Practical Skills Evaluation for Ranch Emergency Response
Use this assessment to evaluate hands-on first aid competency. Skills should be demonstrated and observed by a qualified evaluator.
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ASSESSMENT INFORMATION
Participant Information
| Field | Entry |
|---|---|
| Name | _________________________________ |
| Position | _________________________________ |
| Date of Assessment | _________________________________ |
| Evaluator Name | _________________________________ |
| Evaluator Credentials | _________________________________ |
Assessment Type
- [ ] Initial certification
- [ ] Annual recertification
- [ ] Post-incident review
- [ ] Remedial training
SKILL 1: SCENE ASSESSMENT AND EMERGENCY CALL
Scenario
You arrive at a scene where a worker has fallen from a ladder and is lying on the ground.Performance Criteria
| Skill Component | Demonstrated | Notes |
|---|---|---|
| Scene Safety | ||
| Scans area for hazards before approaching | [ ] Yes [ ] No | _____ |
| Identifies potential dangers (ladder, power lines, etc.) | [ ] Yes [ ] No | _____ |
| Ensures scene is safe before proceeding | [ ] Yes [ ] No | _____ |
| Patient Assessment | ||
| Checks responsiveness (tap and shout) | [ ] Yes [ ] No | _____ |
| Checks for breathing | [ ] Yes [ ] No | _____ |
| Checks for severe bleeding | [ ] Yes [ ] No | _____ |
| Calling for Help | ||
| Calls 911 (or directs someone to call) | [ ] Yes [ ] No | _____ |
| Provides location (GPS coordinates if needed) | [ ] Yes [ ] No | _____ |
| Describes nature of emergency | [ ] Yes [ ] No | _____ |
| Describes patient condition | [ ] Yes [ ] No | _____ |
| Stays on line for instructions | [ ] Yes [ ] No | _____ |
SKILL 2: CPR AND AED USE
Scenario
You find a coworker unresponsive. They are not breathing and have no pulse.Performance Criteria
| Skill Component | Demonstrated | Notes |
|---|---|---|
| Initial Response | ||
| Confirms unresponsiveness | [ ] Yes [ ] No | _____ |
| Calls for help/AED or directs someone | [ ] Yes [ ] No | _____ |
| Places patient on firm, flat surface | [ ] Yes [ ] No | _____ |
| Compressions | ||
| Correct hand placement (center of chest) | [ ] Yes [ ] No | _____ |
| Correct depth (2-2.4 inches) | [ ] Yes [ ] No | _____ |
| Correct rate (100-120/minute) | [ ] Yes [ ] No | _____ |
| Allows full chest recoil | [ ] Yes [ ] No | _____ |
| Minimizes interruptions | [ ] Yes [ ] No | _____ |
| Rescue Breaths | ||
| Opens airway (head tilt-chin lift) | [ ] Yes [ ] No | _____ |
| Creates adequate seal | [ ] Yes [ ] No | _____ |
| Delivers breaths that make chest rise | [ ] Yes [ ] No | _____ |
| Correct ratio (30:2) | [ ] Yes [ ] No | _____ |
| AED Use | ||
| Turns on AED | [ ] Yes [ ] No | _____ |
| Correctly places pads | [ ] Yes [ ] No | _____ |
| Ensures no one touching during analysis | [ ] Yes [ ] No | _____ |
| Clears and delivers shock when indicated | [ ] Yes [ ] No | _____ |
| Resumes CPR immediately after shock | [ ] Yes [ ] No | _____ |
SKILL 3: BLEEDING CONTROL
Scenario
A worker has a severe laceration on their forearm with heavy bleeding.Performance Criteria
| Skill Component | Demonstrated | Notes |
|---|---|---|
| Personal Protection | ||
| Puts on gloves before contact | [ ] Yes [ ] No | _____ |
| Direct Pressure | ||
| Applies direct pressure immediately | [ ] Yes [ ] No | _____ |
| Uses appropriate dressing material | [ ] Yes [ ] No | _____ |
| Maintains consistent pressure | [ ] Yes [ ] No | _____ |
| Elevates limb if possible | [ ] Yes [ ] No | _____ |
| Pressure Bandage | ||
| Applies pressure bandage correctly | [ ] Yes [ ] No | _____ |
| Bandage is snug but not cutting off circulation | [ ] Yes [ ] No | _____ |
| Checks for distal pulse after bandaging | [ ] Yes [ ] No | _____ |
SKILL 4: TOURNIQUET APPLICATION
Scenario
A worker has a severe arterial bleed on the upper thigh that cannot be controlled with direct pressure.Performance Criteria
