (see pharmacological sheet).
Student Name: _____________________________
PATIENT
Labor and Delivery
11. Recognize fetal malpresentations of delivery and perform appropriate
management of situation.
12. Identify and manage shoulder dystocia.
13. Manage multiple-birth deliveries and considerations during transport.
14. Manage potential postpartum complications and identify considerations
during transport.
15. Manage gynecologic issues and emergencies during transport including
ectopic pregnancy, pelvic inflammatory disease, toxic shock syndrome,
ovarian cysts, pathologic cysts, ovarian torsion, and gynecologic trauma
including vulvular hematoma and sexual assault.
**You have responded to an Air extraction request for a 42-week pregnant
patient who was found unconscious in her home by her husband. Discuss
your response to this scene based on considerations that may occur during
pregnancy.
***Knowing you are responding the patient above, and knowing the weather
may prevent immediate departure from site, which equipment, medication
and support would you take with you to respond? What are the doses of the
6
SIM
medication and how is it given?
Neonatal Intensive Care Unit
Student Name: _____________________________
Item
Learning Objectives: Be able to respond appropriately to the following items
PATIENT
SIM
Date/
Date/
Initials
Initials
Cognitive Objectives: Neonatal Intensive Care Unit
1
2
Verbalize physiological and anatomical differences of the neonate. Which
differences does your patient display?
x
x
x
x
heart failure, dysrhythmias, pericarditis
x
x
b. Genetic, endocrine disorders
x
x
x
x
x
x
Recognize, evaluate and manage patients with the signs and symptoms
that present commonly in the NICU:
a. Cardiovascular: cardiomyopathy, congenital heart disease, congestive
c. GI/Nutrition: complications of umbilical catheterization,
gastroesophageal reflux, hepatitis, hyperbilirubinemia, meconium plug,
necrotizing enterocolitis, and nutritional management of high risk
neonates or those with special needs (Cleft lip/palate, other facial
anomalies, etc.)
d. Hematologic conditions: coagulopathy of the newborn, erythroblastosis
fetalis, hemophilia, hydrops fetalis, hyperbilirubinemia, splenomegaly
7
e. Infectious disease: Central line infections, Group B Streptococcal
infections, hepatitis, herpes simplex, intrauterine viral infections, sepsis,
meningitis, nosocomial infections, syphilis, varicella exposure
x
x
x
x
pneumonia, pneumothorax, respiratory distress syndrome
x
x
h. Surgery: pre and post considerations
x
x
Discuss use of ventilators during neonatal transport
x
x
x
x
x
x
Date/
Date/
Initials
Initials
PATIENT
SIMLAB
f. Neurologic disorders: Central apnea, CNS malformations, drug
withdrawal, hydrocephalus, intraventricular hemorrhage, seizures, spina
bifida
g. Pulmonary disorders: atelectasis, bronchopulmonary dysplasia,
meconium aspiration, persistent pulmonary hypertension of the newborn,
3
Discuss how to determine the proper size equipment and adjuncts
4
necessary to treat the neonate
Discuss risks associated with critical care transport, including factors
5
unique to air transport of a neonate
Psychomotor Objectives: Neonatal ICU
1
Perform an assessment of the neonate
2
Differentiate normal and abnormal assessment findings
3
Perform resusitation of the neonate
4
5
Administer pharmacologic agents according to scenario and patient
age/weight
Manage a septic neonate
Recognize and manage congenital anomalies that may lead to compromise
6
of the neonate
7
Manage a patient with infectious disease
8
Assess for and manage a patient with hyperthermia/hypothermia
9
Prepare and maintain an incubator
10
Intubate a neonate. Maintain airway
8
ITEM
Learning Objectives: Be able to respond appropriately to the
following items
Date/
Date/
Initials
Initials
x
x
x
x
COGNITIVE OBJECTIVES: Pediatric Intensive Care Unit
1
Understand the differences of the pediatric patient during assessment of
clinical presentation
Describe anatomical and physiological differences of the
2
pediatric patient that will impact treatment
Describe the management (treatment, pharmacological,
3
equipment, systems support) of the septic child
x
x
4
Describe sedation considerations for the pediatric patient
x
x
patient (size, family, equipment, etc.)
