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Primary Care Paramedic

www.jibc.ca

Practicum Educator

Guide

February 2011

Justice Institute of British Columbia© 2011, Province of British Columbia.

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publisher.

Requests for permission to make copies of any part of this work should be directed to the publisher. Additional copies of the work may be obtained from the publisher:

School of Health SciencesJustice Institute of British Columbia715 McBride BoulevardNew Westminster, BC V3L 5T4Tel: 604-528-5590 Fax: 604-528-5715www.jibc.ca

Published February 2011. Printed in Canada.

Table of ContentsOverview 5

Contact Information

The Justice Institute of BC (JIBC)

Primary Care Paramedic (PCP) Program

Hospital and Ambulance Practicum

Course Content

Understanding Competency Management

Important Information

Appendix I: PCP National Occupational Competency Profi le 17

Appendix II: CompTracker® 25

Appendix III: Work Related Injury Process & Forms 29

Appendix IV: Scope of Practice: Emergency Medical Assistants Regulation 35

Appendix V: Clinical Worksheet and Patient Care Record 39

Appendix VI: BCAS Patient Privacy Policy 45

Overview


Practicum Educator Guide

Contact Information

24 hour emergency contact number: (1) 604 528-5751

During a hospital practicum should an emergency occur (see examples listed below) please call 1-604-528-5751 to contact a SOHS representative. There is a representative available for emergency contact anywhere in the province 7 days a week, 24 hours per day.

Examples of an emergency (but not a complete list) are:

The student has a family emergency and must leave their assigned shift before it is complete• The student has suff ered a work related injury and is admitted to hospital• The student has been exposed to an infectious disease or biohazard and requires emergent care.• The student has had a medical emergency that requires further evaluation by a health care provider.•

ACP Program Coordinator Rick Wong [email protected]

DND Program CoordinatorChilliwack Campus

Michelle Finlay 604.847.0130mfi [email protected]

PCP Program Coordinator Kathy Harms [email protected]

Manager, Practice Education Kevin Sanford [email protected]

Paramedic Scheduling [email protected]

Acting RTCNew Westminster

Lorraine Taylor [email protected]

RTCVictoria

Lisette Robinson [email protected]

RTCParksville

Greg Wright [email protected]

RTCKelowna

Steven Mills [email protected]

Primary Care Paramedic Program: Practicum Educator Guide

School of Health Sciences: Paramedic Academy February 20117

The Justice Institute of BC (JIBC)

The JIBC is a post-secondary institution that provides education in the areas of justice and public safety. The mission of the JIBC is to provide innovative education and training for those who make our communities safe. The JIBC was established in 1978 and is comprised of three schools with a total of eleven academic departments. The main campus is located in New Westminster with regional campuses located in Kelowna, Victoria, Parksville and Prince George. The JIBC is recognized for supporting its academic off erings and programs with simulation exercises. In addition to programs within British Columbia, the JIBC is recognized as a world leader for eff ective education in public safety.

The Academies at the JIBC include the School of Public Safety and Security, School of Community and Social Justice, and the School of Health Sciences.

School of Public Safety and Security:

Pacifi c Traffi c Education Center• Sheriff Academy • Corrections and Community Justice • Police Academy• Fire & Safety Division• Emergency Management Division•

School of Community and Social Justice:

Center for Counseling and Community Safety• Center for Leadership• Center for Confl ict Resolution • Center for Aboriginal Programs and Services•

The School of Health Sciences:

Center for Professional Health Education • Paramedic Academy•


School of Health Sciences: Paramedic AcademyFebruary 20118

School of Health Sciences

The School of Health Sciences programs emphasize collaborative and interdisciplinary practice in both community and clinical settings. An integrative approach to health care utilizes the expertise of paramedics and other health professionals to improve access to care. An applied learning model incorporates the use of patient simulators and emergency scenarios. A hallmark of our paramedic training programs is the fi eld application of the concepts and knowledge gained through independent study, didactic sessions, simulations and clinical opportunities. A simple to complex model is utilized to present program content and to build skill profi ciency to paramedic students. Hospital and ambulance practicum opportunities form the vital bridge linking classroom and simulated learning sessions to the supervised application of skills in the real world.

Primary Care Paramedic (PCP) Program

The PCP certifi cate program is delivered in a variety of ways to ensure maximum fl exibility for students. It is off ered in a full time and part time format at the main campus and regional campuses throughout the province. The full time program is one month of independent study, 15 weeks of full time classroom attendance, and three months of availability to complete the hospital and ambulance practicums. One day in the hospital and two shifts on the ambulance practicum are completed after four weeks of didactic classroom sessions. At the completion of the 15 weeks of classroom sessions, a further two hospital practicum shifts and a minimum of 10 ambulance practicum shifts are completed.



