Core Competency Based Checklist ALS/BLS
1st Shift – Observation
The preceptor should demonstrate the use of equipment, tools and reporting and ensure proper
technique. Direct patient care may be performed by new crew members to the level of their competency
however charting should be demonstrated by the preceptor. New crew members should ensure
appropriate documentation is recorded accordingly.
Objectives
General Information
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Clocking in by phone ~317-963-2665~
Use Vairkko for missed clock-in (iForm)
Ensure access to Windows, Outlook, Team Portal,
Lawson, Image Trend, Vairkko, Diagnotes
Ensure badge access to common IU Health locations
Truck Orientation / Truck Check
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Equipment and supplies in interior compartments
Equipment and supplies in external compartments
Checking lights and siren
Checking oxygen levels (gas and liquid)
Checking patient assessment equipment
Completing a truck check sheet (Vairkko)
Marking “In Service” for the day
Obtain run information from Diagnotes
Expectations at shift change (restock, refuel, equipment
issues, etc.)
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Charting procedures of a run
Adding attachments to a run
Posting a run (with and without “Finishing”)
Generic login to tablet
Where/how to file paperwork after a run is completed
and posted
Observation of Patient Care / Charting
Safety Procedures
1. General Safety
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Demonstrate a safe attitude and maintain situation
awareness
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Knowledge of Fatigue Policy
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Knowledge of the Restraint Policy
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Knowledge of the Uniform Policy
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Secure equipment and use of seatbelts
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Passenger ride-a-long
2. Workplace Safety
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Fire extinguisher locations and operations
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Medical gas store at base
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Diesel Exhaust Fuel (DIF) fluid location
3. Infection Control
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Confirm understanding of Universal Precautions
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Confirm understanding of infection control measures
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Demonstrates proper disposal of sharps and bio-hazard
material
Date Completed
Preceptor Signature
2nd Shift – Initial Patient Care and Report Writing (Assisted)
The new crew member should begin demonstrating direct patient care and report writing while being
assisted by the preceptor. Initial areas of improvement should be identified, discussed and addressed as
needed.
Objectives
Date Completed
Preceptor Signature
General Information
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Understanding of KIPs, Image Trend job aid and Image
Trend narrative instructions (Vairkko)
Understanding of staffing procedures (attendance,
request vacation days, education and policies)
Understand that company e-mail should be checked
each shift
Understanding of company team meeting
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Understanding of shift requirements (truck restock, fuel,
L04-035
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Verbalizes an understanding of how to care for patient’s
valuables and where to document
Verbalizes and demonstrates how to prepare,
administer, and document medications per medical
policy and procedures
Various protocols
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L01-070, L01-075
Communications
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Use handheld and vehicle radios with appropriate
verbiage
Demonstrate clear verbal communication as a
sequence with LifeLine Communications
Understands the use of Diagnotes
Interfaculty Call Operations
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Verbalizes response time expectations/time variance
documentation
Identifies patient rights and responsibilities
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Identifies HIPPA concerns in the transport environment
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Demonstrates an understanding of proper
documentation of patient and medical consent forms
Understand transport process as a whole and time
limitations
Discuss succession of patient care authority: Sending
and Receiving facility staff
Demonstrate good communication skills with Sending
facility staff and obtaining patient report
Demonstrate obtaining appropriate documentation
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Demonstrate good communication skills with Patient,
patient’s family and/or patient friends.
Demonstrate appropriate and safe patient transfer
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Demonstrate securing patient for transport
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Demonstrate safe patient movement (stretcher, Stair
chair)
Demonstrate good communication skills with Receiving
facility staff and Safe Hand-off procedure
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Specific competency information based on new crew member level of certification should begin being
reviewed.
Reference:
 Position Specific Competency BLS/ALS – EMT
 Position Specific Competency BLS/ALS – Paramedic
3rd Shift – Driver Operator / Patient Care and Report Writing (Assisted)
The new crew member should by shown vehicle operations and become familiar with vehicle functions.
Direct patient care and report writing should be continued with limited and minimal assistance by the
preceptor. Additional areas of improvement should be identified, discussed and addressed as needed.
Objectives
Date Completed
Preceptor Signature
Vehicle Operations
1. Vehicle Driver and Operator Overview
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Demonstrate use of vehicle dashboard display
information (steering wheel controls)
Demonstrate the location of the Lock-Out switches
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Demonstrate use of the Brigade system
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Identify seat, peddle and mirror adjustments
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Identify 2-Wheel / 4-Wheel drive selector
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Identify Emergency Start
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Identify scene lights
2. Navigation
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Demonstrates the use navigation assistant devices
(Garmin, MapQuest, Google Map, etc.)
3. Local Area Knowledge
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Counties, major cities and towns
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Roads, highways, intersections, and transportation
hazards
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Hospitals (helipads, capabilities)
4. Communications
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Use handheld and vehicle radio
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Demonstrate clear verbal communication
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Understands the use of Diagnotes
5. Emergency Systems
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Demonstrate emergency warning lights and siren
Demonstrate “Clear Cut” lights
Demonstrate Howler system
General Core Care
1. Oxygen (O2) Therapy
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Verbalizes indication of oxygen therapy in transport
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Identifies the different devices for O2 administration
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State the safety precautions associated with
administering O2 to neonatal and pediatric patients
Specific competency information based on new crew member level of certification should continue being
reviewed and discussed with preceptor to confirm understanding. Areas of improvement should be
identified, discussed and addressed as needed.
Reference:
 Position Specific Competency BLS/ALS – EMT
 Position Specific Competency BLS/ALS – Paramedic
4th Shift – Driver Operator / Patient Care and Report Writing (Assisted)
The new crew member should be familiar and operating the vehicle on a regular basis. Direct patient
care and report writing should continue with limited and minimal assistance by the preceptor. Areas of
improvement should be identified, discussed and addressed as needed.
Specific competency information based on new crew member level of certification should continue being
reviewed and discussed with preceptor to confirm understanding.
Preceptors should begin testing the knowledge base of new crew members in all areas to ensure
understanding, identify areas of weakness and discuss accordingly.
New crew members should revaluate all documentation has been recorded electronically as needed.
5th Shift – Driver Operator / Patient Care and Report Writing (Unassisted)
The new crew member should be familiar and operating the vehicle on a regular basis. Direct patient
care and report writing should continue with no assistance by the preceptor. Areas of improvement
should be identified, discussed and addressed as needed.
Specific competency information based on new crew member level of certification should continue being
reviewed and discussed with preceptor to confirm understanding.
Preceptors should begin testing the knowledge base of new crew members in all areas to ensure
understanding, identify areas of weakness and discuss accordingly.
New crew members should revaluate all documentation has been recorded electronically as needed.
6th Shift – Driver Operator / Patient Care and Report Writing (Unassisted)
The new crew member should be familiar and operating the vehicle on a regular basis. Direct patient
care and report writing should continue with no assistance by the preceptor. Areas of improvement
should be identified, discussed and addressed as needed.
Specific competency information based on new crew member level of certification should continue being
reviewed and discussed with preceptor to confirm understanding.
Preceptors should begin testing the knowledge base of new crew members in all areas to ensure
understanding, identify areas of weakness and discuss accordingly.
New crew members should revaluate all documentation has been recorded electronically as needed .
LifeLine Crew Member Signature: _______________________________
Date: ______/______/________
By signing, as LifeLine Crew Member, I attest that I have completed and am accountable for all listed competency
based objectives.