Proposed Term Year Standards Revisions · Web viewEmergency Medical Technician - Intermediate. Technical Certificate of Credit Proposed Revisions: In the spring of 2004, a group

Posted: 03/27/07

Proposed Fall 2007 Standards RevisionsEmergency Medical Technician - Intermediate

Technical Certificate of Credit

Proposed Revisions:In the spring of 2004, a group of seasoned and new EMS Instructors representing several colleges met at Central Georgia Technical College in Macon to discuss the needs for revising the EMT Curriculum. Also present where Phil Petty and all three EMS FTO’s. Over the course of several months the committee reviewed the National Standard Curriculum (NSC) EMT-Basic 1994, EMT-Intermediate 1985 and the National Registry of EMT’s (Examination Contractor) Job Task Analysis. What we discovered was that there were several Job Task Skill Sets that were not addressed in the NSC, GA OMS or DTAE curricula. This committee was tasked with reviewing all Job Tasks and Curricula to identify valid, measurable objectives to cover these skill sets. During the course of this workgroup’s tasks, the idea was presented to align the revision of the EMT curriculum with that of the Paramedic curriculum. The Paramedic curriculum is presented in courses that align with the NSC 1999 Paramedic curriculum. (I.E. Roles & Responsibilities, Respiratory, Airway, Cardiology, Trauma, etc.) In the Paramedic curriculum a student could fail a course and only have to repeat the course and not the entire quarter. The group unanimously agreed.

Recommended Action – DTAE Staff:Recommend revisions as proposed.

Recommended Action – VPI Council:The Vice Presidents of Instructional Services support the VPI Standards Committee recommendation of changing the term “licensure” be substituted for “certified.”.

Recommended Action – Presidents Council:The Presidents Council concurs with the recommendation of the VPIs.

Recommended Action – DTAE Board:Enter Recommendation(s)

Summary of Credit Hour Changes: Program Name, Award LevelHours Current Proposed Difference

Total Credit 24 24 0Recommended:

DTAE 24 As proposed As proposedVPI Council Presidents Council State Board

Posted: 03/27/07

Fall 2007

Standards Revision ProjectAn Industry-Driven Report of Standardized Programs

InGeorgia Technical Colleges

Emergency Medical Technician - Intermediate

Probe Report

May 2006

Georgia Department of Technical and Adult Education

Facilitator(s):David Foster, III

Phil PettyLarry Roberson

Posted: 03/27/07

Georgia Department of Technical and Adult Education

Date Approved: Implementation Date: Fall 2007

Last Updated:

Technical Certificate of Credit State Standard Institutionally Developed College:

Program Name: Emergency Medical Technician - Intermediate

Major Code:

CIP Code:

PAS Code / PAS Group Name: 560- Paramedic Technology

Curriculum Program Specialist: Phil Petty

Program Description

This program covers the both U.S. Department of Transportation 1985 Emergency Medical Technician-Intermediate Curriculum and the 1994 Emergency Medical Technician-Basic Curriculum. The EMT-I Program is designed to provide additional training and increased knowledge and skills in specific aspects of advanced life support above the basic level. Successful completion of the program allows the graduate to take the National Registry of Emergency Medical Technician EMT-I certification examination and receive Georgia certification. Upon completion of EMS XX5, students would be eligible to sit for the National Registry of EMT Basic Exam.

Curriculum

Course

Code Course TitleClassHours

DemoLab

Hours

PracticalLab

HoursContactHours

CreditHours

CourseType

EMS XX1 Introduction to the EMT Profession 32 8 0 40 3 Standard

EMS XX2

Patient Assessment and Airway For the EMT 24 20 0 44 3 Standard

EMS XX3

Medical/Behavioral & OB Peds Emergencies for the EMT 30 20 0 50 4 Standard

EMS XX4 Trauma Emergencies for the EMT 20 14 0 34 2 Standard

EMS XX5 Summative Evaluations for EMT Basic 12 20 32 64 3 Standard

EMS XX6

Pharmacology and Shock/Trauma Management for the EMT Intermediate 28 24 0 52 3 Standard

EMS XX7

Medical Emergencies for the EMT Intermediate 33 15 0 48 3 Standard

EMS XX8

Summative Evaluations for EMT Intermediate 12 20 32 64 3 Standard

TCC Minimum Required Hours: 191 141 64 396 24

Admission Requirement

Required Age: 18High School Diploma or GED Required: yes

Test: ASSET

MinimumTest

Scores

Reading: 38English: 35

Mathematics: Algebra:

Other Conditions for Admission (if any): YesIf yes, explain: Students entering the EMT Intermediate certificate

program possessing the EMT Basic Certification will begin with course EMS XX5 and will be exempt from courses EMS XX1, EMS XX2, EMS XX3, and EMS XX4 upon successful completion of EMS XX5.

Program Final Exit PointEmergency Medical Technician – Intermediate, Technical Certificate of Credit

Credits Required for Graduation24 minimum quarter-hour credits required for graduation

Proposed course changes in the Emergency Medical Technician - Intermediate

EMS XX1 Introduction to the EMT Profession

Course DescriptionThe course covers all the components of the National Highway Safety Transportation Administration, National Standard Curriculum, Emergency Medical Technician-Basic, 1994 Standard, Module 1 and Module 7. It also covers Sections 1, 2, 3 and 4 of the NHTSA, National Standard Curriculum, EMT-Intermediate-1985. Topics include: basic cardiopulmonary resuscitation/AED, introduction to emergency medical care, roles and responsibilities of the EMT-Intermediate, EMS Systems for EMT-Intermediates, well being of the EMT– Basic, medical/legal and ethical issues, medical-legal aspects for the EMT-Intermediate, blood and airborne pathogens and infectious diseases, the human body, medical terminology, base line vital signs and SAMPLE history, lifting and moving patients, ambulance operations, gaining access, and overviews of HazMat/MCI.

Competency Areas Hours

Basic Cardiopulmonary Resuscitation/AED Class 32Introduction To Emergency Medical Care D. Lab 8Roles And Responsibilities Of The EMT-Intermediate P. Lab/O.B.I. 0EMS Systems For EMT-Intermediates Credit 3Well Being Of The EMT - BasicMedical/Legal And Ethical IssuesMedical/Legal Aspects For The EMT-IntermediateBlood And Airborne Pathogens & Infectious DiseasesThe Human BodyMedical TerminologyBase Line Vital Signs And Sample HistoryLifting And Moving PatientsAmbulance OperationsGaining AccessOverviews Of Hazmat/MCI

Prerequisite:

Program Admission

Corequisite:

Course Guide

Competency After completing this section, the student will be able to:

Hours

Class

D.Lab

P.Lab/

O.B.I.

BASIC CARDIOPULMONARY RESUSCITATION 4 4 0

X1-1.1Students must meet the requirements of the American Heart Association Health Care Provider’s Course or an equivalent course

INTRODUCTION TO EMERGENCY MEDICAL CARE 2 0 0X1-2.1 Define Emergency Medical Services (EMS) systems.

X1-2.2Differentiate the roles and responsibilities of the EMT-Basic from other prehospital care providers.

X1-2.3 Describe the roles and responsibilities related to personal safety.

X1-2.4Discuss the roles and responsibilities of the EMT-Basic towards the safety of the crew, the patient and bystanders.


Hours

Class

D.Lab

P.Lab/

O.B.I.

X1-2.5 Define quality improvement and discuss the EMT-Basic's role in the process. X1-2.6 Define medical direction and discuss the EMT-Basic's role in the process. X1-2.7 State the specific statutes and regulations in your state regarding the EMS system. X1-2.8 Assess areas of personal attitude and conduct of the EMT-Basic. X1-2.9 Characterize the various methods used to access the EMS system in your community. X1-2.10 Identify the role of EMS in local municipal and community prevention programs. (OP 30) ROLES AND RESPONSIBILITIES OF THE EMT-INTERMEDIATE 2 0 0X1-3.1 Identify and describe those activities performed by the EMT-I in the field X1-3.2 Define the role of the EMT-I

X1-3.3Describe and contrast the difference between an EMT-Ambulance and EMT-Intermediate training program

X1-3.4 Define the term “ethics” and “professionalism.” X1-3.5 Describe the differences between ethical behavior and legal requirements. X1-3.6 State specific activities that are most appropriate to ethical behavior.

X1-3.7Identify whether a particular activity is unethical and/or illegal, given certain patient care situations.

X1-3.8Identify whether a particular activity is ethical or unethical given certain patient care situations.

X1-3.9 Define the term "professional." X1-3.10 Define the term "health care professional. “ X1-3.11

Identify whether a particular activity is professional or unprofessional given certain patient care situations.

X1-3.12 State certain activities that are most appropriate to professional behavior. X1-3.13 List current Georgia requirements for EMT-I continuing education X1-3.14

Define and discuss at least three reasons why continuing education is important for the EMT-I

X1-3.15 Define the terms “certification” “licensure” and “registration” X1-3.16 Name and describe current state legislation outlining the scope of prehospital ALS X1-3.17 State the reason it is important to keep EMT-I certification current X1-3.18 State the major purposes of a national association X1-3.19 State the major purposes of a national registration agency X1-3.20 State the major benefits of subscribing to and reading professional journals X1-3.21 Provide examples of activities that constitute appropriate ethical behavior and the EMT-I X1-3.22 State the major benefits of EMT-I’s teaching in their community X1-3.23

Explain EMT-Intermediate Licensure, license renewal and reciprocity requirements for Georgia

EMS SYSTEMS FOR THE EMT-INTERMEDIATE 2 0 0X1-4.1 Discuss citizen access and the various mechanisms of obtaining it. X1-4.2 Discuss prehospital care as an extension of hospital care. X1-4.3 Define stabilization of patients. X1-4.4 Define and describe medical control


Hours

Class

D.Lab

P.Lab/

O.B.I.