Hospital and Ambulance Practicum

The goal of the hospital and ambulance practicum is to provide opportunities for students to interact with patients, their families and members of the interdisciplinary health care team. In addition, it is a time to identify patient management priorities and develop an understanding of the real world work of the paramedic and the relationship between the pre-hospital and hospital environments. Students are provided with logbooks to record patient encounters, their assessments and treatments, and to track the competencies set out in the National Occupational Competency Profi le (NOCP). More specifi c information related to the NOCPs will be described later in this guide.

The contents of the students’ hospital and ambulance logbooks are:

Student logbook submission schedule• NOCP profi les• Clinical Worksheets (CWS) or Patient Care Records (PCR)• Job dimension evaluation forms• Student practicum progress report• Student notes• Reporting a work injury• BCAS Patient Privacy Policy•

In your role as the clinician/preceptor you will be expected to:

Supervise, coach, and evaluate paramedic students during their practice education;• Integrate teaching opportunities into your daily work experiences;• Provide boundaries to protect/care for and allow students to experience day to day routine;• Seek out and provide opportunities for students to meet program objectives and National • Occupational Competency Profi le skills;Provide feedback to students related to their skills, interactions with patients, families, and • other health care providers;Complete documentation of competencies and job dimensions.•



Course Content

Students attend three hospital practicum days and a minimum of twelve ambulance shifts during their PCP training. The fi rst of the three hospital days and the fi rst two of the ambulance shifs are after the student has completed four weeks of classroom training. To this point they have demonstrated classroom competency in the core skills of paramedic practice, as listed below. The intent of the fi rst practicum is to introduce the student to patient assessments, airway management skills, cardiac arrest management skills, and patients experiencing health care issues related to the course topics listed below. However, for the majority of the students it is the fi rst time that they have talked with patients, been exposed to the health care environment, been in an ambulance, moved a patient from the scene to the ambulance and handled the associated pre-hospital equipment. It is also important for students to develop an understanding of their role as a paramedic and as a member of the health care team.

The fi rst four weeks of the PCP course covers the following course content:

Course Topics: F210

Anatomy and Physiology Review• Life as a Paramedic• Communication Skills• Stress Management• Lifts and Transfers• Equipment Orientation• Radio Communication• The Driver’s Role• Ambulance Orientation• Patient Assessment: The Rescue Scene• Communicable Diseases• Occupational Health and Safety• Communicable Diseases and Universal • Precautions

Course Topics: CS221

Pain Management• Wound Management• Burn Management• Fracture Management• Spinal Management• Documentation, Records and Reports• Pharmacology• Fluids and Electrolytes• Drug Administration• Intravenous Therapy•


Introduction to Patient Assessment• Patient Assessment: Primary Survey• Oxygen Therapy• Airway Management• Breathing Management• Hemorrhage Control• Patient Assessment: Secondary Survey• Cardiac Arrest• Grief Management• Physical Assessment•


MCI• HAZMAT• Bio-terrorism• Crime Scene Management• Inter-facility Transfers and Advanced • ProceduresLand Transport Operations• Air Transport Operations• Vehicle Extrication• Patient Recovery•



The remaining hospital days (2 days) and ambulance shifts (10 shifts) are scheduled when the student has successfully completed the entire PCP classroom training. At this point the student has demonstrated classroom competency in the management of classic medical and trauma patient presentations as well as complex patient presentations/situations. During this practicum the students’ focus is to integrate their training while providing care to a patient and continue to build on the experiences of the fi rst practicum.

It has been shown in the past that the students have limited opportunities to meet competencies for oxygen therapy, ventilating patients with a bag valve mask, stabilizing suspected cervical injury and obtaining intravenous starts. During this experience the student must meet integration competencies. These competencies are the fi nal building block of their training. It is a time when the student must combine their knowledge of the pathophysiology, assessment skills, and understanding of protocols to manage specifi c patients and their primary problem. In addition, skills related to assessing, caring and treating a pediatric (1 to puberty*) patient and a geriatric (over 65 years old) patient are evaluated.

