DA Form 7595-4-2 "Measure a Patient's Pulse"

DA Form 7595-4-2 - also known as the "Measure A Patient's Pulse" - is a Military form issued and used by the United States Department of the Army.

The form - often mistakenly referred to as the DD form 7595-4-2 - was last revised on March 1, 2014. Download an up-to-date fillable PDF version of the DA 7595-4-2 below or request a copy through the chain of command.

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MEASURE A PATIENT'S PULSE
For use of this form see TC 8-800; the proponent agency is TRADOC.
IV
TABLE:
STP 8-68W13-SM-TG, Task: 081-831-0011, Measure a Patient's Pulse
REFERENCE:
PRIVACY ACT STATEMENT
10 U.S.C. S 3013 Secretary of the Army; AR 350-1, Army Training Leadership and Development.
AUTHORITY:
S
PRINCIPAL PURPOSE:
To ensure that accomplishment of training is properly credited to the correct individual for NREMT certification
IAW AR 40-68, AR 220-1 and AR 350-1.
ROUTINE USES:
Used by Unit personnel to monitor training. The DOD "Blanket Routine uses" set forth at the beginning of the
Army's compilation of system of records notices may apply to this system.
Voluntary. Failure to provide your name may result in a loss of credit for accomplishing the training or error in
DISCLOSURE:
processing applicable favorable personnel actions. For Official Use Only.
1. Soldier (Last Name, First Name, MI)
2. Date (YYYYMMDD)
SCENARIO:
While responding to an emergency call, you encounter a patient with a medical illness or trauma-related injury. During your assessment of this patient,
you must obtain a baseline pulse.
GRADING SHEET
TASK
COMPLETED
1ST
2ND
3RD
3. Performance Measures
P
F
P
F
P
F
a. Positioned the patient, seated or lying supine.
b. Palpated the pulse point.
c. Counted the radial pulse for 30 seconds and multiplied times two. If the patient is demonstrating a weak or
irregular pulse, the Soldier Medic must measure the pulse for a full 60 seconds.
d. Evaluated the pulse rhythm (regular, irregular).
e. Evaluated the pulse strength (strong, bounding, weak).
f. Documented the pulse rate, rhythm, and strength and the time obtained on the appropriate medical form.
4. Demonstrated Proficiency
Yes
No
5. Start Time
6. Stop Time
7. Initial Evaluator
8. Start Time
9. Stop Time
10. Retest Evaluator
12. Stop Time
13. Final Evaluator
11. Start Time
14. Evaluator's Comments
This form was prepared by U.S. Government employees for use in the 68W MOS. Although it contains, in part, copyrighted material from National
Registry of Emergency Medical Technicians, Inc. (NREMT), skill sheets ©2011, this form has neither been prepared nor approved by NREMT. Use is
restricted to guidelines contained in the Preface to TC 8-800.
Supersedes DA Form 7595-10-R, MAY 2009
DA FORM 7595-4-2, MAR 2014
APD LC v1.00
MEASURE A PATIENT'S PULSE
For use of this form see TC 8-800; the proponent agency is TRADOC.
IV
TABLE:
STP 8-68W13-SM-TG, Task: 081-831-0011, Measure a Patient's Pulse
REFERENCE:
PRIVACY ACT STATEMENT
10 U.S.C. S 3013 Secretary of the Army; AR 350-1, Army Training Leadership and Development.
AUTHORITY:
S
PRINCIPAL PURPOSE:
To ensure that accomplishment of training is properly credited to the correct individual for NREMT certification
IAW AR 40-68, AR 220-1 and AR 350-1.
ROUTINE USES:
Used by Unit personnel to monitor training. The DOD "Blanket Routine uses" set forth at the beginning of the
Army's compilation of system of records notices may apply to this system.
Voluntary. Failure to provide your name may result in a loss of credit for accomplishing the training or error in
DISCLOSURE:
processing applicable favorable personnel actions. For Official Use Only.
1. Soldier (Last Name, First Name, MI)
2. Date (YYYYMMDD)
SCENARIO:
While responding to an emergency call, you encounter a patient with a medical illness or trauma-related injury. During your assessment of this patient,
you must obtain a baseline pulse.
GRADING SHEET
TASK
COMPLETED
1ST
2ND
3RD
3. Performance Measures
P
F
P
F
P
F
a. Positioned the patient, seated or lying supine.
b. Palpated the pulse point.
c. Counted the radial pulse for 30 seconds and multiplied times two. If the patient is demonstrating a weak or
irregular pulse, the Soldier Medic must measure the pulse for a full 60 seconds.
d. Evaluated the pulse rhythm (regular, irregular).
e. Evaluated the pulse strength (strong, bounding, weak).
f. Documented the pulse rate, rhythm, and strength and the time obtained on the appropriate medical form.
4. Demonstrated Proficiency
Yes
No
5. Start Time
6. Stop Time
7. Initial Evaluator
8. Start Time
9. Stop Time
10. Retest Evaluator
12. Stop Time
13. Final Evaluator
11. Start Time
14. Evaluator's Comments
This form was prepared by U.S. Government employees for use in the 68W MOS. Although it contains, in part, copyrighted material from National
Registry of Emergency Medical Technicians, Inc. (NREMT), skill sheets ©2011, this form has neither been prepared nor approved by NREMT. Use is
restricted to guidelines contained in the Preface to TC 8-800.
Supersedes DA Form 7595-10-R, MAY 2009
DA FORM 7595-4-2, MAR 2014
APD LC v1.00
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