Intro to Toughbook – Outside (No Power on)
EMSTARS
Peer-to-Peer
Hands-On
Training
Trainee Guide
Revised 10/22/2009 – Pete Blair
© Pete Blair 2009
Unauthorized Distribution prohibited
Preface
This training is task based. As you learn to perform the various tasks addressed by this course, your mentor will sign the tasks off as you go. The tasks do not have to be taken in order. You and your mentor can decide the sequence that is best for you.
The following material is available for reference by both mentors and trainees as required:
• Panasonic Operating Instructions
• Panasonic Reference Manual
• Pentax Pocket Jet 3 User Guide
When you are working with your mentor, the following basic sequence of events should occur for each task:
1. Mentors will explain as necessary and demonstrate a task while you watch and ask questions. As appropriate, they will discuss when a task is done, why it is done, why it is important that it be done correctly, and what happens if it is not done correctly.
2. Mentors will allow you to perform the task with help and coaching as necessary. You will repeat this step until both of you feel comfortable that you can perform the task on your own.
3. Mentors will then step back and allow you to perform the task without any coaching - at all. If any coaching is required, the task will not be signed off at that time. If, however, you can perform the task without coaching, your mentor will consider the task complete and sign the task sign-off sheet.
Tasks do not have to be addressed in the sequence listed. The sequence of tasks in this publication is, for the most part, the sequence they were addressed in the original classroom version of EMSTARS Hands-On Training. You and your Mentor you are free to address the task in any order you see fit.
Task 1 - Complete all five modules of EMSTARS CBT.
Before receiving any EMSTARS Peer-to-Peer instruction, be sure that your name is on both pages of the Task Sign Off sheet and that the Team Captain has signed off on CBT completion.
Task 2 - Plug and Unplug Power Cable
Background:
Your mentor will show you all of the cable connections on the Toughbook. Be sure you know which one is used for connecting the power supply and which one is used for connecting the USB cable for printing. Realize that although there are two USB connections, only one can be used for printing with the Pentax printer and that is the one next to the power supply connection..
Realize that unless opened for insertion of a cable, all of the rubber covers should remain securely closed.
For performance verification of this test, you must plug and unplug the power cable from both the left and right sides of the Toughbook Rack in the Ready Room. Plugging and unplugging the printer cable is done in Task 21.
Task 3 - Remove and Replace Toughbook Battery
Caution: Power must be off and the Toughbook must be disconnected from its AC Power Source before changing the battery. Otherwise, you can permanently damage the machine. Be sure that your mentor shows you how to recognize and verify that power is off and the power supply is disconnected. (No front-panel lights on or blinking and nothing happens when you close and open the cover.)
Be aware that your mentor will step in and stop you if you are about to open the battery compartment with either power on or the power supply connected. If this happens, you cannot be signed off on this task until another day.
Task 4 - Unlatch, Open, Close, and latch top of Toughbook.
Realize that the Top cover must be aligned with the base and “seated” to prevent damage to the latch mechanism when latching in the closed position. Make sure you do this several times to get the feel of it. Failure to seat the top carefully before latching can damage the latch.
Task 5 - Convert Toughbook to Tablet Mode and return to Clamshell Mode
Be sure you latch the top, even in Tablet Mode.
Task 6 - Identify battery charging status from status of power supply light
Your mentor will go over the primary light conditions with you (Off, Green, Orange, and Red). You must recognize and know what these indications mean. You must also be aware that each time you plug the Toughbook into the rack’s power supply, you need to make sure that the battery light comes on. You must also advise your captain when the Battery Light is blinking. (By the way, don’t confuse the Battery Light with the Power Indicator. The Power Indicator blinks when the unit is in Standby mode, and that is normal. It is not normal for the battery light to blink. See Page 10 of the Panasonic Operating Instructions and Page 27 of the Panasonic Reference Manual for more information if necessary.
Your mentor will use questions to verify performance of this task as opposed to actual observation.
