Breadcrumb Home Other Checklists Emergency Medical Technician (EMT) Form Information Info Name * Last 4 digits of SSN * Contact Phone * Email * Proficiency Scale 1 = No Experience 2 = Need Training 3 = Able to perform with supervision 4 = Able to perform independently Vital Signs Vital Sign - Pulse * Vital Sign - Respiration * Vital Sign - Lung Sounds * Vital Sign - Blood Pressure * Vital Sign - Pulse Oximetry * Basic Airway Management Basic Airway - Oropharyngeal Airway (OPA) * Basic Airway - Nasopharyngeal Airway (NPA) * Basic Airway - Oral Suctioning * Basic Airway - Bag Valve Mask * Basic Airway - Oxygen Administration * Advanced Airway Management Advanced Airway - Multi-Lumen Airway (Combi-Tube) * Patient Assessment Patient Assessment - Trauma * Patient Assessment - Medical * Bleeding Control and Shock Management Bleeding Control/Shock Management * Spinal Immobilization Spinal Immobilization - B/B (Supine Patient) * Spinal Immobilization - KED (Seated Patient) * Helmet Removal Helmet Removal - Football * Helmet Removal - Motorcycle * Splinting Splinting - Long Bone * Splinting - Bipolar Traction (Hare) * Splinting - Unipolar Traction (Sager) * Scoop Stretcher * BLS/ALS Management BLS/ALS - Cardiac Arrest Management (AED) * BLS/ALS - Nitroglycerin Administration (NTG) * BLS/ALS - Epinephrine Administration (EPI) * CPR CPR - Adult / Child / Infant * Foreign Body Airway Obstruction (FBAO) FBAO - Adult / Child / Infant *