Skill Station B – Breathing

ATLS Instructor Evaluation Form

Skill Station B – Breathing

Ονοματεπώνυμο *

Skill Performance Breathing

Assess and recognize adequate ventilation and oxy-genation in a simulated trauma patient. *

	Fail	Incomplete	Satisfactory	Instructor Potential
Result	FailResult Fail	IncompleteResult Incomplete	SatisfactoryResult Satisfactory	Instructor PotentialResult Instructor Potential

Identify patients in respiratory distress. *

	Fail	Incomplete	Satisfactory	Instructor Potential
Result	FailResult Fail	IncompleteResult Incomplete	SatisfactoryResult Satisfactory	Instructor PotentialResult Instructor Potential

Demonstrate systematic reading of chest radiographs. *

	Fail	Incomplete	Satisfactory	Instructor Potential
Result	FailResult Fail	IncompleteResult Incomplete	SatisfactoryResult Satisfactory	Instructor PotentialResult Instructor Potential

Recognize the radiographic signs of potentially life-threatening injuries. *

	Fail	Incomplete	Satisfactory	Instructor Potential
Result	FailResult Fail	IncompleteResult Incomplete	SatisfactoryResult Satisfactory	Instructor PotentialResult Instructor Potential

Identify appropriate landmarks for needle decompression and thoracostomy tube placement. *

	Fail	Incomplete	Satisfactory	Instructor Potential
Result	FailResult Fail	IncompleteResult Incomplete	SatisfactoryResult Satisfactory	Instructor PotentialResult Instructor Potential

Demonstrate how to perform a needle decompression of the pleural space on a task trainer, (i.e., simulator, cadaver, or live anesthetized animal). *

	Fail	Incomplete	Satisfactory	Instructor Potential
Result	FailResult Fail	IncompleteResult Incomplete	SatisfactoryResult Satisfactory	Instructor PotentialResult Instructor Potential

Perform a finger thoracostomy on a task trainer. *

	Fail	Incomplete	Satisfactory	Instructor Potential
Result	FailResult Fail	IncompleteResult Incomplete	SatisfactoryResult Satisfactory	Instructor PotentialResult Instructor Potential

Insert a thoracostomy tube in a task-specific trainer. *

	Fail	Incomplete	Satisfactory	Instructor Potential
Result	FailResult Fail	IncompleteResult Incomplete	SatisfactoryResult Satisfactory	Instructor PotentialResult Instructor Potential

Discuss the basic differences between pediatric chest injury and adult chest injury. *

	Fail	Incomplete	Satisfactory	Instructor Potential
Result	FailResult Fail	IncompleteResult Incomplete	SatisfactoryResult Satisfactory	Instructor PotentialResult Instructor Potential

Explain the importance of adequate pain control. *

	Fail	Incomplete	Satisfactory	Instructor Potential
Result	FailResult Fail	IncompleteResult Incomplete	SatisfactoryResult Satisfactory	Instructor PotentialResult Instructor Potential

List the steps required to safely transfer a patient with a breathing problem. *

	Fail	Incomplete	Satisfactory	Instructor Potential
Result	FailResult Fail	IncompleteResult Incomplete	SatisfactoryResult Satisfactory	Instructor PotentialResult Instructor Potential

Demonstrates / instructs others in skill *

	Fail	Incomplete	Satisfactory	Instructor Potential
Result	FailResult Fail	IncompleteResult Incomplete	SatisfactoryResult Satisfactory	Instructor PotentialResult Instructor Potential

Overall: knowledge, skills, attitude for this skill *

	Fail	Incomplete	Satisfactory	Instructor Potential
Result	FailResult Fail	IncompleteResult Incomplete	SatisfactoryResult Satisfactory	Instructor PotentialResult Instructor Potential

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