Task 7 - Power on Toughbooks
Be sure that your mentor shows you how to turn power on. Even though this may seem like a no brainer, it can be done incorrectly leading to a computer freeze. Make sure that you hold the power switch for approximately one second before releasing it. Flicking the switch or releasing it before one second has elapsed can result in machine lock-up.
Task 8 - Use FN/Function keys to: (See five functions in the task check off list)
Be sure that your mentor shows you how to make the observation or initiate the functions associated with pressing the FN key along with the keys associated the items listed on the Task Sign Off sheet. To check task performance, your mentor will ask you to perform the function and then observe if you perform it correctly.
Task 9 - Activate and Deactivate Num Lock
Like most laptop computers, some of the keys on the Toughbook keyboard are dual function; that is they can be alphabetic keys or numeric keys depending upon the status of Num(ber) lock.
Be sure you can identify the status of NUM Lock by observing the NUMLK indicator.
Also be sure that you can associate seeing numbers appear when typing letters to the status of NUM Lock.
Task 10 - Activate and Deactivate CAPS Lock
Like most computers, there is a CAPS Lock key on the Toughbook. If you are not already familiar with CAPS LOCK, make sure that your mentor explains the cause and effect of CAPS Lock. Be sure that you can recognize when CAPS Lock has accidently been turned on, and know how to turn it off.
Task 11 - Actuate Front Panel Buttons: (Five)
Be sure that your mentor shows you how and when to use the front panel buttons. That includes possibly using Screen Rotation when opening the Toughbook cover 180 degrees so that someone can sign without reaching over the keyboard.
Task 12 - Store Stylus
Your mentor will explain why it is important to store the stylus in the slot provided when not in use. To check performance, your mentor will ask you to show how to store the stylus.
Task 13 - Look up answers to questions in Help
It is important that you know what information is in Help so you will recognize applicable situations and be inclined to use the feature. Be sure you can go back and forth between Reporter and Help by clicking the appropriate taskbar icon as opposed to the minus sign at the top of the screen. (It’s too easy to miss the minus sign and close Reporter.)
You must know how to start help and have it running while using Reporter.
To check performance, your mentor will the street address of several facilities that are found in the Help feature.
Task 14 - Connect and Disconnect to server via Cell connection.
You must be able to establish cell connection as required. This Task can be discussed on education Toughbooks but can only be checked on Toughbooks connected to the live server.
Task 15 - Start Reporter
All Toughbooks are set up with single-click-start icons.
Task 16 – Set-Up Unit, Shift, and Crew (Beginning of the day)
Realize that the Default Roster is the one to use for all set ups. If necessary, users that were left on the Default Roster from the previous day must be deleted before new ones are added.
Criteria for Task performance: Starting with Reporter already set up for a different Unit and Shift (Team) and with the wrong crew members, you must be able to set up for a given Unit, Team and Crew within 60 seconds. The Crew entered must have the EMT as the topmost crewmember.
Task 17 - Change Crew Members for subsequent incidents (Mid day crew or unit change).
There will be times when one or two members of the crew leave for the day and a partial crew change must be made. Before removing the EMT from a crew, the person resetting the crew must make sure that there are no Local reports. The operation is therefore initiated by clicking or tapping the Shift Change button.
Criteria for Task performance: With A crew already set up and the original EMT leaving the crew and a new on coming on board, the trainee must be able to change the crew appropriately within 60 seconds.
Task 18 - Change Crew Members for the current incident only.
There can be times when an incident must be started just as a crew changes one or more members. (This just proves that Sun City Center residents sometime fail to observe our schedules when having an emergency!)
In this case, the new crew could be “out the door” and a new incident started with the old crew still in place. One way to handle this is to delete the incident, do a shift change operation, set up a new crew, and sign in.
On the other hand, the First Responder is in the back of the Ambulance, the EMT is in the front of the Ambulance, you’re running red to a child choking incident! In this case, it may be better to use the Edit Crew icon to change the crew for this particular incident and do the Shift Change operation later.