The content for the remainder of the PCP course is as follows:

Course Topics: CC250

Patient Assessment: Pathophysiology and • Principles of ManagementShock• Kinematics• Trauma Management• Head, Neck and Spine Injuries• Chest and Abdominal Injuries• Injuries to the Extremities• Environmental Injuries• Pediatric and Obstetrics•


Patient Assessment: Diff erential Diagnosis• Management of Trauma Calls• Management of Conscious • Medical Patient CallsManagement of Unconscious• Medical Patient Calls


Management of Medical Patients• Cardiac Conditions• Respiratory Conditions• Abdominal Conditions•


Patient assessment and clinical decision-making• Clinical decision-making and documentation• Special populations• Choosing the right protocol: Shades of gray• Complex case calls• Professionalism• Professional development•


The Unconscious Patient• Neurological Conditions• Diabetic Emergencies• Anaphylaxis• Poisons, Overdoses and Alcohol• Disturbances of Behavior• General Medical Conditions•

*Puberty is defi ned as the development of genital or underarm hair and/or breasts for girls.



Understanding Competency Management

Paramedic Association of Canada - National Occupational Competency Profi le

The Paramedic Association of Canada (PAC) is responsible for setting national competencies of paramedic practice. PAC does not determine the provincial scope of practice (i.e. what a paramedic is licensed to do in each province). In BC, scope of practice is defi ned by legislation, in the Emergency Medical Assistant Regulations, Appendix 4.

The PAC – NOCP skills are defi ned by the following practitioner levels:

Emergency Medical Responder (EMR) • Primary Care Paramedic (PCP) • Advanced Care Paramedic (ACP) • Critical Care Paramedic (CCP)•

Competencies are specifi c to the practitioner’s level and are cumulative. Competencies are evaluated in the following settings and represented by a single letter:

Awareness (X)• Academic (A) • Simulation (S)• Clinical or hospital environment (C)• On-car practicum (P) •

During the hospital/ clinical practicum the clinician/preceptor is able to evaluate only the student’s skills that must be demonstrated in the clinical (C) environment. During the on car ambulance practicum the preceptor is able to evaluate the student’s skills that are demonstrated in the clinical (C) and ambulance/on-car (P) environment. Regardless of the environment, only competencies that are within the student’s scope of practice may be completed. For example, intravenous medications are only administered in the ambulance or (P) environment. The medications that are permitted are: narcan, thiamine, and D10W.

Defi nition of Competency

The School of Health Sciences at the JIBC uses the PAC defi nition of competency to determine that a student has successfully completed all program competencies. Competence involves the demonstration of skills, knowledge and abilities in accordance with the following principles:

Consistency– the ability to repeat practice techniques and outcomes• Independence – the ability to practice without assistance from others• Timeliness – the ability to practice in a time frame that enhances patient safety• Accuracy – the ability to practice utilizing correct techniques and to achieve the intended • outcomes



Appropriateness – the ability to practice in accordance with clinical standards and protocols • outlined within the practice jurisdiction

The Paramedic Association of Canada considers “consistency” to mean that students should perform each specifi c competency more than once in the required performance environment.

The PCP Program requires students to meet the PAC competency requirements. The student must demonstrate competency a minimum of two times. The competency tracking process refl ects these competency requirements.

Tracking National Occupational Competency Profi le Skills

Students record patient encounters, including treatment(s), assessments, and outcome(s) on Clinical Worksheets (CWS) or Patient Care Records (PCR) provided in the log book. NOCP skills are determined after the patient encounter and are documented (by the student) on the CompTracker® web site.

Clinical Worksheet (CWS) or Patient Care Record (PCR)

The clinician/preceptor evaluates and coaches the PCP student’s integration of theoretical components in the hospital or pre-hospital environment. The clinician/preceptor is required to confi rm the student’s completion of a competency according to the PAC guidelines after every patient encounter by approving or assigning an applicable code (described further in this manual) to the competency. The student is responsible to complete the CWS or PCR and claim NOCP competencies on the CompTracker® web site.

Students are required to record each patient encounter during their practicum. Documentation must provide the data for the claimed competencies and refl ect the actions of the student. If patient care is not documented, it is assumed that the care was not done. Patient care documented by the student on the CWS or PCR supports the approved NOCP skills validated (signed) in CompTracker® through the web site. A separate CWS/PCR must be completed for each patient contact. Clinicians/preceptors must print their name and sign or initial the front of the CWS/PCR. This signature confi rms that the student saw the patient. Each CWS/PCR must have a clinician/preceptro signature/initial.