x
x
6
Describe resuscitation of pediatric patients in various scenarios
x
x
7
Describe the management of a patient with physical/sexual abuse
x
x
5
Understand the unique challenges for transport of the pediatric
9
Psychomotor Objectives: Pediatric Intensive Care Unit
PATIENT
SIM
Date/
Date/
Initials
Initials
PATIENT
SIM
Date/
Date/
Initials
Initials
Manage a pediatric patient experiencing a medical event
(Respiratory, Cardiac, GI, Neuro, Toxic, Environmental,
Endocrine, Infectious processes) utilizing laboratory values and
1
2
diagnostic equipment, pharmacologic agents and with
psychosocial and family considerations
Initiate appropriate interventional measures for central and
peripheral vascular access
Set-up, maintain and troubleshoot equipment for measurement
3
of hemodynamic monitoring
Psychomotor Objectives: Pediatric Intensive Care Unit
4
5
Secure an airway utilizing age/size appropriate equipment
Perform appropriate operation of mechanical ventilation
equipment in the various modes
Perform assessment and calculations of pediatric tidal volumes
6
and pressures
7
Insert, confirm placement and maintain an NG and OG tube
8
Perform ECG
Calculate dosages of pharmacological interventions in any given
9
scenario
10
Accurately interpret pediatric ECG
11
Perform urinary catheterization of male and female pediatric
patient with and without abnormal anatomical characteristics
Perform assessment of child with developmental and/or learning
12
deficits
10
Operating Room/Anesthesia/PACU
Student Name: _____________________________
Learning Objectives: Be able to respond appropriately to
ITEM
the following items
PATIENT
SIM
Date/
Date/
Initials
Initials
x
x
x
x
x
x
x
x
PATIENT
SIM
COGNITIVE OBJECTIVES: OR/Anesthesia/PACU
1
2
Identify the indications for basic and advanced airway management
Identify the indications and contraindications for specific airway
interventions
Understand the principles of regional and inhalational anesthetic
techniques including intravenous therapy, principles of the intravenous
administration of drugs, airway management and endotracheal
3
4
intubation, cardiovascular monitoring, and care of the critically ill patient
during the operative period
Understand how to recognize and treat common postoperative
complications
Operating Room/Anesthesia/PACU
11
Date/
Date/
Initials
Initials
Psychomotor Objectives: OR/Anesthesia/PACU
1
2
Perform pre-operative, intra-operative and post-operative assessment of a
critically ill or injured patient
Perform intubation (endotracheal, nasotracheal, orotracheal,
tracheostomy, fiberoptic)
3
React to intubation complications
4
Implement a failed airway algorithm
5
6
Perform alternative airway management techniques (e.g., needle
cricothyrotomy, surgical cricothyrotomy, retrograde intubation, LMA)
Manage a patient with post-operative complications (both surgical and
respiratory)
7
Manage mechanical ventilation
8
Manage a patient with malignant hypothermia
Adult Intensive Care Unit(s)
Student Name: _____________________________
ITEM
Learning Objectives: Be able to respond appropriately to the following items
COGNITIVE OBJECTIVES: Adult ICU
Respiratory 1
2
Define ventilation
Compare inspiration and expiration as to the direction of air movement, use of energy, and
muscles involved
Define the terms related to ventilation (i.e., elastance, surfactant, compliance, airway
3
resistance, work of breathing, tidal volume, anatomic dead space, alveolar ventilations)
4
Identify adventitious sounds that are characterized as continuous and discontinuous
5
Relate clinical conditions that produce crackles, wheezes and rhonchi
6
Formulate a management plan for transporting the patient in respiratory failure
7
Interpret acid-base balance and arterial blood gases
Understand the physiology of ventilation and respiration and identify common pathological
8
events that affect the pulmonary system
12
9
10
Know pharmacological preparations that are used for management of respiratory diseases and
conditions
Know abnormal assessment findings associated with pulmonary diseases and conditions
Understand the indications, contraindications, complications, equipment and techniques for
11
the following:
12
Tracheobronchial suctioning for the intubated patient
13
Alternative methods of endotracheal intubation
14
Needle/Surgical Cricothyrotomy
15
Tube thoracostomy
16
Thoracic drainage system
17