Keep in mind that only one of the listed crew members on a report can re-open (edit) that report after a “Leave Report” operation has been performed.
Edit crew can also be used as a temporary measure when, at the last moment, just before a run, the crew must change ambulances (Units).
Using the Edit Crew function can be a powerful time saver. On the other hand, you can easily shoot yourself in the foot if you don’t know what you are doing.
Be sure you go over crew change with your mentor until you feel comfortable doing it.
Task 19 - Sign on to Reporter.
When setting the crew for remaining scenarios, put one of the EMTs on your team at the top of the list with you and your mentor as the second and third persons respectively.
Task 20 - Complete Scenario A.
This task is different from most tasks in that instead having to perform this task successfully without coaching; your mentor is expected to coach you as necessary.
A word of caution: The more that you are left to figure out things on your own, the more you will internalize and retain the material.
Mentors are instructed to let you go, on your own, on this scenario until you both agree that you need help before they step in. Since you have completed the CBT, you really should be able to complete a PCR with minimal assistance. However, since this is your first time to do this on a real machine, you may be slow and need help.
The boxes to the left of items in this handout are for your convenience and designed as a place for you to check off items as they are completed.
Start Scenario
← Set up a three-person crew with an EMT from your team, you, and your mentor as crew members.
← Start a new report.
|Use the information from the “paper from dispatch” (on the right) to fill in:| |
|Incident Number, |Incident Number |
|The Incident Address |1001 |
|The Nature of Call (NOC) as Dispatched (In this case, select Sick Person | |
|because that is the closest match on the selection list to Vomiting and | |
|Diarrhea.) |Time |
|Call Received Time |08:00 |
|Call Dispatched Time | |
|Note: In cases where the crew is in the squad building when a call comes in,| |
|we record Call Dispatched and Call Received time as the same time.) |Address |
|Set Unit Depart Time 08:03 |213 Runningbrook Way |
|For Type Service Requested, select 911… |(Home Address) |
|For call Status to the Scene, select: Lights and Siren. | |
| | |
| |Problem |
| |Vomiting and Diarrhea |
| | |
| | |
| | |
| |(paper from dispatch) |
| | |
| | |
| | |
Continue on the next page:
Task 20 continued…
Assuming you have followed the instructions on the previous page, you still have two red entries on the Incident Tab, Transport or Non Transport and Available. However, the next piece of information that must be recorded is the Time of Arrival at the scene, and following that, the Time that the EMT makes first contact with the patient (Patient Contact). And, presently there is no place on the Incident Tab to record these times!
Here’s the way we handle that situation. Even though at this point we have no idea whether we are going to transport or not, click on the Transport or Non-Transport line and select Transport. Then Click on the Disposition line and select Emergency Department. Making these two selections, in most time before the phone rings causes most of the needed lines on the Incident Tab.
If you have any questions at this point, discuss them with your mentor.
Now continue with Incident 1001 and enter the following information:
Incident Tab
← Arrival Time: 08:07
← Patient Contact: 08:08
← Unit Departs For South Bay Hospital 08:25
← Arrive at South Bay 08:30
← Available at 08:40
← Patient Number, Total Patients, Mass Casualty – Either figure out on your own or discuss with Mentor
← NOC at Scene: Sick Person
← Anatomic Location: Abdomen
← Organ System: Unknown (this will always be “unknown.”
← Primary Symptom: Nausea/Vomiting.
← Other Associated Symptoms select Diarrhea
← Trauma: Discuss the significance of Trauma with your mentor
← Alerts: None
← Cardiac Arrest: No
← Incident Onset Time 22:00 last night. (You may need Mentor assistance for this one)
← Call Status from the Scene: No Lights and Siren
← Call Level
← Type of Transport: Ground
← Facility Taken To: South Bay
← Destination Zip: 33573
← Reason: Patient Choice
← Patient Condition: Unchanged
← How EMS Accessed: Phone
← Report Given to: Emergency Department Staff
← Transport of patient: Without incident
Continued on Next Page
← Exposure, Barrier to Care, and Alcohol/Drug Use: None
← Condition Code: Abdominal Pain
← Total Patients: 1
Patient Tab:
← Patient’s name is Bill Doe
← Patient Street Number: Since the incident and patient address are the same, use the Use Inc F2 key on the virtual keyboard.
