Standards for State Endorsement of Emergency Medical Services Educational Institutes - BLS Level

Sep 23, 2026

Uploaded by Kyle

Standards for State Endorsement of Emergency Medical Services Educational Institutes provide structured BLS-level requirements and reporting formats. The materials include psychomotor skill summary sheets for EMR initial and refresher courses, capturing candidate identity fields, exam date and location, certification identifiers, test type (including entire practical retest), evaluator and instructor verification, and pass/fail or verified scoring. Included skill stations cover trauma and medical patient assessments, bleeding control and shock management, oxygen administration with non-rebreather masks, BVM ventilation, cardiac arrest management/AED, vital signs, spinal immobilization, long bone and joint immobilization, and naloxone administration.

LanguageEnglish

CategoryExam

FormatPDF

Pages54

Reading Time2 h 16 min

AccessFree to download

BLS Level

Skill and Skill Summary Sheets

Appendix C - EMR Initial Skills Summary Sheets

Appendix D - EMR Refresher Skills Summary Sheets

Appendix E - EMT Initial Skills Summary Sheets

Appendix F - EMT Refresher Skills Summary Sheets

Appendix I - EMR Skill Sheets

Appendix J - EMT Skill Sheets

Standards for State Endorsement of EmergencyMedical Services Educational Institutes # BLS Level Skill and SkillSummary Sheets | Table of Contents | | | | --- | --- | --- | | | Appendix C-EMR Initial Skills Summary Sheets | 53 | | | Appendix D-EMR Refresher Skills Summary Sheets | 56 | | | Appendix E-EMT Initial Skills Summary Sheets | 59 | | | Appendix F-EMT Refresher Skills Summary Sheets | 62 | | | Appendix¹-EMR Skill Sheets | 71 | | | AppendixJ-EMT Skill Sheets | 85 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Page Left Blank Intentionally # APPENDIX C EMR Initial SkillSummary Sheets # West Virginia Office of Emergency Medical Services Policies andProcedures EMR Psychomotor Skills Summary Sheet-Initial Course | __/______/_____
Name:
Exam Date:_ | | | | | | --- | --- | --- | --- | --- | | First
Last
MI
WV Certification Number:__
_Exam Location: | | | | | | Training Agency Class Number:_
WVOEMS Class Number:_
Test Type:
Entire Practical Retest | | | | | | Evaluator
NOTES
EMR"TESTED"Skill Station
Score *CS
Initials | | | | | | Patient Assessment -Trauma | | | | | | Bleeding Control/Shock Management | | | | | | Patient Assessment-Medical
(Includes Baseline Vital Signs) | | | | | | Oxygen Admin,by Non-Rebreather Mask | | | | | | BVM Ventilation of an Apneic Patient | | | | | *Any failure requires a completed skill sheet to be attached to this summary sheet. West Virginia Office of Emergency Medical Services Policies andProcedures EMR Psychomotor Skills Summary Sheet-Initial Course | _/______/____
Name:_
Exam Date:_
Last
First
MI
WV Certification Number:________
____Exam Location:____
Training Agency Class Number:________
WVOEMS Class Number:_______
Entire Practical Retest
Test Type: | | | | | | --- | --- | --- | --- | --- | | Date
EMR"VERIFIED"Skill Station
Score Pass/Fail
Instructor Signature | | | | | | Cardiac Arrest Management/AED | | | | | | Baseline Vital Signs | | | | | | Spinal Immobilization-Seated Patient | | | | | | Spinal Immobilization-Supine Patient | | | | | | Long Bone Immobilization | | | | | | Joint Immobilization | | | | | | Naloxone Administration | | | | | Instructor signature verifies that the student has shown competence in the respective skill in accordance with the accompanying skill sheet. APPENDIX D # EMR Refresher SkillSummary Sheets West Virginia Office of Emergency Medical Services Policies andProcedures # EMR Psychomotor Skills Summary Sheet-Refresher Course | Exam Date:_
_/_______/_____
Name:_____
MI
First
Last
WV Certification Number:_____ ___Exam Location: | | | | | | --- | --- | --- | --- | --- | | WVOEMS Class Number:________
Training Agency Class Number:_
Test Type:
Entire Practical Retest | | | | | | Instructor Signature
Date
EMR Skill Station
Score Pass/Fail | | | | | | Patient Assessment -Trauma | | | | | | Bleeding Control/Shock Management | | | | | | Patient Assessment-Medical
(Includes Baseline Vital Signs) | | | | | | Oxygen Admin,by Non-Rebreather Mask | | | | | | BVM Ventilation of an Apneic Patient | | | | | *Any failure requires a completed skill sheet to be attached to this summary sheet. West Virginia Office of Emergency Medical Services Policies andProcedures EMR Psychomotor Skills Summary Sheet-Refresher Course | Name:_
Exam Date:_
/______/_____ | | | | | | --- | --- | --- | --- | --- | | First
Last
MI
WV Certification Number:_
_Exam Location: | | | | | | WVOEMS Class Number:_
Training Agency Class Number:_

FAQs

What information is collected on the EMR psychomotor skills summary sheets?

The sheets collect candidate identity (name, MI, WV certification number), exam date and location, training agency and WVOEMS class numbers, test type (including entire practical retest), and evaluator or instructor details for scoring and verification.

What happens if a candidate fails the EMR skill summary evaluation?

Any failure requires a completed skill sheet to be attached to the corresponding summary sheet.

Which EMR skills are listed in the initial psychomotor skills summary?

The initial course lists skills including trauma and medical patient assessment (with baseline vital signs), bleeding control/shock management, oxygen administration via non-rebreather mask, BVM ventilation of an apneic patient, and related station scoring and initials.

Sep 23, 2026

Uploaded by Kyle

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