End-tidal CO2 monitoring
18
Mechanical Transport ventilators with flow-control and PEEP attachments
COGNITIVE OBJECTIVES: ADULT ICU
Cardiovascular Describe the initial approach to managing the manifestations of chest pain as related to
19
cardiovascular disease
20
Describe the physiology of cardiovascular disease
21
Differentiate between normal and abnormal ECGs using multi-lead ECGs
Understand indications, contraindications, equipment, techniques and maintenance of various
22
methods of hemodynamic monitoring
Utilize assessment data obtained from hemodynamic monitoring in the formulation of a
23
clinical impression and management plan for the cardiovascular compromised patient
24
Understand diagnostic resources such as laboratory tests, ultrasound, ECHO, etc.
25
Taking data from various diagnostic resources, understand alternative plans of care
26
Understand differential diagnosis and management priorities of cardiovascular emergencies
13
Understand all aspects of equipment used for patients with cardiovascular compromised
27
disease including but not limited to ventricular assist devices, intra-aortic balloon pumps, and
venous pacemaker
Neurological Understand the differences in the neurological assessment between a brain injured or spinal
28
cord injured patient
29
Know the management of non-traumatic neurological emergencies
Describe the major components of a neurological exam and describe the findings of a normal
30
and abnormal exam
31
Identify transport considerations for the patient with neurological injury
32
Describe the pathophysiology of ICP including knowing how to describe an ICP waveform
33
Understand the terms and implications of compliance, herniation, CPP as related to the brain
COGNITIVE OBJECTIVES: ADULT ICU
34
Identify signs and symptoms of increasing ICP and strategies for decreasing ICP during critical
care transport
Describe the advantages, disadvantages, and transport considerations for the following ICP
monitoring devices: Intraventricular catheter; Epidural catheter; Subdural/subarachnoid
35
monitoring devices; fiber optic transducer tipped probe; to include other vices developed for
transport considerations
Gastrointestinal, Genitourinary and Renal 36
Discuss the characteristics and manifestations of blood in the gastrointestinal tract
37
Differentiate the signs and symptoms of acute and chronic GI, GU and renal diseases
38
Know the commonly accepted methods of managing GI, GU, and Renal patients
39
Know the pharmacological management of the GI, GU and Renal patient
40
Know different renal dialysis techniques; along with complications and management
techniques associated with each method
14
41
Recognize lab values related to GI, GU and Renal pathophysiology
42
Discuss the discontinuation of dialysis in the event of acute complications
43
Understand differential diagnosis and management priorities of GI, GU and Renal disease
Burn Understand burn assessment criteria and how to score the burn in terms of total body
44
45
46
percentage
Understand hemodynamic assessment criteria associated with burn related injuries and their
effect on body system functions in include potential complications
Understand management of burn injuries to include wound, airway and pain management
Describe burn wound treatment protocols and products based on the latest criteria established
47
for burn management
Understand the considerations for treatment and management for the various types of burn
48
related injuries (Chemical, Heat/Fire, Radiation)
COGNITIVE OBJECTIVES: ADULT ICU
General Recognize the various types of equipment utilized in an in-patient setting and transport
49
equipment differences
50
Understand blood and blood product indications, administration and management
Recognize equipment generally used within the Intensive Care setting and comparable
51
equipment used during transport if applicable
52
Describe situations warranting diversion or interception in a critical situation
53
Understand basic gas laws and discuss the ramifications on patient transport
54
Discuss effect of an unpressurized cabin on equipment
55
Discuss special considerations for patients being air transported
Recognize your own limitations during care of the critically ill or injured patient and plan for
56
these limitations
Endocrine -
57
Explain the A&P of the endocrine system including associated hormones
58