On the back of the CWS/PCR there is a NOCP Reference Guide that the student may complete. There is also an area where the clinician can make comments regarding student performance. Comments may identify strengths and areas for improvement. This area may be reviewed by clinicians to determine the student’s learning plan for the shift. Comments made by the clinician should be initialed or signed at the bottom of the sheet.

You can fi nd a copy of a CWS and a PCR in Appendix V of this guide.



Competency Management System (CompTracker®)

NOCP competencies are managed by a software program (CompTracker®) and through the Internet. CompTracker® provides students, instructors, clinicians, and administrative staff with the ability to communicate and track program progress on a daily basis. Students use the web to log attendance, classroom simulations, and acquisition of competencies. Instructors, ambulance preceptors, and hospital clinicians, sign off or validate student progress through the CompTracker® web site.

The software is developed and hosted by Great Big Solutions Ltd., in Edmonton, Alberta. This software is used by paramedic training agencies across Canada. Log in information with a password will be provided.

Any questions about the software program, hardware, or technical requirements can be addressed on the website www.studentlogbook.com or by calling Great Big Solutions at 1-866-432-3280. Help line support is available Monday, to Friday from 0800 to 1600 hours (MST) or via a chat line on the CompTracker® home page. A quick reference for approving competencies on line is available on the CompTracker website, training tab or in the Appendices, Appendix 2.

Validating NOCP

After a student has claimed competencies, they must be validated by the clinician/preceptor. The clinician/preceptor and the student will review the claimed competencies. Any NOCP claimed by the student must be supported by documentation on the CWS or PCR.

Groups of students cannot claim the same integration competency for the same patient.

If competencies are not approved, a comment must be provided. A drop down menu provides consistent comments that can be used in addition to any comments that one wishes to add.

Students are encouraged to submit their competencies to the clinician/preceptor within 48 hours from the completion of their day or shift. Competencies submitted outside this time frame may not be counted toward competency completion and may not be validated by clinicians/preceptors.

NOCP Evaluation Parameters

Appendix I in this guide lists the NOCP skills in the seven domains of practice that are evaluated during a hospital or ambulance practicum. The list identifi es the area or environment where the skill is evaluated and it is represented by a letter.

Skills evaluated in the hospital practicum are identifi ed by the letter C. These skills may also be evaluated during the ambulance practicum. Any other letters that are recorded next to a NOCP skill are a requirement for a BC Ambulance Service Paramedic scope of practice and are recorded at this time to ensure familiarity with these skills.

The evaluation codes are identifi ed by the letters A, B, C, and D as described below. The Paramedic Association of Canada directs that for students to be successful at achieving their competencies they must achieve two A, competent, evaluations for each competency.



Evaluation Codes

CodeA Approved, completes objective competently (according to PAC defi nition of competency)B Requires prompting/assistance to complete objectiveC Fails to complete objectiveD Not observed/lack of volumeN.B.: Comments are required for any non-approved competency

Job Dimensions

Paramedic Job Dimensions are best described as a sorting or categorization of the numerous job competencies that represent the performance areas that are critical to function as a paramedic or manage patient care in the hospital. The Job Dimension evaluation amalgamates the NOCP skills into a tool for the clinician/preceptor to review the student assessment or how the student processes the information and determines next steps. Each process is evaluated and graded according to the PAC evaluation criteria. A Job Dimension evaluation is completed at the end of a block of shifts with the student or when a preceptor may need to make comments/suggestions for improvement. Job Dimension forms are available in the student logbook or on the CompTracker® web site.

Student Guidelines for Documentation Submission

It is expected that each student will submit their logbook for review to the Regional Training Coordinator (RTC) or Lead Instructor at the completion of the fi rst Practicum block. In addition, after the fi rst ambulance block, the student must call and schedule a face to face meeting and review of the logbook before their next ambulance practicum shift. Failure to schedule a meeting will result in the suspension of their next block of ambulance practicum shifts. Students will be notifi ed of this situation by email.

Students must submit their logbooks for review after completion of the following:

Core Skills Practicum (1 hospital and 2 on car shifts)• Hospital Clinical Practicum (after 3rd shift)•

After the last hospital practicum shift, the student logbook must be submitted to the clinical liaison, RTC, lead instructor or designate within 7 calendar days. The SOHS will respond and advise of the practicum status within 14 calendar days from the date received.

Review by the RTC, Lead Instructor or designate determines the fi nal acceptance and approval of competencies.

If there are any questions regarding the use of the logbook please contact your local RTC or the Program Coordinator. Contact information is included at the beginning of this guide.



