FOOTHILL COLLEGE
Bleeding Control and Shock Management
Candidate Name: _________________________________________ Date: ______________________
Examiner Name and Signature: _________________________________________________________
Time Started: __________ Time Ended: __________ Points: _____/8 PASS/FAIL (Circle One)
| Points Possible | Points Awarded | |
| Applies direct pressure to wound | 1 | |
| EXAMINER STATES THAT THE WOUND CONTINUES TO BLEED | ||
| Applies tourniquet properly | 1 | |
| Assesses distal extremity for pulse and continued bleeding | 1 | |
| Applies second tourniquet if bleeding continues | 1 | |
| EXAMINER STATES THAT THE PATIENT IS EXHIBITING SIGNS AND SYMPTOMS OF HYPOPERFUSION | ||
| Properly positions patient | 1 | |
| Administers high concentration of oxygen | 1 | |
| Initiates steps to prevent heat loss from patient | 1 | |
| Indicates need for immediate transportation | 1 | |
Points Possible: 8 Total Points Awarded_______________
Critical Criteria
● Did not apply a high concentration of oxygen
● Did not control hemorrhage using correct procedures in timely manner
● Did not indicate need for immediate transportation
Notes: ____________________________________________________________________________________________
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