| Skill Component | Demonstrated | Notes |
|---|---|---|
| Decision Making | ||
| Recognizes need for tourniquet (life-threatening bleed) | [ ] Yes [ ] No | _____ |
| Application | ||
| Places tourniquet high and tight (2-3" above wound) | [ ] Yes [ ] No | _____ |
| Tightens until bleeding stops | [ ] Yes [ ] No | _____ |
| Secures windlass properly | [ ] Yes [ ] No | _____ |
| Verifies bleeding has stopped | [ ] Yes [ ] No | _____ |
| Notes time of application | [ ] Yes [ ] No | _____ |
| Does NOT remove or loosen tourniquet | [ ] Yes [ ] No | _____ |
| Communication | ||
| Reports tourniquet use to EMS | [ ] Yes [ ] No | _____ |
SKILL 5: SHOCK MANAGEMENT
Scenario
A worker has been injured and is showing signs of shock (pale, clammy skin, rapid pulse, anxiety).Performance Criteria
| Skill Component | Demonstrated | Notes |
|---|---|---|
| Recognition | ||
| Identifies signs of shock | [ ] Yes [ ] No | _____ |
| Treatment | ||
| Calls or has called for emergency help | [ ] Yes [ ] No | _____ |
| Controls any obvious bleeding | [ ] Yes [ ] No | _____ |
| Positions patient appropriately (legs elevated if no spinal injury suspected) | [ ] Yes [ ] No | _____ |
| Maintains body temperature (covers with blanket) | [ ] Yes [ ] No | _____ |
| Loosens restrictive clothing | [ ] Yes [ ] No | _____ |
| Reassures patient | [ ] Yes [ ] No | _____ |
| Does NOT give food or drink | [ ] Yes [ ] No | _____ |
| Monitoring | ||
| Continues to monitor vital signs | [ ] Yes [ ] No | _____ |
SKILL 6: HEAT ILLNESS RESPONSE
Scenario
During summer work, a coworker becomes confused, stops sweating, and has hot, red skin.Performance Criteria
| Skill Component | Demonstrated | Notes |
|---|---|---|
| Recognition | ||
| Identifies heat stroke (vs. heat exhaustion) | [ ] Yes [ ] No | _____ |
| Immediate Actions | ||
| Calls 911 immediately | [ ] Yes [ ] No | _____ |
| Moves person to shade/cool area | [ ] Yes [ ] No | _____ |
| Rapid Cooling | ||
| Removes excess clothing | [ ] Yes [ ] No | _____ |
| Applies cold packs to neck, armpits, groin | [ ] Yes [ ] No | _____ |
| Wets skin and fans | [ ] Yes [ ] No | _____ |
| Does NOT give fluids if unconscious/confused | [ ] Yes [ ] No | _____ |
| Monitoring | ||
| Monitors breathing and responsiveness | [ ] Yes [ ] No | _____ |
| Prepared to perform CPR if needed | [ ] Yes [ ] No | _____ |
SKILL 7: EPINEPHRINE AUTO-INJECTOR USE
Scenario
A coworker who is allergic to bee stings was just stung. They are having difficulty breathing and have hives spreading across their body.Performance Criteria
| Skill Component | Demonstrated | Notes |
|---|---|---|
| Recognition | ||
| Identifies anaphylaxis | [ ] Yes [ ] No | _____ |
| Preparation | ||
| Retrieves EpiPen | [ ] Yes [ ] No | _____ |
| Removes safety cap correctly | [ ] Yes [ ] No | _____ |
| Administration | ||
| Positions at outer thigh | [ ] Yes [ ] No | _____ |
| Swings and presses firmly | [ ] Yes [ ] No | _____ |
| Holds for 10 seconds | [ ] Yes [ ] No | _____ |
| Removes and massages area | [ ] Yes [ ] No | _____ |
| Follow-Up | ||
| Calls 911 (before or immediately after) | [ ] Yes [ ] No | _____ |
| Notes time of administration | [ ] Yes [ ] No | _____ |
| Knows second dose may be needed | [ ] Yes [ ] No | _____ |
| Saves device for EMS | [ ] Yes [ ] No | _____ |
SKILL 8: SPLINTING
Scenario
A worker has an obvious deformity of the lower leg after being struck by equipment.Performance Criteria
| Skill Component | Demonstrated | Notes |
|---|---|---|
| Assessment | ||
| Checks circulation below injury (pulse, color, sensation) | [ ] Yes [ ] No | _____ |
| Does NOT attempt to realign severely angulated fracture | [ ] Yes [ ] No | _____ |
| Splint Application | ||
| Immobilizes joint above and below injury | [ ] Yes [ ] No | _____ |
| Pads splint appropriately | [ ] Yes [ ] No | _____ |
| Secures splint without cutting off circulation | [ ] Yes [ ] No | _____ |