X1-4.5 Describe physician responsibility for Medical Control X1-4.6 Describe the relationship between: - the physician on the scene, EMT-I and the physician on the radio - the physician who is with the patient when the EMT-I arrives

- the physician who arrives on the scene after the EMT-I’s have started evaluating and treating the patient

X1-4.7Describe the benefits of EMT-1 follow-up on patient condition, diagnosis, and retrospective review of prehospital care

X1-4.8 Describe GSA/KKK Ambulance standards

X1-4.9Define the American College of Surgeons Essential Equipment List and how it relates to local State laws.

X1-4.10

Define the national standard levels of prehospital provider as defined by curriculum, respectively.

A: Discuss ambulance placement and the parameters that should be utilized in its development, including the differences in urban, suburban and rural settings.

X1-4.11 Discuss the medical community role in overseeing prehospital care.

X1-4.12 Define protocols and standing orders. X1-4.13 Describe the development of protocols. X1-4.14 Define local training standards X1-4.15 Describe the legislation in the EMT-I’s State as regards prehospital care. X1-4.16

Describe integration of prehospital care into the continuum of total patient care with the emergency department phase of hospital care

X1-4.17 Discuss replacement of equipment and supplies X1-4.18 Discuss the EMT-I’s initial responsibilities when arriving on the scene. X1-4.19

Discuss ambulance placement and the parameters that should be utilized in its development,

including the differences in urban, suburban, and rural settings X1-4.20

Discuss the varying philosophies between the management of medical patients and trauma patients prehospital

X1-4.21 Describe the transition of patient care from the EMT-Intermediate, including: a. Transfer of responsibility (legal and medical) b. Reporting of patient status to physician or nurse. X1-4.22 Describe basic concepts of incident management. X1-4.23 Define the fundamental components of extrication. WELL BEING OF THE EMT - BASIC 1 0 0

X1-5.1List possible emotional reactions that the EMT-Basic may experience when faced with trauma, illness, death and dying.

X1-5.2Discuss the possible reactions that a family member may exhibit when confronted with death and dying.

X1-5.3State the steps in the EMT-Basic's approach to the family confronted with death and dying.


Hours

Class

D.Lab

P.Lab/

O.B.I.

X1-5.4State the possible reactions that the family of the EMT-Basic may exhibit due to their outside involvement in EMS.

X1-5.5 Recognize the signs and symptoms of critical incident stress. X1-5.6 State possible steps that the EMT-Basic may take to help reduce/alleviate stress. X1-5.7 Explain the need to determine scene safety. X1-5.8 Discuss the importance of body substance isolation (BSI).

X1-5.9Describe the steps the EMT-Basic should take for personal protection from airborne and bloodborne pathogens.

X1-5.10 List the personal protective equipment necessary for each of the following situations: -Hazardous materials -Rescue operations -Violent scenes -Crime scenes -Exposure to bloodborne pathogens -Exposure to airborne pathogens X1-5.11

Explain the rationale for serving as an advocate for the use of appropriate protective equipment.

X1-5.12

Given a scenario with potential infectious exposure, the EMT-Basic will use appropriate personal protective equipment. At the completion of the scenario, the EMT-Basic will properly remove and discard the protective garments.

X1-5.13

Given the above scenario, the EMT-Basic will complete disinfection/cleaning and all reporting documentation.

X1-5.14

Describe behavior that is a manifestation of stress in patients and those close to them and describe how that behavior relates to EMT stress. (OP22)

X1-5.15

Given a scenario involving a stressful situation, formulate an appropriate strategy to help adapt to the stress. (OP22)

X1-5-16

Discuss personal counseling techniques common to interactions with patients, family members and co-workers. (OP25)

MEDICAL/LEGAL AND ETHICAL ISSUES 1 0 0X1-6.1 Define the EMT-Basic scope of practice.

X1-6.2Discuss the importance of Do Not Resuscitate [DNR] (advance directives) and local or state provisions regarding EMS application

X1-6.3 Define consent and discuss the methods of obtaining consent X1-6.4 Differentiate between expressed and implied consent X1-6.5 Explain the role of consent of minors in providing care X1-6.6 Discuss the implications for the EMT-Basic in patient refusal of transport

X1-6.7Discuss the issues of abandonment, negligence, and battery and their implications to the EMT-Basic

X1-6.8 State the conditions necessary for the EMT-Basic to have a duty to act. X1-6.9 Explain the importance, necessity and legality of patient confidentiality X1-6.10 Discuss the considerations of the EMT-Basic in issues of organ retrieval X1-6.11

Differentiate the actions that an EMT-Basic should take to assist in the preservation of a crime scene.

X1-6.12 State the conditions that require an EMT-Basic to notify local law enforcement officials X1- Explain the role of EMS and the EMT-Basic regarding patients with DNR orders


Hours

Class

D.Lab

P.Lab/

O.B.I.

6.13X1-6.14 Explain the rationale for the needs, benefits and usage of advance directives X1-6.15 Explain the rationale for the concept of varying degrees of DNR MEDICAL/LEGAL ASPECTS FOR THE EMT-INTERMEDIATE 2 0 0

X1-7.1

Discuss the significance and scope of the following in relationship to EMT practice: State Medical Practice Act, Good Samaritan Act/Civil Immunity, state EMS statutes, state motor vehicle codes, and state and local guidelines for "Do Not Resuscitate."

X1-7.2 Define the following: - Negligence - Medical liability - Tort - Duty to act - Battery - Slander - Libel - Informed consent - Expressed consent - implied consent - Abandonment - Liable - Assault - False imprisonment - Borrowed Servant Doctrine

X1-7.3Describe the significance of accurate documentation and record keeping in substantiating incident.

X1-7.4Identify those situations that require the EMT-I to report those incidents to appropriate authorities.

X1-7.5 Describe the four elements to prove medical liability. X1-7.6 Describe the significance of obtaining expressed consent.

X1-7.7Describe the extent to which force and restraint may be used to protect the EMT, the patient, and the third party.

BLOOD AND AIRBORNE PATHOGENS & INFECTIOUS DISEASES 4 0 0X1-8.1 Define blood/airborne pathogens X1-8.2 Describe five modes of transmission of pathogens X1-8.3 Identify exposure risks related to health care workers X1-8.4 Name at least three diseases to which health care workers may be exposed

X1-8.5Identify student protections afforded by the college blood and airborne exposure control plan

X1-8.6Outline precautions that are designed to reduce the potential of an exposure to health care workers

X1-8.7Describe the benefits of needless systems and/or engineered sharps designed to prevent exposure incidents

X1-8.8 Describe the correct methods of disposal of potentially infectious materials X1-8.9 Describe the correct method of disposing of contaminated needles and sharps X1-8.10 Describe the proper methods of decontamination of potentially infectious materials X1-8.11

Discuss the advantages and disadvantages of the Hepatitis B vaccine for health care workers


Hours

Class

D.Lab

P.Lab/

O.B.I.

X1-8.12 Make an “informed decision” regarding the hepatitis B vaccine X1-8.13 List actions to be taken when a student or HCW has an exposure incident

X1-8.14

Describe causative agents, symptoms, occurrence, reservoir, mode of transmission, incubation period, period of communicability, prevention and control measures for the following diseases:

HIV/AIDS Hepatitis Tuberculosis Meningitis Measles Chickenpox Herpes

X1-8.15

Given a scenario with potential infectious exposure, the EMT-B will use appropriate PPE. At the completion of the scenario, the EMT-B will properly remove and discard the protective garments

X1-8.16

Given the above scenario, the EMT-B will complete disinfection/cleaning and all reporting documentation

X1-8.17

Describe the assessment of a patient suspected of, or identified as having an infectious or communicable disease

X1-8.18

Demonstrate the emergency medical care of a patient suspected of, or identified as having an infectious or communicable disease

THE HUMAN BODY 1 0 0

X1-9.1Identify the following topographic terms: medial, lateral, proximal, distal, superior, inferior, anterior, posterior, midline, right and left, mid-clavicular, bilateral, mid-axillary.

X1-9.2Describe the anatomy and function of the following major body systems: Respiratory, circulatory, musculoskeletal, nervous and endocrine

MEDICAL TERMINOLOGY 2 0 0X1-10.1 Explain the meaning of medical terminology X1-10.2 Provide three examples of each of the following: - word root - refix - suffix - combining form - combining vowel X1-10.3 Identify various medical terms given to various anatomical parts of the body X1-10.4 Identify common medical abbreviations from a list X1-10.5 Identify common root words and determine their meaning. X1-10.6 identify and define common prefixes and suffixes X1-10.7

Identify common root words and determine their meaning. identify and define common prefixes and suffixes


Hours

Class

D.Lab

P.Lab/

O.B.I.

X1-10.8 Locate one or more medical terms in a medical dictionary X1-10.9 Describe the four planes of the human body X1-10.10 Describe the main directional terms for the human body X1-10.11 Describe the six normal body movements X1-10.12 Describe the anatomic positions of the body X1-10.12 Define the following prefixes: (See Addendum A-1) X1-10.13 Define the following suffixes: (See Addendum A1) BASE LINE VITAL SIGNS AND SAMPLE HISTORY 2 2 0X1-11.1 Identify the components of the extended vital signs X1-11.2 Describe the methods to obtain a breathing rate X1-11.3 Identify the attributes that should be obtained when assessing breathing. X1-11.5 Differentiate between shallow, labored and noisy breathing. X1-11.4 Describe the methods to obtain a pulse rate. X1-11.6 Identify the information obtained when assessing a patient's pulse. X1-11.7 Differentiate between a strong, weak, regular and irregular pulse. X1-11.8

Describe the methods to assess the skin color, temperature, condition (capillary refill in infants and children).