Important Information

Work Related Injury

WorkSafe BC recognizes the Justice Institute of BC, School of Health Sciences as an employer in relation to a work related injury. Paramedic students are covered by WorkSafe BC for injuries that happen during the hospital practicum. The process (found in the Appendix) that is required to report a work related injury followed by a copy of the WorkSafe BC, Form 6A that must be completed and submitted to the RTC or designate. Each student log book contains a copy of the WorkSafe Form 6A that must be submitted to the School of Health Sciences. Form 6A must be submitted to the SOHS within 48 hours of the work related injury.

Should the student be involved in an incident that requires a debriefi ng please contact the SOHS Program Coordinator, Regional Training Coordinator, or Manager, Practice Education. JIBC Student Services and critical incident stress debriefers are available for students.

Patient Privacy

Students are responsible for adherence to the BCAS Patient Privacy Policy throughout their Practicum. Please see Appendix VI for a copy of this policy.

Useful Links

CompTracker: 1. www.studentlogbook.com

EMA licensing to see the complete regulation that includes the scope of practice for EMR, PCP, 2. ACP, and CCP practitioners: www.health.gov.bc.ca/ema

Justice Institute of BC new Teaching and Learning Center, for faculty:3. www.jibc.ca/programs-courses/graduate-studies-academic-services/faculty-support

School of Health Sciences: Clinician and Preceptor Newsletter – PARAgraph: 4. www.jibc.ca/programs-courses/schools-departments/school-health-sciences/paragraph-archives

BC Academic Council – Practice Education Guidelines:5. www.practiceeducation.org

Paramedic Association of Canada: 6. www.paramedic.ca

http://www.studentlogbook.com

http://www.health.gov.bc.ca/ema

http://www.jibc.ca/programs-courses/graduate-studies-academic-services/faculty-support

http://www.jibc.ca/programs-courses/schools-departments/school-health-sciences/paragraph-archives

http://www.practiceeducation.org

http://www.paramedic.ca

Appendix IPCP National Occupational Competency Profi le





National Occupational Competency Profi le

Primary Care Paramedic ProgramNational Occupational Competency Profi le

Area 1: Professional ResponsibilitiesP 1.1.a Maintain patient dignity.

P 1.1.b Refl ect professionalism through use of appropriate language.

P 1.1.c Dress appropriately and maintain personal hygiene.

P 1.1.e Maintain patient confi dentiality.

P 1.1.h Promote awareness of emergency medical system and profession.

P 1.1.j Behave ethically.

P 1.1.k Function as patient advocate.

P 1.3.a Comply with scope of practice.

P 1.3.c Include all pertinent and required information on ambulance call report forms.

P 1.5.a Work collaboratively with a partner.

P 1.5.b Accept and deliver constructive feedback.

P 1.5.c Work collaboratively with other emergency response agencies.

P 1.5.d Work collaboratively with other members of the health care team.

P 1.6.a Exhibit reasonable and prudent judgement.

P 1.6.b Practice eff ective problem-solving.

P 1.6.c Delegate tasks appropriately.

Area 2: CommunicationP 2.1.a Deliver an organized, accurate and relevant report utilizing telecommunication devices.

P 2.1.b Deliver an organized, accurate and relevant verbal report.

P 2.1.c Deliver an organized, accurate and relevant patient history.

P 2.1.d Provide information to patient about their situation and how they will be treated.

P 2.1.e Interact eff ectively with the patient, relatives and bystanders who are in stressful situations.

P 2.1.f Speak in language appropriate to the listener.

P 2.1.g Use appropriate terminology.

P 2.2.a Record organized, accurate and relevant patient information.

P 2.3.b Practice active listening techniques.

P 2.3.c Establish trust and rapport with patients and colleagues.

P 2.3.d Recognize and react appropriately to non-verbal behaviours.

P 2.4.a Treat others with respect.

P 2.4.b Exhibit empathy and compassion while providing care.

P 2.4.c Recognize and react appropriately to individuals and groups manifesting coping mechanisms.

P 2.4.d Act in a confi dent manner.

P 2.4.e Act assertively as required.

P 2.4.f Manage and provide support to patients, bystanders and relatives manifesting emotional reactions.

P 2.4.g Exhibit diplomacy, tact and discretion.




Area 3: Health & SafetyP 3.1.e Exhibit physical strength and fi tness consistent with the requirements of professional practice.

P 3.2.a Practice safe biomechanics.

P 3.2.b Transfer patient from various positions using applicable equipment and/or techniques.

P 3.2.d Secure patient to applicable equipment.

