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 <br /> <br />39|Page <br /> <br /> <br />Candidate: <br />Date of Eval: <br /> <br />ͲͲͲVFIBARRESTͲͲͲ <br /> <br />Patientstates“Idon’tfeelsogood.Ifeeldizzy.”ThepatientproceedsintoVͲFibArrestwithagonalrespirations. <br /> <br /> <br />/1FollowsCARDIACARRESTProtocol(includingCPR/defibrillation): <br /> <br />Patientinterventions: <br />/C*AutomatedDefibrillationProcedure(CPRasrequired,placepads,turnonmonitor,utilizeAEDmodeappropriately) <br /> <br />ͲͲͲPatientROSCpostdefibrillationandisALERTwithaGCSof15ͲͲͲ <br /> <br />/1Reassesspatientvitalsigns/exam <br />BP:100/60P:70ͲweakͲregularRR:15O2:94% <br /> <br />Respiratory:Lungsoundsclearinallfieldswithequalchestriseandfall. <br />Cardiovascular:ChestPain,Pulseregular <br />Gastrointestinal:Soft,tendertopalpationepigastric/gastricregiononly,nodistention,nodiscoloration. <br />Musculoskeletal:Milddiscomforttochestsecondarytodefibrillation <br />Neurological:Alert.Nomotororsensorydeficitsnoted.LAStrokeScale=Neg <br />Integumentary:Nosignsoftrauma.Skinispale,cool,andclammytotouch <br /> <br /> <br />/1Callinappropriatereporttoreceivinghospital <br /> <br /> <br /> <br /> <br /> <br /> <br />ScoreSummary <br />CriticalActionsCompleted:of4 <br /> <br />IndividualPointsTotal:of10 <br /> <br />Finaloutcome(pass/fail): <br />ExaminerSignature: <br /> <br /> <br />S <br />A <br />M <br />P <br />L <br />E <br />DocuSign Envelope ID: 79C5D167-B6CA-4E59-B4AC-AA38CC1B20BD