← His phone number is 633-1411
← His date of birth is February 27, 1931. If the Patient Age is not automatically entered for you, get your mentor to show you how to enter DOB so that the patient’s age automatically calculates.
← Bill is White
← His Social Security number is 111-11-1111.
← His doctor is Dr. Gonzales.
Assessment Tab:
← Assessment done at 08:08 (Notice that this is the same time as patient contact back on the Incident Tab.)
← Bill is alert, talking and telling what happened. He is able to do what you ask him to do. This indicates that his airway is patent or open.
← He seems to breathing normally.
← A Quick Radial Pulse Check reveals irregular but strong pulse.
← Skin feels as if there might be a temperature
← Skin moisture appears normal
← Skin color appears normal
← Cap Refill is less than 2 seconds
← Penlight reveals that both pupils are normal and reactive.
PMH Tab:
← Takes Aspirin 325 mg 1, once a day
← Takes Zocor, 25 mg 1, one time per day
← Takes Altace, 10 mg 1, one time per day
← Takes Omeprazole 20 mg 1, one time per day
← Had heart attack in 2003.
← Had CVA in 2005
← Bill is allergic to penicillin.
Continued on Next Page
Narrative Tab:
First Responders: Simply enter the words ”First Responders.”
EMTs: Use the Auto-Narrative and answer the questions based on the information that follows. Bill says that pain started as dull abdominal discomfort about 10 hours ago.
← Pain has moved to RLQ and is now sharp and getting worse.
← Nausea and diarrhea started about an hour ago and getting worse.
← Exam indicates Pain in RLQ upon palpation – Worse upon release of pressure.
Flow Sheet Tab – Vitals and Interventions
← Vitals taken at 08:15
← Pulse: 87
← Respirations: 20
← SPO2: 97 (Room Air)
← BP 145/87
← Pain 7
← GCS Eyes = 4
← GCS Verbal = 5
← GCS Motor = 6
Impression Tab
← Primary Impression, select Abdominal pain/problems.
← Secondary Impression, select Other, Not Listed.
Signatures Tab
← Bill signs HIPAA on the Signature Tab.
Go over the report with your mentor to make sure you know how to make entries on each tab.
Task 21 - Print PCR
Your mentor will go over the print process from beginning to end. To fulfill the requirements for this task, print Incident 1001 that you completed in the previous task.
Task 22 - Distinguish Between Transfer of Care and Cancellation
Your mentor will discuss various scenarios to ensure that trainees know the difference between being cancelled by another EMS Agency and transferring care to another EMS Agency. It is vitally important that the decision to classify a call as a cancellation or a transfer of care be made correctly, one hundred percent of the time!
This task is complete when your mentor decides that you know the difference and can be reasonably expected to make the correct selection 100 percent of the time with respect to Non-Transport Disposition.
Task 23 - Identify situations calling for Mutual Aid as Type Service Requested
Your mentor will discuss various scenarios to ensure that you know when to select Mutual Aid as the Type of Service Requested.
This task is complete when the Mentor is satisfied that you know the definition of Mutual Aid and can be reasonably expected to make the correct selection 100 percent of the time with respect to Type of Service Requested when, in fact, it is a Mutual Aid Call.
Task 24 - Identify situations calling for Standby as Type Service Requested
You and your mentor will discuss various scenarios to ensure that you know when to select Standby as the Type of Service Requested.
This task is complete when your mentor is satisfied that you know the definition of Standby and can be reasonably expected to make the correct selection 100 percent of the time with respect to Type of Service Requested when, in fact, it is a Standby Call.