P 3.2.e Lift patient and stretcher in and out of ambulance with partner.

P 3.3.a Assess scene for safety.

P 3.3.b Address potential occupational hazards.

P 3.3.f Practice infection control techniques.

P 3.3.g Clean and disinfect equipment.

P 3.3.h Clean and disinfect an emergency vehicle.

Area 4: Assessment & DiagnosticsP 4.2.a Obtain list of patient’s allergies.

P 4.2.b Obtain list of patient’s medications.

P 4.2.c Obtain chief complaint and/or incident history from patient, family members and/or bystanders.

P 4.2.d Obtain information regarding patient’s past medical history.

P 4.2.e Obtain information about patient’s last oral intake.

P 4.2.f Obtain information regarding incident through accurate and complete scene assessment.

P 4.3.a Conduct primary patient assessment and interpret fi ndings.

P 4.3.b Conduct secondary patient assessment and interpret fi ndings.

P 4.3.c Conduct cardiovascular system assessment and interpret fi ndings.

P 4.3.d Conduct neurological system assessment and interpret fi ndings.

P 4.3.e Conduct respiratory system assessment and interpret fi ndings.

P 4.3.j Conduct musculoskeletal assessment and interpret fi ndings.

P 4.3.k Conduct assessment of the immune system and interpret fi ndings.

P 4.3.l Conduct assessment of the endocrine system and interpret fi ndings.

P 4.3.n Conduct multisystem assessment and interpret fi ndings.

P 4.4.a Assess pulse.

P 4.4.b Assess respiration.

C 4.4.c Conduct non-invasive temperature monitoring.

P 4.4.d Measure blood pressure by auscultation.

P 4.4.e Measure blood pressure by palpation.

C 4.4.f Measure blood pressure with non-invasive blood pressure monitor.

P 4.4.g Assess skin condition.

P 4.4.h Assess pupils.

P 4.4.i Assess level of mentation.

C 4.5.a Conduct oximetry testing and interpret fi ndings.

P 4.5.c Conduct glucometric testing and interpret fi ndings.




Area 5: TherapeuticsC 5.1.a Use manual maneuvers and positioning to maintain airway patency.

P 5.2.e Utilize portable oxygen delivery systems.

C 5.3.a Administer oxygen using nasal cannula.

C 5.3.d Administer oxygen using high concentration mask.

C 5.4.a Provide oxygenation and ventilation using bag-valve-mask.

C 5.5.c Maintain peripheral intravenous (IV) access devices and infusions of crystalloid solutions with-out additives

A 5.5.d Conduct peripheral intravenous cannulation

P 5.6.a Treat soft tissue injuries.

P 5.7.b Immobilize suspected fractures involving axial skeleton.

A 5.8.a Recognize principles of pharmacology as applied to the medication listed in Appendix 5.

S 5.8.b Follow safe process for responsible medication administration.

S 5.8.c Administer medication via subcutaneous route.

X 5.8.e Administer medication via the intravenous route

S 5.8.h Administer medication via the sublingual route.

S 5.8.j. Administer medication via the oral route

S 5.8.l Administer medication via inhalation.

Area 6: IntegrationP 6.1.a Provide care to patient experiencing illness or injury primarily involving cardiovascular system.

P 6.1.b Provide care to patient experiencing illness or injury primarily involving neurological system.

P 6.1.c Provide care to patient experiencing illness or injury primarily involving respiratory system.

P 6.1.e Provide care to patient experiencing illness or injury primarily involving gastrointestinal system.

P 6.1.f Provide care to patient experiencing illness or injury primarily involving integumentary system.

P 6.1.g Provide care to patient experiencing illness or injury primarily involving musculoskeletal system.

P 6.1.l Provide care to patient experiencing non-urgent medical problem.

P 6.1.o Provide care to patient based on understanding of common physiological, anatomical, incident and patient-specifi c fi eld trauma criteria that determine appropriate decisions for triage, transport, and destination.

C 6.2.b Provide care for pediatric patient.

C 6.2.c Provide care for geriatric patient.

P 6.3.a Conduct ongoing assessments based on patient presentation and interpret fi ndings.

P 6.3.b Re-direct priorities based on assessment fi ndings.

Area 7: TransportationP 7.1.a Conduct vehicle maintenance and safety.



NOCP Appendix 5 Medications for PCP

This list is marked with an “X” to indicate the groups of pharmacologic agents with which Primary Care Paramedics should be familiar.The technical skill of medication administration is included in the profi le as General Competency 5.8.The administration of any medication by a paramedic is at the sole discretion of the respective

Medical Director.