| Splints in position found (unless no pulse) | [ ] Yes [ ] No | _____ |
| Post-Splinting | ||
| Rechecks circulation after splinting | [ ] Yes [ ] No | _____ |
| Applies ice over splint (with barrier) | [ ] Yes [ ] No | _____ |
SKILL 9: CHOKING (CONSCIOUS ADULT)
Scenario
A coworker is choking and cannot speak, cough, or breathe.Performance Criteria
| Skill Component | Demonstrated | Notes |
|---|---|---|
| Recognition | ||
| Asks "Are you choking?" | [ ] Yes [ ] No | _____ |
| Recognizes severe airway obstruction | [ ] Yes [ ] No | _____ |
| Abdominal Thrusts | ||
| Positions behind victim | [ ] Yes [ ] No | _____ |
| Correct hand placement (above navel, below sternum) | [ ] Yes [ ] No | _____ |
| Delivers inward and upward thrusts | [ ] Yes [ ] No | _____ |
| Continues until object expelled or victim unconscious | [ ] Yes [ ] No | _____ |
| If Victim Becomes Unconscious | ||
| Lowers to ground safely | [ ] Yes [ ] No | _____ |
| Calls 911 | [ ] Yes [ ] No | _____ |
| Begins CPR (checking mouth for object before breaths) | [ ] Yes [ ] No | _____ |
SKILL 10: SNAKEBITE RESPONSE
Scenario
A worker was bitten by what appeared to be a rattlesnake on the lower leg.Performance Criteria
| Skill Component | Demonstrated | Notes |
|---|---|---|
| Immediate Actions | ||
| Moves victim away from snake | [ ] Yes [ ] No | _____ |
| Keeps victim calm and still | [ ] Yes [ ] No | _____ |
| Calls 911 or arranges transport | [ ] Yes [ ] No | _____ |
| Proper Care | ||
| Removes jewelry/tight items near bite | [ ] Yes [ ] No | _____ |
| Positions bite below heart level | [ ] Yes [ ] No | _____ |
| Marks leading edge of swelling with time | [ ] Yes [ ] No | _____ |
| Avoids Harmful Actions | ||
| Does NOT cut the wound | [ ] Yes [ ] No | _____ |
| Does NOT suck the wound | [ ] Yes [ ] No | _____ |
| Does NOT apply ice | [ ] Yes [ ] No | _____ |
| Does NOT apply tourniquet | [ ] Yes [ ] No | _____ |
| Documentation | ||
| Notes snake description if possible | [ ] Yes [ ] No | _____ |
| Notes time of bite | [ ] Yes [ ] No | _____ |
OVERALL ASSESSMENT SUMMARY
Skill Results
| Skill | Points Earned | Points Possible | Percentage | Pass/Fail |
|---|---|---|---|---|
| 1. Scene Assessment | _____ | 11 | _____% | _______ |
| 2. CPR/AED | _____ | 18 | _____% | _______ |
| 3. Bleeding Control | _____ | 8 | _____% | _______ |
| 4. Tourniquet | _____ | 8 | _____% | _______ |
| 5. Shock Management | _____ | 9 | _____% | _______ |
| 6. Heat Illness | _____ | 9 | _____% | _______ |
| 7. EpiPen Use | _____ | 11 | _____% | _______ |
| 8. Splinting | _____ | 8 | _____% | _______ |
| 9. Choking | _____ | 10 | _____% | _______ |
| 10. Snakebite | _____ | 12 | _____% | _______ |
| TOTAL | _____ | 104 | _____% | _______ |
Overall Assessment
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REMEDIATION PLAN
|-------------------|-----------------|-------------|-----------| | _________________ | ________________ | ____________ | [ ] | | _________________ | ________________ | ____________ | [ ] | | _________________ | ________________ | ____________ | [ ] |
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SIGNATURES
Participant Acknowledgment
I have completed this skills assessment and understand my results.
| Field | Entry |
|---|---|
| Signature | _________________________________ |
| Date | _________________________________ |
Evaluator Certification
I certify that this assessment was conducted fairly and the results accurately reflect the participant's demonstrated skills.
| Field | Entry |
|---|---|
| Evaluator Signature | _________________________________ |
| Evaluator Name (Print) | _________________________________ |
| Credentials | _________________________________ |
| Date | _________________________________ |
Tool ID: 7.5.7 Category: Health & First Aid Tools Last Updated: January 2026 Part of the Texas Ranch Safety Tool Series