Task 25 - Identify situations calling for Medical Transport as Type Service Requested
You and your mentor will discuss various scenarios to ensure that you know when to select Medical Transport as the Type of Service Requested.
This task is complete when your mentor is satisfied that you know the definition of Medical Transport and can be reasonably expected to make the correct selection 100 percent of the time with respect to Type of Service Requested when in fact it is a Medical Transport Call.
Task 26 - Complete Scenario B
This task is similar to the task associated with Task 20. The primary difference is that you should require less assistance with Scenario 2, than you did with Scenario 1.
Incident Tab
|Use the information from the “paper from dispatch” (on the right) to fill in:| |
|Incident Number, |Incident Number |
|The Incident Address |1002 |
|The Nature of Call (NOC) as Dispatched (In this case, select Fall Victim. | |
|Call Received Time | |
|Call Dispatched Time |Time |
|Note: In cases where the crew is in the squad building when a call comes in,|08:00 |
|we record Call Dispatched and Call Received time as the same time.) | |
|Set Unit Depart Time 08:03 | |
|For Type Service Requested, select 911… |Address |
|For call Status to the Scene, select: Lights and Siren. |101 Ray Watson Drive |
| |(Home Address) |
| | |
| | |
| |Problem |
| |Fall – Bleeding from head |
| | |
| | |
| | |
| |(paper from dispatch) |
| | |
| | |
| | |
Incident Tab (Continued)
← Wheels Rolling at: 08:03
← Arrive Location: 08:07
← Patient Contact at 08:08
← Unit Departs from Scene 08:25
← Arrive at Hospital 08:30
← Available 08:40
← Incident Onset Time 07:30 (use today’s date)
← After applying a pressure bandage to his head to control bleeding, we transport Joe to the Emergency department at South Bay (his choice).
← Primary Symptom:, select Bleeding
← Other Associated Symptoms: select Not Applicable
← Condition Code, select Other.
You can probably figure out all other information needed for the Incident Tab. Discuss with your mentor as needed.
Patient Tab:
← Patient’s name is Joe Whizbang
← Joe’s address is the same as the Incident Address
← His date of birth is July 27, 1941.
← His Social Security number is 111-11-1111.
← Joe says his phone number is 633-1411.
← Joe is Caucasian
← His doctor is Dr. Salvadore.
Assessment Tab:
← Assessment begins with patient contact. 08:08
← Joe is alert and able to explain what happened. He is able to do what you ask him to do.
← He seems to breathing normally.
← Quick Radial Pulse Check reveals regular but strong pulse.
← Bleeding from head wound (skin tear) above the right eyebrow. He’s probably not going to bleed to death, but it’s definitely a pretty good sized skin tear and bleeding pretty badly. (About 2 inches).
← Penlight reveals that Pupils are normal and reactive.
← Skin feels Normal
← Skin moisture appears normal
← Cap Refill is less than 2 seconds
← Rapid head to Toe Trauma Exam reveals no other injuries; Pulse, Motor, and Sensation checked and present in all four extremities. Note: This information is used by EMTs on the Narrative Tab.
Injury Secondary Tab
← 2 inch laceration and contusion on the Forehead
PMH Tab:
← Joe takes one 325 mg Aspirin tablet, once a day
← Had knee surgery in 2004.
← Has been blacking out for a few seconds at a time for the past several months.)
← Joe is allergic to Morphine.
Narrative Tab
First Responders: Simply enter the words ”First Responders.”
EMTs: Use the Auto-Narrative and answer the questions based on the information that follows: Joe Fell about 30 minutes before calling the squad. Joe says he must have blacked out because he does not remember falling. It appears that he hit head on a dresser as he went down to a tile floor. No sign of neck or back injury In all trauma cases, you should do a head to toe exam and document the fact that you did so in the Narrative.