A. Medications aff ecting the central nervous system.

A.1 Opioid Antagonists X

A.2 Anaesthetics

A.3 Anticonvulsants

A.4 Antiparkinsonism Agents

A.5 Anxiolytics, Hypnotics and Antagonists

A.6 Neuroleptics

A.7 Non-narcotic analgesics X

A.8 Opioid Analgesics

A.9 Paralytics

B. Medications aff ecting the autonomic nervous system.

B.1 Adrenergic Agonists X

B.2 Adrenergic Antagonists

B.3 Cholinergic Agonists

B.4 Cholinergic Antagonists

B.5 Antihistamines

C. Medications aff ecting the respiratory system.

C.1 Bronchodilators X

D. Medications aff ecting the cardiovascular system.

D.1 Antihypertensive Agents

D.2 Cardiac Glycosides

D.3 Diuretics

D.4 Class 1 Antidysrhythmics




D.8 Antianginal Agents X



NOCP Appendix 5 Medications for PCP - continued

This list is marked with an “X” to indicate the groups of pharmacologic agents with which Primary Care Paramedics should be familiar.The technical skill of medication administration is included in the profi le as General Competency 5.8.The administration of any medication by a paramedic is at the sole discretion of the respective

Medical Director.

E. Medications aff ecting blood clotting mechanisms.

E.1 Anticoagulants

E.2 Thrombolytics

E.3 Platelet Inhibitors X

F. Medications aff ecting the gastrointestinal system.

F.1 Antiemetics

G. Medications aff ecting labour, delivery and postpartum hemorrhage.

G.1 Uterotonics

G.2 Tocolytics

H. Medications used to treat electrolyte and substrate imbalances.

H.1 Vitamin and Electrolyte Supplements

H.2 Antihypoglycemic Agents X

H.3 Insulin

I. Medications used to treat / prevent infl ammatory responses and infections.

I.1 Corticosteroids

I.2 NSAID

I.3 Antibiotics

I.4 Immunizations

J. Medications used to treat poisoning and overdose.

J.1 Antidotes or Neutralizing Agents

Appendix IICompTracker®





CompTracker®

Quick Start Guide: Online approvals

Appendix IIIWork Related Injury Process & Forms









Appendix IVScope of Practice

Emergency Medical Assistants Regulation





Schedule 1[am. B.C. Reg. 207/2006, ss. 2 and 3]

Services – Licence Category

EMA FR

Scene assessment;• Assessment of level of consciousness, skin colour and temperature, pulse, and respiration;• Rapid body survey to identify and attend to any life threatening injuries followed by a • secondary assessment consisting of a physical examination, medical and incident history, and vital signs;Cardiopulmonary resuscitation;• Basic wound and fracture management;• Maintenance of airways and ventilation•

EMR

All services specifi ed in this Schedule and Schedule 2 for the category of EMA FR;• Occupational fi rst aid• Lifting/loading, extrication/evacuation and transportation;• Cervical collar application and spinal immobilization on a long spine board;• Blood pressure assessment by ausculatation and palpitation;• Emergency fracture management/immobilization• Oropharyngeal airway suctioning• Oxygen administration and equipment• Administration of semi-automatic or automatic external defi brillator• Soft tissue injury treatment•

PCP

All services specifi ed in this Schedule and Schedule 2 for the category of EMR;• Administration of the following intravenous, oral, sublingual, subcutaneous, inhaled, intra-• muscular or nebulized medications;

Narcotic antagonist• Bronchodilator• Anti-histaminic• Sympathomimetic agent•

http://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/10_562_2004; 5/18/2010



Schedule 2[am. B.C. Reg. 207/2006, ss. 4 and 5.]

Services – Licence Endorsement

EMA FR

use of airway management techniques including oropharyngeal airways, oral suction devices • and oxygen-supplemented mask devices to assist ventilation;use of an automatic or semi-automatic external defi brillator;• cervical collar application and spinal immobilization on a long spine board;• administration of oxygen;• administration of oral glucose;• emergency childbirth• ventilation using a pocket mask and bag/valve/mask devices•

EMR

maintenance of intravenous lines without medications or blood products while transporting • persons between health facilities;use and interpretation of a pulse oximeter;• administration of the following oral, sublingual, and inhaled medications:•

anti-anginal;• anti-hypoglycemic agent;• analgesia;• platelet inhibitors;•

use and interpretation of a glucometer;• chest auscultation•

PCP

initiation of peripheral intravenous lines• administration of the following intravenous fl uids and medications•

anti-hypoglycemic agent,• isotonic crystalloid solutions, or• Vitamin B1•

Endotracheal intubation.•

http://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/10_562_2004; 5/18/2010