X1-11.9 Identify the normal and abnormal skin colors. X1-11.10 Differentiate between pale, blue, red and yellow skin color X1-11.11 Identify the normal and abnormal skin temperature. X1-11.12 Differentiate between hot, cool and cold skin temperature. X1-11.13 Identify normal and abnormal skin conditions. X1-11.14 Identify normal and abnormal capillary refill in infants and children. X1-11.15 Describe the methods to assess the pupils. X1-11.16 Identify normal and abnormal pupil size X1-11.17 Differentiate between dilated (big) and constricted (small) pupil size X1-11.18 Differentiate between reactive and non-reactive pupils and equal and unequal pupils X1-11.19 Describe the methods to assess blood pressure X1-11.20 Define systolic pressure


Hours

Class

D.Lab

P.Lab/

O.B.I.

X1-11.21 Define diastolic pressure X1-11.22 Explain the difference between auscultation and palpation for obtaining a blood pressure X1-11.23 Identify the components of the SAMPLE history X1-11.24 Differentiate between a sign and a symptom X1-11.25 State the importance of accurately reporting and recording the baseline vital signs X-11.26 Discuss the need to search for additional medical identification X1-11.27 Explain the value of performing the baseline vital signs X1-11.28 Recognize and respond to the feelings patients experience during assessment X1-11.29 Defend the need for obtaining and recording an accurate set of vital signs X1-11.30 Explain the rationale of recording additional sets of vital signs X1-11.31 Explain the importance of obtaining a SAMPLE history X1-11.32 Demonstrate the skills involved in assessment of breathing X1-11.33 Demonstrate the skills associated with obtaining a pulse. X1-11.34

Demonstrate the skills associated with assessing the skin color, temperature, condition, and capillary refill in infants and children.

X1-11.35 Demonstrate the skills associated with assessing the pupils. X1-11.36 Demonstrate the skills associated with obtaining blood pressure X1-11.37

Demonstrate the skills that should be used to obtain information from the patient, family, or bystanders at the scene.

X1-11.38

Discuss the important components that must be identified in taking an appropriate history from a patient.

LIFTING AND MOVING PATIENTS 2 2 0X1-12.1 Define body mechanics X1-12.2

Discuss the guidelines and safety precautions that need to be followed when lifting a patient

X1-12.3 Describe the safe lifting of cots and stretchers. X1-12.4 Describe the guidelines and safety precautions for carrying patients and/or equipment X1-12.5 Discuss one-handed carrying techniques. X1-12.6 Describe correct and safe carrying procedures on stairs X1-12.7 State the guidelines for reaching and their application. X1-12.8 Describe correct reaching for log rolls X1-12.9 State the guidelines for pushing and pulling.


Hours

Class

D.Lab

P.Lab/

O.B.I.

X1-12.10 Discuss the general considerations of moving patients X1-12.11 State three situations that may require the use of an emergency move X1-12.12 Identify the following patient carrying devices: Wheeled ambulance stretcher Portable ambulance stretcher Stair chair Scoop stretcher Long spine board Basket stretcher Flexible stretcher X1-12.13 Explain the rationale for properly lifting and moving patients

X1-12.14

Working with a partner, prepare each of the following devices for use, transfer a patient to the device, properly position the patient on the device, move the device to the ambulance and load the patient into the ambulance:

Wheeled ambulance stretcher Portable ambulance stretcher Stair chair Scoop stretcher Long spine board Basket stretcher Flexible stretcher X1-12.15

Working with a partner, the EMT-Basic will demonstrate techniques for the transfer of a patient from an ambulance stretcher to a hospital stretcher.

AMBULANCE OPERATIONS 2 0 0X1-13.1 Discuss the medical and non-medical equipment needed to respond to a call. X1-13.2 List the phases of an ambulance call. X1-13.3

Describe the general provisions of state laws relating to the operation of the ambulance and privileges in any or all of the following categories:

· Speed · Warning lights · Sirens · Right-of-way · Parking · Turning X1-13.4 List contributing factors to unsafe driving conditions. X1-13.5 Describe the considerations that should by given to: · Request for escorts. · Following an escort vehicle. · Intersections. X1-13.6 Discuss "Due Regard For Safety of All Others" while operating an emergency vehicle. X1-13.7 State what information is essential in order to respond to a call. X1-13.8 Discuss various situations that may affect response to a call


Hours

Class

D.Lab

P.Lab/

O.B.I.

X1-13.9

Differentiate between the various methods of moving a patient to the unit based upon injury or illness

X1-13.10 Apply the components of the essential patient information in a written report. X1-13.11 Summarize the importance of preparing the unit for the next response. X1-13.12 Identify what is essential for completion of a call. X1-13.13

Distinguish among the terms cleaning, disinfection, high-level disinfection, and sterilization Describe how to clean or disinfect items following patient care.

X1-12.14 Describe how to clean or disinfect items following patient care. X1-13.15 Explain the rationale for appropriate report of patient information. X1-13.16 Explain the rationale for having the unit prepared to respond. X1-13.17

Describe the benefits and complications of lights and sirens and when they should be used.

GAINING ACCESS 2 0 0X1-14.1 Describe the purpose of extrication. X1-14.2 Discuss the role of the EMT-Basic in extrication X1-14.3 Identify what equipment for personal safety is required for the EMT-Basic. X1-14.4 Define the fundamental components of extrication. X1-14.5 State the steps that should be taken to protect the patient during extrication. X1-14.6 Evaluate various methods of gaining access to the patient. X1-14.7 Distinguish between simple and complex access. OVERVIEW OF HAZMAT/MCI 1 0 0X1-15.1 Explain the EMT-Basic's role during a call involving hazardous materials

X1-15.2

Describe what the EMT-Basic should do if there is reason to believe that there is a hazard at the scene.

X1-15.3 Describe the actions that an EMT-Basic should take to ensure bystander safety. X1-15.4

State the role the EMT-Basic should perform until appropriately trained personnel arrive at the scene of a hazardous materials situation.

X1-15.5 Break down the steps to approaching a hazardous situation. X1-15.6 Discuss the various environmental hazards that affect EMS. X1-15.7 Describe the criteria for a multiple-casualty situation. X1-15.8 Evaluate the role of the EMT-Basic in the multiple-casualty situation. X1-15.9 Summarize the components of basic triage. X1-15.10 Define the role of the EMT-Basic in a disaster operation.


Hours

Class

D.Lab

P.Lab/

O.B.I.

X1-15.11 Describe basic concepts of incident management X1-15.12 Explain the methods for preventing contamination of self, equipment and facilities. X1-15.13 Review the local mass casualty incident plan. X1-15.14 Given a scenario of a mass casualty incident, perform triage.(P-2) X1-15.15

Demonstrate the use of self-protection equipment such as air pack (breathing apparatus), etc.

FINAL EXAM FOR XX1 2 0 0 Written & Practical Examination TOTAL HOURS 32 8 0

EMS XX2 – Patient Assessment and Airway for the EMT

Course DescriptionThe course covers all the components of the National Highway Safety Transportation Administration, National Standard Curriculum, Emergency Medical Technician-Basic, 1994 standard, Module 2 and 3. In addition to the NSC-B 1994 standards, this course also includes the NSC EMT-Intermediate 1985 Standard, Sections 5, 6, and 7. Topics include: Scene-Size Up, Initial Assessment, Focused History & Physical Exam for both Medical and Trauma Patients, Detailed Physical Exam, On-Going Assessment, Communications/Documentation, EMS communications for the EMT-I, airway, advanced airway and Basic/Advanced Airway Management.


Scene Size-Up Class 24Initial Assessment D. Lab 20Focused History And Physical Exam - Trauma Patients P. Lab/O.B.I. 0Focused History And Physical Exam – Medical Patients Credit 3Detailed Physical ExamOn-Going AssessmentCommunicationsEMS Communications For The EMT-IntermediateDocumentationAirwayAdvanced AirwayAdvanced Airway Practical Skills LabReview And Practical Skills Lab

Prerequisite: Program AdmissionCorequisite: EMS XX1

Course Guide

Competency After completing this section, the student will be able to:Hours

Class D.Lab

P.Lab/O.B.I.

SCENE SIZE-UP 1 0 0X2-1.1 Recognize hazards/potential hazards.

X2-1.2Describe common hazards found at the scene of a trauma and a medical patient.

X2-1.3 Determine if the scene is safe to enter X2-1.4 Discuss common mechanisms of injury/nature of illness

X2-1.5 Discuss the reason for identifying the total number of patients at the scene

X2-1.6 Explain the reason for identifying the need for additional help or assistance.

X2-1.7Explain the rationale for crew members to evaluate scene safety prior to entering.

X2-1.8Serve as a model for others explaining how patient situations affect your evaluation of mechanism of injury or illness

X2-1.9 Observe various scenarios and identify potential hazards

X2-1.10 Describe the problems an EMT-I might encounter in a hostile situation and describe mechanisms of management.


Class D.Lab

P.Lab/O.B.I.

X2-1.11 Describe the various types of protective equipment available to the EMT-I for self-protection and patient protection.

X2-1.12 Discuss the appropriate methods of patient protection in each situation. INITIAL ASSESSMENT 2 2 0X2-2.1 Summarize the reasons for forming a general impression of the patient X2-2.2 Discuss methods of assessing altered mental status

X2-2.3Differentiate between assessing the altered mental status in the adult, child and infant patient.

X2-2.4 Discuss methods of assessing the airway in the adult, child and infant patient

X2-2.5State reasons for management of the cervical spine once the patient has been determined to be a trauma patient

X2-2.6 Describe methods used for assessing if a patient is breathing.

X2-2.7State what care should be provided to the adult, child and infant patient with adequate breathing.

X2-2.8State what care should be provided to the adult, child and infant patient without adequate breathing.

X2-2.9 Differentiate between a patient with adequate and inadequate breathing.

X2-2.10Distinguish between methods of assessing breathing in the adult, child and infant patient.

X2-2.11Compare the methods of providing airway care to the adult, child and infant patient.

