National Registry of emergency medical technicians advanced level psychomotor examination patient assessment medical takes or verbalizes appropriate PPE precautions seam size up determines the seams lash situation is safe determines the mechanism of injury / nature of illness determines the number of patients requests additional help if necessary consider stabilization of spine primary survey verbalizes general impression of the patient determines responsiveness / level of consciousness determines chief complaint / apparent life threats assesses airway and breathing assessment assures adequate ventilation initiates appropriate oxygen therapy assesses circulation assesses / controls major bleeding assesses skin either skin color temperature or condition assesses pulse identifies priority patient / makes transport decision history taking in secondary assessment history of present illness onset severity provocation time quality clarifying have associated signs and symptoms as related to o pqrst radiation past medical history allergies past pertinent history events leading to present onus medications last oral intake performed secondary assessment assess affected body part system or if indicated completes rapid assessment cardiovascular neurological into the mentor II reproductive pulmonary musculoskeletal GI /gu psychological / social vital signs pulse respiratory rate and quality blood pressure avpu Diagnostics blood glucose test pulse oximetry ET c as indicated States field impression of patient verbalizes treatment plan for patients and calls for appropriate interventions transport decision re-evaluated reassessment repeats primary survey repeats vital signs evaluates response to treatments repeats secondary assessment regarding patient complaint or injuries critical fail criteria failure to initiate or call for transport of the patient within 15 minute time limit failure to take off further lies appropriate PPE precautions failure to determine scene safety before approaching patient failure to voice and ultimately provide appropriate oxygen therapy failure to assess / provide adequate ventilation failure to find or appropriately manage problems associated with airway breathing image or shark HIPAA perfusion failure to differentiate patients need for immediate transportation vs. continued assessment and treatment at the scene does other detailed history or physical examination before assessing and treating threats to airway and circulation failure to determine the patient's primary problem orders a dangerous or inappropriate intervention failure to provide for spinal protection when indicated