Appendix VClinical Worksheet and Patient Care Record





Clinical Worksheet

Student:

Chief Complaint/Description of Incident:

Past Medical History:

Clinician:

Date:

Vital SignsTime LOC Pulse Resp. B/P Skin Pupils SP02 BG Other

Gender: M FHistory of Chief Complaint: Age:

Focused Physical Exam/Functional Inquiry:

RESULTTIME MEDICATIONS/TREATMENTS

CWS # asdf

Time: E: V: M: Total:


Treatment Priorities:

Hospital:

Medications:

Allergies:Glasgow Coma Scale

print name initials

ction

V:

V:

Glasg

nal Inquiry:

Time: E:

Time: E:me

E:

na

:

quiry:

meTimTTim

uiry



Area of Strength:

Recommendations for Improvement:

Comments:

On completing this form, please review with the student and sign below.

Clinician Signature/Initials: Student Signature:

ement:

Competency Reference GuideArea 4: Assesssment & Diagnostic

C 4.4.c Non-invasive temp.

C 4.4.f Non-invasive BP

C 4.5.a Oximetry testing

Area 5: Therapeutics

C 5.1.a Manual airway

C 5.3.a Nasal cannula oxygen

C 5.3.d High concen. oxygen

C 5.4.a B-V-M oxygen

C 5.5.c Peripheral IV

Area 6: Integration

C 6.2.b Pediatric Patient

C 6.2.c Geriatric Patient



Patient Care Record Student:

Dispatch for/chief Complaint:

Past Medical History:

Date:

Vital SignsTime LOC Pulse Resp. B/P Skin Pupils SP02 BG Other

Gender: M FHistory of Chief Complaint: Age:

Focused Physical Exam/Functional Inquiry:

RESULTTIME MEDICATIONS/TREATMENTS

PCR # asdf

Transport by: PCP to __________________________ ACP Other:_____________________________



Impression:

Station #:

Medications:

Allergies:Glasgow Coma Scale

ction

V:

V:

Glasg

al Inquiry:

Time: E:

Time: E:e

E:

na ququiry

me:Tim

ry

print name

print name: initialsPreceptor:



Area of Strength:

Recommendations for Improvement:

Comments:

Preceptor Signature: Student Signature:

Student NOCP Reference GuideArea 1: Professional Responsibilities

Area 2: Communication Area 3: Health & Safety P 4.3.a Area 5: Therapeutics Area 6: Integration

P 4.3.b

P 1.1.a P 2.1.a P 3.1.e P 4.3.c C 5.1.a P 6.1.a

P 1.1.b P 2.1.b P 3.2.a P 4.3.d P 5.2.e P 6.1.b

P 1.1.c P 2.1.c P 3.2.b P 4.3.e C 5.3.a P 6.1.c

P 1.1.e P 2.1.d P 3.2.d P 4.3.j C 5.3.d P 6.1.e

P 1.1.h P 2.1.e P 3.2.e P 4.3.k C 5.4.a P 6.1.f

P 1.1.j P 2.1.f P 3.3.a P 4.3.l C 5.5.c P 6.1.g

P 1.1.k P 2.1.g P 3.3.b P 4.3.n A 5.5.d P 6.1.l

P 1.3.a P 2.2.a P 3.3.f P 4.4.a P 5.6.a P 6.1.o

P 1.3.c P 2.3.b P 3.3.g P 4.4.b P 5.7.b C 6.2.b

P 1.5.a P 2.3.c P 3.3.h C 4.4.c C 6.2.c

P 1.5.b P 2.3.d Area 4: Assessment & P 4.4.d P 6.3.a

P 1.5.c P 2.4.a Diagnostics P 4.4.e P 6.3.b

P 1.5.d P 2.4.b P 4.2.a C 4.4.f Area 7: Transportation

P 1.6.a P 2.4.c P 4.2.b P 4.4.g P 7.1.a

P 1.6.b P 2.4.d P 4.2.c P 4.4.h

P 1.6.c P 2.4.e P 4.2.d P 4.4.i

P 2.4.f P 4.2.e C 4.5.a

P 2.4.g P 4.2.f P 4.5.c

Appendix VIBCAS Patient Privacy Policy













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