X2-2.12 Describe the methods used to obtain a pulse

X2-2.13 Differentiate between obtaining a pulse in an adult, child and infant patient. X2-2.14 Discuss the need for assessing the patient for external bleeding X2-2.15 Describe normal and abnormal findings when assessing skin color

X2-2.16 Describe normal and abnormal findings when assessing skin temperature. X2-2.17 Describe normal and abnormal findings when assessing skin condition

X2-2.18Describe normal and abnormal findings when assessing skin capillary refill in the infant and child patient

X2-2.19 Explain the reason for prioritizing a patient for care and transport. X2-2.20 Explain the importance of forming a general impression of the patient. X2-2.21 Explain the value of performing an initial assessment. X2-2.22 Demonstrate the techniques for assessing mental status. X2-2.23 Demonstrate the techniques for assessing the airway. X2-2.24 Demonstrate the techniques for assessing if the patient is breathing. X2-2.25 Demonstrate the techniques for assessing if the patient has a pulse. X2-2.26 Demonstrate the techniques for assessing the patient for external bleeding.

X2-2.27Demonstrate the techniques for assessing the patient's skin color, temperature, condition and capillary refill (infants and children only).

X2-2.28 Demonstrate the ability to prioritize patients.

X2-2.29 Describe the mechanisms of evaluating the effectiveness of perfusion, including pulse, skin color, capillary refill.

X2-2.30 Describe exposing the patient’s body for total evaluation.

X2-2.31 Discuss when this should and should not be carried out.

FOCUSED HISTORY AND PHYSICAL EXAM - TRAUMA PATIENTS 2 2 0

X2-3.1 Discuss the reasons for reconsideration concerning the mechanism of injury. X2-3.2 State the reasons for performing a rapid trauma assessment


Class D.Lab

P.Lab/O.B.I.

X2-3.3Recite examples and explain why patients should receive a rapid trauma assessment

X2-3.4Describe the areas included in the rapid trauma assessment and discuss what should be evaluated.

X2-3.5Differentiate when the rapid assessment may be altered in order to provide patient care.

X2-3.6 Discuss the reason for performing a focused history and physical exam

X2-3.7Recognize and respect the feelings that patients might experience during assessment.

X2-3.8 Describe the trauma score; define its usefulness and how it is accomplished.

X2-3.9Demonstrate the rapid trauma assessment that should be used to assess a patient based on mechanism of injury.

FOCUSED HISTORY AND PHYSICAL EXAM – MEDICAL PATIENTS 2 2 0

X2-4.1Describe the unique needs for assessing an individual with a specific chief complaint with no known prior history.

X2-4.2

Differentiate between the history and physical exam that is performed for responsive patients with no known prior history and patients responsive with a known prior history.

X2-4.3Describe the unique needs for assessing an individual who is unresponsive or has an altered mental status

X2-4.4

Differentiate between the assessment that is performed for a patient who is unresponsive or has an altered mental status and other medical patients requiring assessment

X2-4.5 Attend to the feelings that these patients might be experiencing.

X2-4.6Demonstrate the patient care skills that should be used to assist with a patient who is responsive with no known history

X2-4.7Demonstrate the patient care skills that should be used to assist with a patient who is unresponsive or has an altered metal status.

DETAILED PHYSICAL EXAM 1 2 0X2-5.1 Discuss the components of the detailed physical exam

X2-5.2State the areas of the body that are evaluated during the detailed physical exam

X2-5.3Explain what additional care should be provided while performing the detailed physical exam

X2-5.4Distinguish between the detailed physical exam that is performed on a trauma patient and that of the medical patient.

X2-5.5 Explain the rationale for the feelings that these patients might be experiencing.

X2-5.6 Demonstrate the skills involved in performing the detailed physical exam

ON-GOING ASSESSMENT 1 2 0

X2-6.1Discuss the reasons for repeating the initial assessment as part of the on-going assessment.

X2-6.2 Describe the components of the on-going assessment X2-6.3 Describe trending of assessment components. X2-6.4 Explain the value of performing an on-going assessment

X2-6.5Recognize and respect the feelings that patients might experience during assessment

X2-6.6Explain the value of trending assessment components to other health professionals who assume care of the patient.

X2-6.7 Demonstrate the skills involved in performing the on-going assessment.


Class D.Lab

P.Lab/O.B.I.

X2-6.8 Describe the mechanisms of continued evaluation of the patient en route to the hospital.

X2-6.9 Describe how the patient is monitored en route to the hospital.

X2-6.10 Describe how the hospitals are selected for receipt of patients based on patient need and hospital capability.

X2-6.11 Describe the reasons for and mechanisms of patient reassessment in the resuscitation phase.

X2-6.12 Define the definitive care phase.





X2-6.12 Define the definitive care phase.





X2-6.12 Define the definitive care phase. COMMUNICATIONS 1 0 0X2-7.1 List the proper methods of initiating and terminating a radio call. X2-7.2 State the proper sequence for delivery of patient information

X2-7.3Explain the importance of effective communication of patient information in the verbal report.

X2-7.4 Identify the essential components of the verbal report.

X2-7.5Describe the attributes for increasing effectiveness and efficiency of verbal communications

X2-7.6 State legal aspects to consider in verbal communication.

X2-7.7Discuss the communication skills that should be used to interact with the patient.

X2-7.8

Discuss the communication skills that should be used to interact with the family, bystanders, individuals from other agencies while providing patient care and the difference between skills used to interact with the patient and those used to interact with others.

X2-7.9 List the correct radio procedures in the following phases of a typical call: ! To the scene. ! At the scene. ! To the facility. ! At the facility. ! To the station. ! At the station.

X2-7.10Explain the rationale for providing efficient and effective radio communications and patient reports

X2-7.11 Perform a simulated, organized, concise radio transmission

X2-7.12Perform an organized, concise patient report that would be given to the staff at a receiving facility


Class D.Lab

P.Lab/O.B.I.

X2-7.13

Perform a brief, organized report that would be given to an ALS provider arriving at an incident scene at which the EMT-Basic was already providing care.

EMS COMMUNICATIONS FOR THE EMT-INTERMEDIATE (I-M4) 2 0 0

X2-8.1 Describe the phases of communications necessary to complete a typical EMS event.

X2-8.2 Name the possible components of an EMS communications system and explain the function of each.

X2-8.3 Describe maintenance procedures for field radio equipment.

X2-8.4 Describe the position of the antenna on a portable transmitter/receiver that will deliver maximum coverage.

X2-8.5 Describe an advantage of a repeater system over a nonrepeater system.

X2-8.6 Describe basic functions and responsibilities of the Federal Communications Commission.

X2-8.7 Describe the responsibilities of an EMS dispatcher.

X2-8.8 Name information items that must be gathered from a caller by the dispatcher.

X2-8.9 Describe the ten-code used in the local community.

X2-8.10 Describe three communications techniques that influence the clarity of radio transmissions.

X2-8.11 Describe three communications techniques that influence the content of radio transmissions.

X2-8.12 Describe the importance of written medical protocols.

X2-8.13 Describe two purposes of verbal communication of patient information to the hospital.

X2-8.14 Describe information that should be included in patient assessment information verbally reported to the physician.

X2-8.15 Organize a list of patient assessment information in the correct order for radio transmission to the physician according to the format used locally.

X2-8.16 Demonstrate the proper use of a mobile transmitter/receiver to receive and transmit information.

X2-8.17 Demonstrate the proper use of a portable transmitter/receiver to receive and transmit information.

X2-8.18 Demonstrate the proper use of a digital encoder.

X2-8.19Demonstrate the proper use of a mobile or portable transmitter in a real or simulated patient situation to organize and transmit patient assessment information, using a standardized format.

X2-8.20 Describe proper use of both mobile and portable radios to receive and transmit information

X2-8.21 Describe the proper use of a digital encoder

X2-8.22Describe the interaction between the EMT-I and Medical Command authority in regard to: receiving hospital, family physician on the scene, bystander physician on the scene, orders for patient care, needs of the family, and needs of the patient.

X2-8.23 Identify and differentiate among the following communications systems: a. Simplex b. Multiplex c. Duplex d. Trunked e. Digital communications f. Cellular telephone


Class D.Lab

P.Lab/O.B.I.

g. Facsimile h. computer X2-8.24 Describe how the Emergency Medical Dispatcher functions as an integral part of the EMS team X2-8.25 Identify the role of Emergency Medical Dispatch in a typical EMS event X2-8.26 List appropriate information to be gathered by the Emergency Medical Dispatcher. X2-8.27 List factors which enhance verbal communications. X2-8.28 Describe the importance of written medical protocols. X2-8.29 Describe the procedure of verbal communication of patient information to the hospital. X2-8.30 Name five uses of the EMS patient care report. DOCUMENTATION 1 0 0

X2-9.1Explain the components of the written report and list the information that should be included on the written report.

X2-9.2 Identify the various sections of the written report

X2-9.3Describe what information is required in each section of the prehospital care report and how it should be entered.

X2-9.4 Define the special considerations concerning patient refusal. X2-9.5 Describe the legal implications associated with the written report X2-9.6 Discuss all state and/or local record and reporting requirements. X2-9.7 Explain the rationale for patient care documentation. X2-9.8 Explain the rationale for the EMS system gathering data. X2-9.9 Explain the rationale for using medical terminology correctly.

X2-9.10Explain the rationale for using an accurate and synchronous clock so that information can be used in trending

X2-9.11 Complete a prehospital care report X2-9.12 Name five uses of the written EMS run form.

X2-9.13 Describe the significance of accurate documentation and record keeping in substantiating incident.

AIRWAY 4 3 0

X2-10.1 Name and label the major structures of the respiratory system on a diagram. X2-10.2 List the signs of adequate breathing. X2-10.3 List the signs of inadequate breathing. X2-10.4 Describe the steps in performing the head-tilt chin-lift. X2-10.5 Relate mechanism of injury to opening the airway. X2-10.6 Describe the steps in performing the jaw thrust

X2-10.7State the importance of having a suction unit ready for immediate use when providing emergency care.

X2-10.8 Describe the techniques of suctioning. X2-10.9 Describe how to artificially ventilate a patient with a pocket mask.

