Patient B – Initial Assessment and Management

Instructor Evaluation Form

Patient B – Initial Assessment and Management

YESNO
Adhere to the appropriate priority sequence in management.
YES
NO
Have an organized approach to patient treatment
YES
NO
Perform the assessment and management phases properly and in the correct sequence.
YES
NO
Recognize the patient's airway obstruction as a result of the maxillofacial trauma and quickly perform a cricothyroid-otomy while protecting the patient's cervical spine. This is the only acceptable method to secure a patent airway in this patient.
YES
NO
Recognize that the patient has a potential cervical spine injury, exercise the appropriate precautionary measures.
YES
NO
Recognize and indicate the need for ventilatory assistance and oxygenation.
YES
NO
Recognize the patient's hemorrhagic shock, and initiate appropriate resuscitative therapy, including hemmorrhage control and vigorous, warmed fluid therapy.
YES
NO
Recognize the source of the patient's hemorrhage as being arterial bleeding from the femur and scalp and apply appropriate measures to control the hemorrhage.
YES
NO
Identify the patient's open head injury and take the necessary steps to prevent secondary brain injury.
YES
NO
Identify and manage the conditions requiring critical treatment decisions in the order listed.
YES
NO

Potentials for Adverse Outcome: If the student’s performance is borderline and the student fails to recognize or perform one or more of the items below, the instructor may determine that the student’s overall performance is unsuccessful.

YESNO
Restricted spinal motion
YES
NO
Performed cricothyroidotomy in timely fashion.
YES
NO
Provided assisted ventilation.
YES
NO
Ordered blood transfusion in timely fashion.
YES
NO
Controlled external hemorrhage early.
YES
NO
Applied a traction splint to control hemorrhage and restore circulation early.
YES
NO
Recognized/immobilized the left wrist fracture.
YES
NO
Did not perform and nasal instrumentation, such as insertion of a nasogastric tube.
YES
NO
Identified a depressed skull fracture and protected the wound from contamination.
YES
NO
Protected the patient from hypothermia.
YES
NO
Considered the need for tetanus prophylaxis.
YES
NO
Recognized the need for transfer.
YES
NO
Did not delay transfer to perform diagnostic tests.
YES
NO
Adequately prepared for contingencies during the transfer process, such as malfunction of the cricothyroidotomy, chest tube malfunction, and deterioration in neurologic status.
YES
NO