National Registry of Emergency Advanced Level Psychomotor ...

National Registry of Emergency Advanced Level Psychomotor Examination

STATIC CARDIOLOGY

_______ ____

Attempt P/F

NREMT Use Only

Candidate: __________________________________________Examiner: ________________________________________

Date: ______________________________________________Signature: ________________________________________ SET #________________

Examiner: Document the provided interpretation in the Scenario Interpretation Blocks. Document candidate's interpretation in Candidate's Interpretation Blocks. Document Treatment in Treatment Blocks

Actual Time Started:_________

STRIP #1

NOTE: ZERO POINTS ARE AWARDED FOR TREATMENT IF INTERPRETATION IS INCORRECT

Scenario Interpretation:

Candidate's Interpretation:

Possible Points

1

Points Awarded

Treatment:

2

STRIP #2

NOTE: ZERO POINTS ARE AWARDED FOR TREATMENT IF INTERPRETATION IS INCORRECT

Scenario Interpretation:

Candidate's Interpretation:

1

Treatment:

2

STRIP #3

NOTE: ZERO POINTS ARE AWARDED FOR TREATMENT IF INTERPRETATION IS INCORRECT

Scenario Interpretation:

Candidate's Interpretation:

1

Treatment:

2

STRIP #4

NOTE: ZERO POINTS ARE AWARDED FOR TREATMENT IF INTERPRETATION IS INCORRECT

Scenario Interpretation:

Candidate's Interpretation:

1

Treatment:

2

Actual Time Ended: __________ Elapsed Time: __________ Maximum 6 minutes

CRITICAL CRITERIA ____ Failure to correctly diagnose or adequately treat v-fib, v-tach, asystole, or pulseless electrical activity ____ Uses/orders a dangerous or inappropriate intervention

You must factually document your rationale for checking any of the above critical items on this form.

TOTAL

12

My signature above affirms that, to the best of my knowledge, this candidate was evaluated without conflict of interest or bias in accordance with NREMT policies and that his/her performance has been documented accurately.

? 2018 National Registry of Emergency Medical Technicians, Inc., Columbus, OH All materials subject to this copyright may be photocopied for the non-commercial purpose of educational or scientific advancement.

p307/05-18

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