Flow Sheet Tab - Vitals:
← Vitals taken at 08:15
← Pulse: 85
← Respirations: 20
← SPO2: 97 (Room Air)
← BP 107/68
← Pain is negligible
← GCS Eyes = 4
← GCS Verbal = 5
← GCS Motor = 6
← Intervention at 08:17 - Bleeding Control and Wound Control – Response: Improved: Complications: None
Impression Tab:
← Primary Impression: select Traumatic Injury.
← Secondary Impression: select Other, Not Listed.
Signature Tab
← Joe signs HIPAA on the Signature Tab.
When you have finished with this scenario, ask your mentor to review it. If you wish to print it for future reference, feel free to do so.
When you have finished, delete the incident.
Task 27 - EMTs Only - messaging associated tasks - and EMT “calls.”.
The messaging part of Task 27 is satisfied when you complete the Computer Based Training (CBT) course on Messaging.
Tasks 28 - 38 Complete Scenarios 6001 - 6011
When you finish the PCRs, send them to the server but not to sign and close them. As you finish the scenarios, your mentor will look them over and either counsel you as necessary or delete the scenarios when they are satisfactory.
Training Completion: When all Tasks have been signed off, return the signoff sheets to your captain.
Page 1 of 2
|Tasks |Trainer/Mentor |Date |
|Complete all 5 Modules of CBT |Captain: | |
|(This task must be signed of by the Team Captain.) | | |
|Plug and Unplug Power cable | | |
|Remove and Replace Toughbook Battery | | |
|Unlatch, Open, Close, and latch top of Toughbook. | | |
|Convert Toughbook to Tablet Mode and return to Clamshell Mode | | |
|Identify battery charging status from status of power supply light | | |
|Power On Toughbook | | |
|Use FN/Function keys to: | | |
|Adjust Toughbook LCD brightness up and down | | |
|Turn speaker on and off | | |
|Adjust speaker volume up and down | | |
|Activate and Deactivate Standby Mode | | |
|Determine Remaining battery level | | |
|Activate and Deactivate Num Lock | | |
|Determine from indicator lights when NUM Lock is on | | |
|Activate and Deactivate CAPS Lock | | |
|Determine from indicator lights when CAPS Lock is on | | |
|From Front Panel Buttons: | | |
|Adjust Screen Brightness | | |
|Turn Panasonic Virtual Keyboard on and off | | |
|Select appropriate Virtual Keyboard style and size | | |
|Move virtual around screen as necessary to prevent hiding text | | |
|Perform Press Enter function | | |
|Rotate Screen Image | | |
|Lock and Unlock unit | | |
|Store stylus | | |
|Look up answers to questions in Help | | |
|Connect and Disconnect to server via Cell connection | | |
|Start Reporter | | |
|Set Up Unit, Shift, and Crew | | |
|Change Crew Members for subsequent incidents (Mid day crew or unit | | |
|change). | | |
|Change Crew Members for the current incident only. | | |
|Sign on to Reporter | | |
|Complete Scenario A | | |
|Print report on a USB connected printer | | |
|Distinguish Between Transfer of Care and Cancellation | | |
|Identify situations calling for Mutual Aid as Type Service Requested | | |
|Identify situations calling for Standby as Type Service Requested | | |
|Identify situations calling for Medical Transport as Type Service | | |
|Requested | | |
|Complete Scenario B | | |
|EMTs Only | | |
|Recognize Message Waiting situation | | |
|Move between messaging and reports | | |
|Respond appropriately to requests to: | | |
|Comment | | |
|Produce Addendum | | |
|Change Report | | |
|Complete Scenario 6001 | | |
|Complete Scenario 6002 | | |
|Complete Scenario 6003 | | |
|Complete Scenario 6004 | | |
|Complete Scenario 6005 | | |
|Complete Scenario 6006 | | |
|Complete Scenario 6007 | | |
|Complete Scenario 6008 | | |
|Complete Scenario 6009 | | |
|Complete Scenario 6010 | | |
|Complete Scenario 6011 | | |
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