X2-10.10Describe the steps in performing the skill of artificially ventilating a patient with a bag-valve-mask while using the jaw thrust.

X2-10.11 List the parts of a bag-valve-mask system.

X2-10.12Describe the steps in performing the skill of artificially ventilating a patient with a bag-valve-mask for one and two rescuers.

X2-10.13 Describe the signs of adequate artificial ventilation using the bag-valve-mask.

X2-10.14 Describe the signs of inadequate artificial ventilation using the bag-valve-mask.


Class D.Lab

P.Lab/O.B.I.

X2-10.15Describe the steps in artificially ventilating a patient with a flow restricted, oxygen-powered ventilation device.

X2-10.16List the steps in performing the actions taken when providing mouth-to-mouth and mouth-to-stoma artificial ventilation.(C-1)

X2-10.17 Describe how to measure and insert an oropharyngeal (oral) airway. X2-10.18 Describe how to measure and insert a nasopharyngeal (nasal) airway X2-10.19 Define the components of an oxygen delivery system.

X2-10.20Identify a non-rebreather face mask and state the oxygen flow requirements needed for its use.

X2-10.21Describe the indications for using a nasal cannula versus a non-rebreather face mask.

X2-10.22 Identify a nasal cannula and state the flow requirements needed for its use.

X2-10.23Explain the rationale for basic life support artificial ventilation and airway protective skills taking priority over most other basic life support skills.

X2-10.24

Explain the rationale for providing adequate oxygenation through high inspired oxygen concentrations to patients who, in the past, may have received low concentrations.

X2-10.25 Demonstrate the steps in performing the head-tilt chin-lift. X2-10.26 Demonstrate the steps in performing the jaw thrust. X2-10.27 Demonstrate the techniques of suctioning.

X2-10.28Demonstrate the steps in providing mouth-to-mouth artificial ventilation with body substance isolation (barrier shields).

X2-10.29 Demonstrate how to use a pocket mask to artificially ventilate a patient. X2-10.30 Demonstrate the assembly of a bag-valve-mask unit.

X2-10.31Demonstrate the steps in performing the skill of artificially ventilating a patient with a bag-valve-mask for one and two rescuers.

X2-10.32Demonstrate the steps in performing the skill of artificially ventilating a patient with a bag-valve-mask while using the jaw thrust.

X2-10.33Demonstrate artificial ventilation of a patient with a flow restricted, oxygen-powered ventilation device.

X2-10.34 Demonstrate how to artificially ventilate a patient with a stoma. X2-10.35 Demonstrate how to insert an oropharyngeal (oral) airway. X2-10.36 Demonstrate how to insert a nasopharyngeal (nasal) airway. X2-10.37 Demonstrate the correct operation of oxygen tanks and regulators.

X2-10.38Demonstrate the use of a non-rebreather face mask and state the oxygen flow requirements needed for its use.

X2-10.39Demonstrate the use of a nasal cannula and state the flow requirements needed for its use.

X2-10.40 Demonstrate how to artificially ventilate the infant and child patient. X2-10.41 Demonstrate oxygen administration for the infant and child patient.

ADVANCED AIRWAY (I-M7) 4 0 0

X2-11.1Describe the anatomy of the following: upper airway, tongue, hypopharynx, nasopharynx, oropharynx, larynx, vocal cords.

X2-11.2 Describe the flow of air from outside the body into the trachea

X2-11.3Describe the reasons for and mechanism of humidification and warming of the air as it passes through the naso-and oral pharynx

X2-11.4Recall the anatomic relationship of the larynx to the tongue, pharynx, epiglottis, vocal cords, esophagus

X2-11.5 Relate the difference between true and false vocal cords


Class D.Lab

P.Lab/O.B.I.

X2-11.6Recall and demonstrate the essential elements of assessing airway patency, breathing effectiveness and oxygenation in the ill or injured patient

X2-11.7 Describe and demonstrate the procedures used to manually open the airway X2-11.8 Describe the methods and management of an obstructed airway

X2-11.9

Discuss indications, contraindications, methods of insertion and use of the following: oropharyngeal airway, nasopharyngeal airway, EOA, Combitube, EGTA, and pharyngotracheal lumen airway.

X2-11.10Discuss indications, contraindications, methods of insertion and use of the Laryngeal Mask Airway.

X2-11.11 Describe the anatomy of the following: Lungs Trachea Alveolus Diaphragm Thoracic wall Pleural space.

X2-11.12 Describe how pulmonary ventilation (inhalation and exhalation) is accomplished

X2-11.13Describe the gaseous exchange across the alveoli-capillary membrane (02 and CO2)

X2-11.14

Describe the pulmonary problems that can complicate exhalation and inhalation, the mechanisms by which they reduce ventilation and management of each problem, including:

Open pneumothorax Diaphragmatic injury Closed pneumothorax (simple and tension) Flail chest X2-11.15 Describe the problems of ventilation X2-11.16 Define mouth-to-mask ventilation, its benefits and limitations X2-11.17 Discuss the bag-valve-mask (BVM), its benefits and limitations X2-11.18 Discuss the techniques for evaluating the effectiveness of ventilation

X2-11.19Describe the anatomy of the following: upper airway, tongue, hypopharynx, nasopharynx, oropharynx, larynx, and vocal cords.

X2-11.20 Describe the function of the vocal cords.

X2-11.21

Describe the pathological conditions that can occur in the nose, pharynx, and larynx to obstruct or retard air flow and identify the complications of laryngeal fracture.

X2-11.22 Explain the pathophysiology of airway compromise.(C-1) X2-11.23 Describe the proper use of airway adjuncts.(C-1) X2-11.24 Review the use of oxygen therapy in airway management.(C-1) X2-11.25 Discuss ventilation with an Advanced Airway. X2-11-26 Describe the methods of airway management. X2-11.27 Describe how the cervical spine is protected throughout these maneuvers. X2-11.28 Describe the relationship between: Cords and larynx Esophagus and larynx Epiglottis and larynx Tongue and larynx True cords and false cords Pharynx and larynx X2-11.29 List factors which cause decreased oxygen concentrations


Class D.Lab

P.Lab/O.B.I.

in the blood. X2-11.30 List the factors which increase and decrease carbon dioxide production in the body X2-11.31 Describe the measurement of oxygen in the blood. X2-11.32 Describe the measurement of carbon dioxide in the blood.

X2-11.33Given a list of arterial oxygen concentrations, the student should be able to select the normal P0,, for a young adult breathing air

X2-11.34Given a list of arterial carbon dioxide concentrations, the student should be able to select the normal PCO2

X2-11.35

Given an. increase in arterial PCO2, the student should be able to name this condition and describe its effect on respiratory activity and on blood pH in the normal individual

X2-11.36 Given a decrease in arterial P02, the student should be able to name this condition and describe its effect on respiratory activity in the normal individual

X2-11.37Given an increase in CO2 production, the student should be able to list at least two ways in which this increase may occur

X2-11.38Given an increase in CO2 elimination, the student should be able to describe how this elimination can occur

X2-11.39 Identify types of suction catheters, including hard or rigid catheters and soft catheters X2-11.40 Explain the purpose for suctioning the upper airway. X2-11.41 Identify types of suction equipment. X2-11.42 Describe the indications for suctioning the upper airway. X2-11.43 Identify special considerations of suctioning the upper airway.

X2-11.44Given a list of statements, the student should be able to identify the statement that best describes the purpose of suctioning a patient

X2-11.45

Given a diagram of a piston-powered suction unit, the student should be able to label and describe the operation and cleaning of each component and attached part

X2-11.46

Given that there are various types of suction units, the student should be able to list at least four different types of units determined by the method in which the suction effect is obtained

X2-11.47

Given that there are various types of suction catheters, the student should be able to list at least three different types, determined by difference in use and material composition

X2-11.48Given a list of situations describing patients who require suctioning, the student should indicate which type of catheter should be used

X2-11.49 Describe the indications, contraindications, advantages, disadvantages, complications, equipment, and technique for using a dual lumen airway X2-11.50 Explain the primary objective of airway maintenance.

X2-11.51

Given a list of statements, the student should be able to identify the statement that best describes the purpose of using the esophageal obturator airway/Dual Lumen Airway/Laryngeal Mask Airway.

X2-11.52

Given a list of Situations describing patients with airway maintenance problems or potential airway maintenance problems, the student should be able to identify situations in which the use of the esophageal obturator airway/Dual Lumen Airway/Laryngeal Mask

X2-11.53

Given a list of situations, the student should be able to identify those situations in which the esophageal airway/Dual Lumen Airway/Laryngeal Mask Airway may be removed


Class D.Lab

P.Lab/O.B.I.

X2-11.54

Given a list of advantages, the student should be able to identify the advantages of using the esophageal obturator airway/Dual Lumen Airway/Laryngeal Mask Airway over other methods of airway control

X2-11.55

Given a list of airway adjuncts, advantages and disadvantages, the student should be able to identify the disadvantages of using the esophageal obturator airway/Dual Lumen Airway/Laryngeal Mask Airway over other methods of airway control

X2-11.56

Given a list of airway adjuncts, advantages, and disadvantages, the student should be able to match the airway adjuncts with the advantages and disadvantages

X2-11.57

Given a diagram of the esophageal obturator airway/Dual Lumen Airway/Laryngeal Mask Airway, the student should be able to label and describe the function of all component

X2-11.58Given a list of equipment and materials the student should be able to identify those items that must be available before esophageal obturation is begun

X2-11.59 Identify the commonly neglected prehospital skills related to airway. X2-11.60 Define normal tidal volumes for the adult. X2-11.61 List the concentration of gases which comprise atmospheric air. X2-11.62 Define normal respiratory rates for adult, child, and infant. X2-11.63 Define and differentiate between hypoxia and hypoxemia. X2-11.64 Describe the modified forms of respiration. X2-11.65 Define gag reflex. X2-11.66 List the factors which affect respiratory rate and depth. X2-11.67 Describe the voluntary and involuntary regulation of respiration. X2-11.68 Describe causes of upper airway obstruction. X2-11.69 Describe the use, advantages, and disadvantages of an oxygen humidifier. X2-11.70 Describe the indications, contraindications, advantages, disadvantages, complications, equipment, and technique for using a dual lumen airway X2-11.71 Explain the relationship between pulmonary circulation and respiration. X2-11.72 Demonstrate effective mouth-to-mask ventilation X2-11.73 Demonstrate effective bag-valve ventilations with Mask EOA Combitube Laryngeal Mask Airway (LMA) X2-11.74 Demonstrate the manual methods of airway management X2-11.75 Demonstrate the methods of management of an obstructed airway X2-11.76 Demonstrate the mechanical methods of airway management Nasal Oral Dual Lumen Airway Laryngeal Mask Airway

X2-11.77 Demonstrate the use of various types of portable and fixed suction devices

X2-11.78List complications associated with advanced airway management.(C-1)

X2-11.79 Explain the rationale for confirming breath sounds.(A-2) X2-11.80 Explain the value of performing advanced airway procedures.(A-2)

X2-11.81Defend the need for the EMT-Basic to perform advanced airway procedures.(A-3)

X2-11.82Recognize and respect the feelings of the patient and family during advanced airway procedures.(A-1)


Class D.Lab

P.Lab/O.B.I.