Differentiate between normal and abnormal findings in the endocrine assessment
15
59
Describe the etiology, pathophysiology, presenting systems and management of endocrine
system disorders
Identify the indications, contraindications and maintenance of insulin drip therapy, insulin
60
pumps and Vasopressin
Multiple Organ Dysfunction Syndrome -
61
Differentiate the major types of shock according to causes and pathophysiologic alterations
62
Identify patients at risk to develop each of the major types of shock
63
Describe the body's responses to shock, including early and late
64
Summarize the clinical findings of shock
65
List the abnormal laboratory findings in shock
Describe the hemodynamic findings in hypovolemic, cardiogenic, neurogenic, anaphylactic,
66
and septic shock
67
List complications of shock
COGNITIVE OBJECTIVES: ADULT ICU
68
Differentiate definitive and supportive measures for the patient with shock
69
Explain fluid administration in shock
State the cardiovascular effects of stimulation of alpha, beta1, beta2, and dopaminergic
70
receptors
Summarize the actions, indications, dosages and adverse effects of dopamine, dobutamine,
71
milrione, epinephrine, norepinephrine, phenylephrine, and vasopressin in treating shock
Adult Intensive Care Unit(s)
Student Name: _____________________________
ITEM
Learning Objectives: Be able to respond appropriately to the following
items
PSYCHOMOTOR OBJECTIVES: Adult ICU
Respiratory 16
PATIENT
SIM
Date/
Date/
Initials
Initials
Perform age appropriate life-saving measures for patients with
1
respiratory illness or injury
Interpret and respond to patient assessment, and changes in
2
condition/assessment
Interpret and respond to diagnostic data such as laboratory results,
3
bedside testing, and equipment data
Correctly administer appropriate pharmacologic agents for specific
4
pulmonary scenarios
5
Initiate age appropriate life support guidelines
6
Perform orotracheal intubation with assessment of placement
7
Perform nasotracheal intubation with assessment of placement
8
Perform needle and surgical cricothyrotomy procedure
9
10
Perform procedure for facilitated intubation using sedation and
neuromuscular blockade
Set up, maintain, and troubleshoot a thoracic drainage system
Set up, maintain and troubleshoot various brands of mechanical
11
ventilator during pre-flight, and flight
12
Perform tube throacostomy procedure
Cardiovascular -
13
14
Perform age appropriate life-saving measures for patients with
cardiovascular illness or injury
Interpret and respond to diagnostic data such as laboratory results,
bedside testing, and equipment data
Correctly administer appropriate pharmacologic agents for specific
15
cardiovascular scenarios
PATIENT
Psychomotor Objectives: Adult ICUP
16
Perform a 12 Lead ECG and interpret data
17
Access, manage and assess complications associated with Central Lines
18
Manage and assess for complications associated with Balloon Pump
management
17
SIM
19
Set-up, maintain, and/or troubleshoot hemodynamic monitoring systems
20
Troubleshoot IABP, VAD and ECMO equipment functioning
21
Assess and recognize abnormal heart and lung sounds
22
Perform pharmacological intervention as indicated by assessment
Neurological Perform age appropriate life-saving measures for patients with
23
neurological injury or illness
Interpret and respond to diagnostic data such as laboratory results,
24
25
bedside testing, and equipment data
Correctly administer appropriate pharmacologic agents for specific
neurological scenarios
Perform neurological assessment of patient with coma or altered mental
26
status
27
Calculate CPP
28
Identify various waveforms on neurological monitoring devices
29
Troubleshoot and maintain intracranial pressure monitoring device
30
Perform appropriate ventilation measures for a patient with suspected
head injury with ETCO2 monitoring
31
Assess need for spinal immobilization
32
Manage a patient with seizures from unknown cause
GI, GU and Renal -
33
Perform age appropriate life-saving measures for patients with GI, GU
and/or Renal injury or illness
Interpret and respond to diagnostic data such as laboratory results,
34
bedside testing, and equipment data
PATIENT
Psychomotor Objectives: Adult ICU
Correctly administer appropriate pharmacologic agents for specific GI,
35
36
GU and/or Renal scenarios
Manage a patient with gastrointestinal devices i.e. PEG tub, drainage
devices, etc.
