Title Page

  • Conducted on

  • Evaluator You must be on this list to perform Credentialing skills evaluations. If you are not on the approved list, see your training officer before continuing.

  • Home Department of Candidate:

  • Candidate Name *If the Candidate’s name does not appear in the list, select “*Not Available”

  • Type Candidate's name in the following format: Last Name, First Name, License #

  • Level of Credential

Assessment

Instructions

  • READ TO CANDIDATE: Place an Nasal Pharyngeal Airway (NPA) followed by an Oral Pharyngeal Airway (OPA).

Assessment - NPA

  • Correctly measures NPA

  • Properly lubricates the NPA (If a different method of lubrication is used on a manikin, Evaluator will instruct Candidate to verbalize proper lubrication technique used on a real patient)

  • Correctly inserts appropriately sized NPA

Assessment - OPA

  • Correctly measures OPA

  • Correctly places appropriately sized OPA

Completion

  • Successfully completed all steps

  • Explain what was not completed correctly

  • Safely completed all steps

  • Explain what was not completed safely

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