ADVANCED AIRWAY PRACTICAL SKILLS LAB 0 2 0X2-12.2 Demonstrate effective bag-valve ventilations with - Mask - Advanced Airway Devices X2-12.3 Demonstrate the manual methods of airway management. X2-12.4 Demonstrate the methods of management of an obstructed airway. X2-12.5 Demonstrate the mechanical methods of airway management -Nasal -Oral

X2-12.6Demonstrate the use of various types of portable and fixed suction devices.

X2-12.7

Given that a patient requires an esophageal obturator airway/Dual Lumen Airway/Laryngeal Mask Airway. The student should be able to list the procedures for insertion of the esophageal airway, including all steps in the proper sequence

X2-12.7

Given a list of errors, the student should be able to identify common errors involved in the use of the esophageal obturator airway/Dual Lumen Airway/Laryngeal Mask Airway

X2-12.8 Discuss skill deterioration and methods of prevention X2-12.9 Discuss need for rapid placement of an advanced airway device.

X2-12.10 Discuss methods of assuring and maintaining correct placement of an ET tube X2-12.11 Discuss ventilation with an endotracheal tube.

X2-12.12Describe the equipment and method of suctioning the airway, pharynx, and endotracheal tube.

X2-12.13

Given that a patient needs suctioning and already has an endotracheal tube in place, the student should be able to describe the difference between endotracheal suctioning and oropharyngeal suctioning including:

Dangers Precautions

X2-12.14

Given an adult manikin, oropharyngeal and nasopharyngeal airways, pocket mask, oxygen cylinder, and bag-valve-mask, the student should be able to demonstrate the procedure for administering intermittent positive pressure ventilation using:

Pocket mask Bag-valve-mask and oropharyngeal airway Bag-valve-mask with oxygen Nasopharyngeal airway with bag valve mask

X2-12.15Given a bag-valve mask, the student should be able to demonstrate the assembly, disassembly, and cleaning of the bag-valve mask unit.

X2-12.16

Given an adult manikin, an oropharyngeal airway, and a demand-valve unit, the student should be able to demonstrate the procedure for performing intermittent positive-pressure ventilation

X2-12.17Given a demand-valve unit, the student should be able to demonstrate the assembly, disassembly, and cleaning of the unit.

X2-12.18

Given an adult intubation manikin, an esophageal obturator airway/Dual Lumen Airway/Laryngeal Mask Airway. 30-cc syringe, and a bag-valve unit, the student should be able to demonstrate the technique for the insertion of an esophageal obturator airway/Dual Lumen Airway

X2-12.19 Perform body substance isolation (BSI) procedures during basic airway management, advanced airway management, and ventilation.


Class D.Lab

P.Lab/O.B.I.

X2-12.20 Perform pulse oximetry. X2-12.21 Demonstrate proper insertion of a dual lumen airway. MODULE 2 REVIEW AND PRACTICALS SKILLS LAB 2 2 0 Demonstrate competency of module components

FINAL EXAM for Patient Assessment and Airway 1 3 0 Written Examination (GA Lessons 2-1 & 3-10) Practical Examination (GA Lessons 2-1 & 3-10) TOTAL HOURS 24 20 0

EMS XX3 – Medical/Behavioral & OB/Pediatric Emergencies for the EMT

Course DescriptionThe course covers all the components of the National Highway Safety Transportation Administration, National Standard Curriculum, Emergency Medical Technician-Basic, 1994 standard, Module 4 and Module 6. Topics include General Pharmacology, Respiratory Emergencies, Cardiovascular Emergencies, Diabetic Emergencies, Allergic Reactions, Poisoning/Overdose Emergencies, Environmental Emergencies, Behavioral Emergencies, OB/GYN Emergencies, Infants & Children and patients with special needs.


General Pharmacology Class 30Respiratory Emergencies D. Lab 20Cardiovascular Emergencies P. Lab/O.B.I. 0Diabetes/Altered Mental Status Credit 4AllergiesPoisoning/OverdoseEnvironmental EmergenciesBehavioral EmergenciesObstetrics/GynecologyPractical Skills Lab: Obstetrics/GynecologyInfants and ChildrenInfants and Children Practical Skills LabPatients with Special NeedsReview and Practical Skills Lab

Prerequisite: EMS XX2Corequisite:

Course Guide


Class D.Lab P.Lab/O.B.I.

General Pharmacology 2 1 0X3-1.1 Identify which medications will be carried on the unit.

X3-1.2 State the medications carried on the unit by the generic name

X3-1.3Identify the medications with which the EMT-B may assist the patient with administering.

X3-1.4State the medications the EMT-B can assist the patient with by the generic name.

X3-1.5 Discuss the forms in which the medications may be found X3-1.6 Explain the rationale for the administration of medications

X3-1.7Demonstrate general steps for assisting patient with self administration of medications.

X3-1.8 Read the labels and inspect each type of medication Respiratory Emergencies 4 1 0X3-2.1 List the structure and function of the respiratory system X3-2.2 State the signs and symptoms of a patient with breathing difficulty.

X3-2.3Describe the emergency medical care of the patient with breathing difficulty

X3-2.4Recognize the need for medical direction to assist in the emergency medical care of the patient with breathing difficulty

X3-2.5Describe the emergency medical care of the patient with breathing distress



X3-2.6Establish the relationship between airway management and the patient with breathing difficulty

X3-2.7 List signs of adequate air exchange.

X3-2.8State the generic name, medication forms, dose, administration, action, indications and contraindications for the prescribed inhaler.

X3-2.9 Distinguish between the emergency medical care of the infant, child and adult patient with breathing difficulty

X3-2.10 Differentiate between upper airway obstruction and lower airway disease in the infant and child patient.

X3-2.11 Defend EMT-Basic treatment regimens for various respiratory emergencies

X3-2.12 Explain the rationale for administering an inhaler. X3-2.13 Demonstrate the emergency medical care for breathing difficulty. X3-2.14 Perform the steps in facilitating the use of an inhaler Cardiovascular Emergencies 6 4 0X3-3.1 Describe the structure and function of the cardiovascular system

X3-3.2 Identify the location of the following structures on a diagram of the normal heart:

- Pericardium - Myocardium - Epicardium - Right and left atria - Interatrial septum - Right and left ventricles - Intraventricular septum - Superior and inferior vena cava - Aorta - Pulmonary vessels - Coronary arteries - Tricuspid valve - Mitral valve - Aortic valve - Pulmonic valve - Papillary muscles - Chordae tendinae X3-3.2 Describe the function of each structure listed in objective 1.9.2. X3-3.3 Describe the size, shape, and location/ orientation (in regard to other

body structures) of the heart muscle.

X3-3.4 Describe the emergency medical care of the patient experiencing chest pain/discomfort.

X3-3.5 List the indications for automated external defibrillation (AED). X3-3.6 List the contraindications for automated external defibrillation X3-3.7 Define the role of EMT-B in the emergency cardiac care system X3-3.8 Explain the impact of age and weight on defibrillation. X3-3.9 Discuss the position of comfort for patients with various cardiac

emergencies.

X3-3.10 Establish the relationship between airway management and the patient with cardiovascular compromise.

X3-3.11 Predict the relationship between the patient experiencing cardiovascular compromise and basic life support

X3-3.12 Discuss the fundamentals of early defibrillation. X3-3.13 Explain the rationale for early defibrillation.



X3-3.14Explain that not all chest pain patients result in cardiac arrest and do not need to be attached to an automated external defibrillator.

X3-3.15 Explain the importance of prehospital ACLS intervention if it is available.

X3-3.16Explain the importance of urgent transport to a facility with Advanced Cardiac Life Support if it is not available in the prehospital setting.

X3-3.17 Discuss the various types of automated external defibrillators.

X3-3.18Differentiate between the fully automated and the semiautomated defibrillator.

X3-3.19

Discuss the procedures that must be taken into consideration for standard operations of the various types of automated external defibrillators.

X3-3.20State the reasons for assuring that the patient is pulseless and apneic when using the automated external defibrillator.

X3-3.21 Discuss the circumstances which may result in inappropriate shocks

X3-3.22Explain the considerations for interruption of CPR, when using the automated external defibrillator.

X3-3.23Discuss the advantages and disadvantages of automated external defibrillators

X3-3.24 Summarize the speed of operation of automated external defibrillation X3-3.25 Discuss the use of remote defibrillation through adhesive pads. X3-3.26 Discuss the special considerations for rhythm monitoring. X3-3.27 List the steps in the operation of the automated external defibrillator.

X3-3.28Discuss the standard of care that should be used to provide care to a patient with persistent ventricular fibrillation and no available ACLS

X3-3.29Discuss the standard of care that should be used to provide care to a patient with recurrent ventricular fibrillation and no available ACLS.