37
Access and manage AV shunts and temporary renal shunts
38
Manage TPN lines
18
SIM
39
Insert and manage Foley catheter
40
Insert and manage Nasogastric tubes
Burn Perform age appropriate life-saving measures for patients with burn
41
injuries
Interpret and respond to diagnostic data such as laboratory results,
42
43
44
bedside testing, and equipment data
Correctly administer appropriate pharmacologic agents for specific
burn scenarios
Assess neurovascular status of injured and/or immobilized extremity
Perform calculations and monitoring of fluids for circulation
45
management in burn patient
46
Perform trauma score assessment
47
48
Demonstrate appropriate airway management technique for burn
patients
Monitor and maintain core body temperature
Endocrine Perform age appropriate life-saving measures for patients with
49
50
endocrine system disorders or injuries
Interpret and respond to diagnostic data such as laboratory results,
bedside testing, and equipment data
Correctly administer appropriate pharmacologic agents during specific
51
endocrine system scenarios
52
Initiate and maintain insulin drip therapy
PATIENT
Psychomotor Objectives: Adult ICU
Multiple Organ Dysfunction Syndrome 53
54
Perform age appropriate life-saving measures for patients with multiorgan dysfunction
Interpret and respond to diagnostic data such as laboratory results,
bedside testing, and equipment data
Correctly administer appropriate pharmacologic agents for specific
55
multi-organ dysfunction scenarios
19
SIM
Demonstrate the maintenance and troubleshooting of necessary
56
equipment needed to maintain stability in patients with multi-organ
dysfunction
Other -
57
Administer blood products (PRBC, FFP) to a trauma patient
58
Administer blood products to an ICU patient
59
Administer blood products to a Burn ICU patient
60
Manage the patient with an orthopedic injury
61
Manage a patient with a toxic exposure
62
Administer poison antidotes
63
Manage a patient experiencing a cold-related illness
STUDENT NAME: _______________________________________
Learning Objectives: Given a critical care transport scenario, be
SCENARIO
SIMLAB
able to assess, perform and manage the patient while performing
appropriate skills, tasks and critical thinking.
Date/Initials
Feedback From Instructor
Respiratory
Cardiovascular
Neurological
GI, GU, Renal
20
Labor/Delivery
Neonate
Pediatric
Burn
Multi-System
Multi-System
Multi-System
Special Population
UTHS EHS Clinical Evaluation form of Provider
Name of Provider: ____________________________________________________________________
Clinical Unit: ________________________________________________________________________
Date: _______________________________________________________________________________
Student: ____________________________________________________________________________
Rating Key: 1 = Strongly Agree, 2 = Agree, 3 = Disagree, 4 = Strongly Disagree
1. When you arrived on the unit, the provider greeted you and integrated you into his/her schedule. ____
2. The provider gave a brief orientation to the patients and unit.
____
3. The provider encouraged patient contact and provided effective and
discreet educational coaching.
____
4. The preceptor made you feel welcome.
____
5. The provider encouraged your presence during patient contact, and treatment discussion.
____
6. The provider served as an effective resource for your questions.
____
7. Additional feedback about provider, unit or today’s experience:
21
22