X3-3.30Differentiate between the single rescuer and multi-rescuer care with an automated external defibrillator

X3-3.31Explain the reason for pulses not being checked between shocks with an automated external defibrillator.

X3-3.32Discuss the importance of coordinating ACLS trained providers with personnel using automated external defibrillators.

X3-3.33 Discuss the importance of post-resuscitation care. X3-3.34 List the components of post-resuscitation care.

X3-3.35Explain the importance of frequent practice with the automated external defibrillator.

X3-3.36Discuss the need to complete the Automated Defibrillator: Operator's Shift Checklist.

X3-3.37Discuss the role of the American Heart Association (AHA) in the use of automated external defibrillation

X3-3.38Explain the role medical direction plays in the use of automated external defibrillation.

X3-3.39State the reasons why a case review should be completed following the use of the automated external defibrillator

X3-3.40 Discuss the components that should be included in a case review.

X3-3.41Discuss the goal of quality improvement in automated external defibrillation



X3-3.42Recognize the need for medical direction of protocols to assist in the emergency medical care of the patient with chest pain.

X3-3.43 List the indications for the use of nitroglycerin

X3-3.44 State the contraindications and side effects for the use of nitroglycerin.

X3-3.45Define the function of all controls on an automated external defibrillator, and describe event documentation and battery defibrillator maintenance.

X3-3.46Defend the reasons for obtaining initial training in automated external defibrillation and the importance of continuing education.

X3-3.47 Defend the reason for maintenance of automated external defibrillators.

X3-3.48Explain the rationale for administering nitroglycerin to a patient with chest pain or discomfort.

X3-3.49Demonstrate the assessment and emergency medical care of a patient experiencing chest pain/discomfort.

X3-3.50Demonstrate the application and operation of the automated external defibrillator.

X3-3.51 Demonstrate the maintenance of an automated external defibrillator.

X3-3.52Demonstrate the assessment and documentation of patient response to the automated external defibrillator.

X3-3.53Demonstrate the skills necessary to complete the Automated Defibrillator: Operator's Shift Checklist.

X3-3.54Perform the steps in facilitating the use of nitroglycerin for chest pain or discomfort.

X3-3.55Demonstrate the assessment and documentation of patient response to nitroglycerin.

X3-3.56Practice completing a prehospital care report for patients with cardiac emergencies

X3-3.57 Describe the pathophysiology of cardiac arrest.

X3-3.58Demonstrate the post-resuscitative assessment and emergency medical care of the cardiac arrest patient. (CA 6)

X3-3.59 Name the common chief complaints of cardiac patients.

X3-3.60Describe why the following occur in patients with cardiac problems:

- Chest pain or discomfort - Shoulder, arm, neck, or jaw pain/ discomfort - Dyspnea - Syncope - Palpitations/ abnormal heart beat

X3-3.61 Describe those questions to be asked during history taking for each of the common cardiac chief complaints.

X3-3.62 Describe the four most pertinent aspects of the past medical history in a patient with a suspected cardiac problem.

X3-3.63 Describe those aspects of the physical examination that should be given special attention in the patient with suspected cardiac problems.

X3-3.64 Describe the significance of the following physical exam findings in a cardiac patient:

- Altered level of consciousness - Peripheral edema - Cyanosis



- Poor capillary refill - Cool, clammy skin

DIABETES/ALTERED MENTAL STATUS 2 0 0

X3-4.1Identify the patient taking diabetic medications with altered mental status and the implications of a diabetes history.

X3-4.2State the steps in the emergency medical care of the patient taking diabetic medicine with an altered mental status and a history of diabetes.

X3-4.3Establish the relationship between airway management and the patient with altered mental status

X3-4.4State the generic and trade names, medication forms, dose, administration, action, and contraindications for oral glucose

X3-4.5Evaluate the need for medical direction in the emergency medical care of the diabetic patient.

X3-4.6 Explain the rationale for administering oral glucose

X3-4.7

Demonstrate the steps in the emergency medical care for the patient taking diabetic medicine with an altered mental status and a history of diabetes.

X3-4.8 Demonstrate the steps in the administration of oral glucose

X3-4.9Demonstrate the assessment and documentation of patient response to oral glucose.

X3-4.10Demonstrate how to complete a prehospital care report for patients with diabetic emergencies

ALLERGIES 2 0 0X3-5.1 Recognize the patient experiencing an allergic reaction.

X3-5.2Describe the emergency medical care of the patient with an allergic reaction.

X3-5.3Establish the relationship between the patient with an allergic reaction and airway management.

X3-5.4Describe the mechanisms of allergic response and the implications for airway management.

X3-5.5

State the generic and trade names, medication forms, dose, administration, action, and contraindications for the epinephrine auto-injector.

X3-5.6Evaluate the need for medical direction in the emergency medical care of the patient with an allergic reaction

X3-5.7

Differentiate between the general category of those patients having an allergic reaction and those patients having an allergic reaction and requiring immediate medical care, including immediate use of epinephrine auto-injector.

X3-5.8 Explain the rationale for administering epinephrine using an auto-injector

X3-5.9Demonstrate the emergency medical care of the patient experiencing an allergic reaction.

X3-5.10 Demonstrate the use of epinephrine auto-injector.

X3-5.11Demonstrate the assessment and documentation of patient response to an epinephrine injection.

X3-5.12 Demonstrate proper disposal of equipment.

X3-5.13Demonstrate completing a prehospital care report for patients with allergic emergencies

POISONING/OVERDOSE 2 0 0X3-6.1 List various ways that poisons enter the body X3-6.2 List signs/symptoms associated with poisoning.



X3-6.3Discuss the emergency medical care for the patient with possible overdose.

X3-6.4Describe the steps in the emergency medical care for the patient with suspected poisoning

X3-6.5Establish the relationship between the patient suffering from poisoning or overdose and airway management.

X3-6.6

State the generic and trade names, indications, contraindications, medication form, dose, administration, actions, side effects and re-assessment strategies for activated charcoal.

X3-6.7Recognize the need for medical direction in caring for the patient with poisoning or overdose.

X3-6.8 Explain the rationale for administering activated charcoal.

X3-6.9Explain the rationale for contacting medical direction early in the prehospital management of the poisoning or overdose patient.

X3-6.10Demonstrate the steps in the emergency medical care for the patient with possible overdose.

X3-6.11Demonstrate the steps in the emergency medical care for the patient with suspected poisoning

X3-6.12Perform the necessary steps required to provide a patient with activated charcoal.

X3-6.13 Demonstrate the assessment and documentation of patient response

X3-6.14Demonstrate proper disposal of administration of activated charcoal equipment.

X3-6.15Demonstrate completing a prehospital care report for patients with a poisoning/overdose emergency

ENVIRONMENTAL EMERGENCIES 1 0 0X3-7.1 Describe the various ways that the body loses heat. X3.7.2 List the signs and symptoms of exposure to cold.

X3.7.3Explain the steps in providing emergency medical care to a patient exposed to cold.

X3-7.4 List the signs and symptoms of exposure to heat.

X3-7.5Explain the steps in providing emergency care to a patient exposed to heat

X3-7.6 Recognize the signs and symptoms of water-related emergencies X3-7.7 Describe the complications of near drowning. X3-7.8 Discuss the emergency medical care of bites and stings

X3-7.9Demonstrate the assessment and emergency medical care of a patient with exposure to cold.

X3-7.10Demonstrate the assessment and emergency medical care of a patient with exposure to heat

X3-7.11Demonstrate the assessment and emergency medical care of a near drowning patient

X3-7.12Demonstrate completing a prehospital care report for patients with environmental emergencies.

X3-7.13 Demonstrate the emergency medical care of bites and stings. (OP 29) BEHAVIORAL EMERGENCIES 1 0 0X3-8.1 Define behavioral emergencies

X3-8.2Discuss the general factors that may cause an alteration in a patient's behavior

X3-8.3 State the various reasons for psychological crises

X3-8.4Discuss the characteristics of an individual's behavior which suggests that the patient is at risk for suicide



X3-8.5Discuss special medical/legal considerations for managing behavioral emergencies

X3-8.6Discuss the special considerations for assessing a patient with behavioral problems.

X3-8.7Discuss the general principles of an individual's behavior which suggests that he is at risk for violence

X3-8.8 Discuss methods to calm behavioral emergency patients.

X3-8.9Explain the rationale for learning how to modify your behavior toward the patient with a behavioral emergency

X3-8.10Demonstrate the assessment and emergency medical care of the patient experiencing a behavioral emergency

X3-8.11Demonstrate various techniques to safely restrain a patient with a behavioral problem

OBSTETRICS/GYNECOLOGY 2 0 0X3-9.1 Describe how to assess an obstetrical patient.

X3-9.2Identify the following structures: Uterus, vagina, fetus, placenta, umbilical cord, amniotic sac, and perineum.

X3-9.3 Identify and explain the use of the contents of an obstetrics kit. X3-9.4 Identify pre-delivery emergencies. X3-9.5 State indications of an imminent delivery.

X3-9.6Differentiate the emergency medical care provided to a patient with predelivery emergencies from a normal delivery.(C-3)

X3-9.7 State the steps in the pre-delivery preparation of the mother.

X3-9.8Establish the relationship between body substance isolation and childbirth.

X3-9.9 State the steps to assist in the delivery X3-9.10 Describe care of the baby as the head appears. X3-9.11 Describe how and when to cut the umbilical cord. X3-9.12 Discuss the steps in the delivery of the placenta.

X3-9.13 List the steps in the emergency medical care of the mother post-delivery. X3-9.14 Summarize neonatal resuscitation procedures.

X3-9.15Describe the procedures for the following abnormal deliveries: Breech birth, prolapsed cord, limb presentation.

X3-9.16 Differentiate the special considerations for multiple births. X3-9.17 Describe special considerations of meconium. X3-9.18 Describe special considerations of a premature baby.

X3-9.19Discuss the emergency medical care of a patient with a gynecological emergency

X3-9.20Explain the rationale for understanding the implications of treating two patients (mother and baby).

Practical Skills Lab: Obstetrics/Gynecology 0 4 0X3-10.1 Demonstrate the steps to assist in the normal cephalic delivery.

X3-10.2Demonstrate necessary care procedures of the fetus as the head appears.

X3-10.3 Demonstrate infant neonatal procedures X3-10.4 Demonstrate post delivery care of infant. X3-10.5 Demonstrate how and when to cut the umbilical cord. X3-10.6 Attend to the steps in the delivery of the placenta. X3-10.7 Demonstrate the post-delivery care of the mother.

X3-10.8Demonstrate the procedures for the following abnormal deliveries: vaginal bleeding, breech birth, prolapsed cord, limb presentation



X3-10.9Demonstrate the steps in the emergency medical care of the mother with excessive bleeding.

X3-10.10Demonstrate completing a prehospital care report for patients with obstetrical/gynecological emergencies.

Infants and Children 4 0 0

X3-11.1 Identify the developmental considerations for the following age groups: Infants Toddlers pre-school school age adolescent

X3-11.2Describe differences in anatomy and physiology of the infant, child and adult patient

X3-11.3Differentiate the response of the ill or injured infant or child (age specific) from that of an adult.

X3-11.4 Indicate various causes of respiratory emergencies. X3-11.5 Differentiate between respiratory distress and respiratory failure.

X3-11.6 List the steps in the management of foreign body airway obstruction.

X3-11.7Summarize emergency medical care strategies for respiratory distress and respiratory failure.

X3.11.8Identify the signs and symptoms of shock (hypoperfusion) in the infant and child patient.

X3-11.9Describe the methods of determining end organ perfusion in the infant and child patient.

X3-11.10State the usual cause of cardiac arrest in infants and children versus adults.

X3-11.11 List the common causes of seizures in the infant and child patient. X3-11.12 Describe the management of seizures in the infant and child patient.

X3-11.13 Differentiate between the injury patterns in adults, infants, and children. X3-11.14 Discuss the field management of the infant and child trauma patient. X3-11.15 Summarize the indicators of possible child abuse and neglect. X3-11.16 Describe the medical legal responsibilities in suspected child abuse.

X3-11.17Recognize need for EMT-Basic debriefing following a difficult infant or child transport.

X3-11.18Explain the rationale for having knowledge and skills appropriate for dealing with the infant and child patient.

X3-11.19Attend to the feelings of the family when dealing with an ill or injured infant or child.

X3-11.20Understand the provider's own response (emotional) to caring for infants or children.

X3-11.21Discuss the assessment findings associated with abuse and neglect in infants and children.

X3-11.22Discuss the management/ treatment plan for abuse and neglect in infants and children, including documentation and reporting.

X3-11.23Describe the technique for performing a comprehensive physical examination on the infant or child complaining of abdominal pain.

X3-11.24Develop a patient management plan based on field impression in the infant or child with abdominal pain.

X3-11.25Describe the assessment of a patient suspected of, or identified as having, an infectious/ communicable disease.



X3-11.26Describe the management/treatment of an infant or child with a hematological disorder.

X3-11.27 Describe how to assess an obstetrical patient.

X3-11.28Discuss the assessment findings associated with fever in the infant or child.

X3-11.29 Discuss the management/ treatment plan for fever in the infant or child. Infants and Children Practical Skills Lab 0 4 0

X3-12.1Demonstrate the techniques of foreign body airway obstruction removal in the infant.

X3-12.2Demonstrate the techniques of foreign body airway obstruction removal in the child

X3-12.3 Demonstrate the assessment of the infant and child. X3-12.4 Demonstrate bag-valve-mask artificial ventilations for the infant. X3-12.5 Demonstrate bag-valve-mask artificial ventilations for the child. X3-12.6 Demonstrate oxygen delivery for the infant and child.

X3-12.7Demonstrate an appropriate trauma assessment for different developmental age groups.

X3-12.8 Demonstrate appropriate treatment of infants and children with trauma.

X3-12.9Demonstrate the proper assessment and management of a child or infant with cardiac arrest, in accordance with the latest ECC Guidelines.

X3-12.10Perform an assessment of the infant or child with a suspected hematological disorder.

PATIENTS WITH SPECIAL NEEDS/GERIATRIC EMERGENCIES 2 0 0

X3-13.1Discuss assessment techniques for children with special health care needs (CSHCN)

X3-13.2Describe complications and key interventions for selected special needs children’

X3-13.3Outline management priorities for technology dependant children with complications of indwelling devices

X3-13.4 Define the term Elderly X3-13.5 State the leading causes of death of the elderly X3-13.6 Describe the physiologic changes of aging.

X3-13.7Describe the process of gathering patient information for the elderly patient

X3-13.8 Describe the following basics of patient assessment for the elderly: Scene size up Initial Assessment Focused history and physical exam X3-13.9 List the steps in assessing the elderly patient X3-13.10 Describe communication basics used with and elderly patient X3-13.11 Describe trauma assessment in the elderly

X3-13.12Describe acute illness assessment (for the following conditions) in the elderly

Cardiovascular emergencies Dyspnea / Respiratory emergencies Syncope Altered mental status Acute abdomen X3-13.13 Describe the nature of the problem of abuse involving the elderly



X3-13.14List the categories and characteristics of abuse involving the elderly

X3-13.15 Define the term Special Needs as related to patients X3-13.16 Describe methods of providing care to patients with special needs

X3-13.17Identify developmental considerations for patients with special needs

X3-13.18 Describe examples of patients with developmental disabilities

X3-13.19Identify feelings of the family and caregivers in relation to an ill or injured special needs patient

X3-13.10Explain the need for knowledge and skills in treating special needs patients

X3-13.11Discuss the EMT’s own emotional response to caring for a patient with special needs

X3-13.12Develop methods of providing emergency care while appreciating the unique needs of each patient and family

Module Skills Evaluations (GA Lesson 4-10 Practical Evaluations) Module Evaluation - (GA Lessons 4-11 & 6-3 Evaluation) Module 4 Review and Practical Skills Lab 1 3 0

Demonstrate competency of module components FINAL EXAM for Medical Emergencies 1 3 0

Written Examination Practical Examination

TOTAL HOURS 30 20 0

EMS XX4 - Trauma Emergencies for the EMT

Course DescriptionThe course covers all the components of the National Highway Safety Transportation Administration, National Standard Curriculum, Emergency Medical Technician-Basic, 1994 standard, Module 5. Topics Include: bleeding and shock, soft tissue injuries, musculoskeletal care, injuries to the head/spine and emergency medical response to WMD .


Bleeding and Shock Class 20Soft Tissue Injuries D. Lab 14Musculoskeletal Care P. Lab/O.B.I. 0Injuries to the Head and Spine Credit 2Practical Skills Lab: TraumaEmergency Medical Response to Weapons of Mass Destruction

Prerequisite: Corequisite:

Course Guide

Competency After completing this section, the student will be able to: Hours


BLEEDING AND SHOCK 3 1 0X4-1.1 List the structure and function of the circulatory system

x4-1.2 Differentiate between arterial, venous and capillary bleeding.

x4-1.3 State methods of emergency medical care of external bleeding.

X4-1.4Establish the relationship between body substance isolation and bleeding.

X4-1.5Establish the relationship between airway management and the trauma patient

X4-1.6Establish the relationship between mechanism of injury and internal bleeding.

X4-1.7 List the signs of internal bleeding

X4-1.8List the steps in the emergency medical care of the patient with signs and symptoms of internal bleeding.

X4-1.9 List signs and symptoms of shock (hypoperfusion).

X4-1.10State the steps in the emergency medical care of the patient with signs and symptoms of shock (hypoperfusion).

X4-1.11Explain the sense of urgency to transport patients that are bleeding and show signs of shock (hypoperfusion).

X4-1.12 Discuss the need for assessing the patient for external bleeding

X4-1.13Demonstrate completing a prehospital care report for patient with bleeding and/or shock (hypoperfusion)

X4-1.14Differentiate the structural and functional aspects of arterial and venous blood vessels.



SOFT TISSUE INJURIES 4 0 0X4-2.1 State the major functions of the skin X4-2.2 List the layers of the skin.

X4-2.3Establish the relationship between body substance isolation (BSI) and soft tissue injuries

X4-2.4 List the types of closed soft tissue injuries.

X4-2.5Describe the emergency medical care of the patient with a closed soft tissue injury.

X4-2.6 State the types of open soft tissue injuries.

X4-2.7Describe the emergency medical care of the patient with an open soft tissue injury.

X4-2.8Discuss the emergency medical care considerations for a patient with a penetrating chest injury.

X4-2.9State the emergency medical care considerations for a patient with an open wound to the abdomen.

X4-2.10Differentiate the care of an open wound to the chest from an open wound to the abdomen.

X4-2.11 List the classifications of burns. X4-2.12 Define superficial burn. X4-2.13 List the characteristics of a superficial burn. X4-2.14 Define partial thickness burn. X4-2.15 List the characteristics of a partial thickness burn. X4-2.16 Define full thickness burn. X4-2.17 List the characteristics of a full thickness burn.

X4-2.18Describe the emergency medical care of the patient with a superficial burn.

X4-2.19Describe the emergency medical care of the patient with a partial thickness burn.

X4-2.20Describe the emergency medical care of the patient with a full thickness burn.

X4-2.21 List the functions of dressing and bandaging. X4-2.22 Describe the purpose of a bandage. X4-2.23 Describe the steps in applying a pressure dressing.

X4-2.24Establish the relationship between airway management and the patient with chest injury, burns, blunt and penetrating injuries.

X4-2.25Describe the effects of improperly applied dressings, splints and tourniquets.

X4-2.26Describe the emergency medical care of a patient with an impaled object

X4-2.27 Describe the emergency medical care of a patient with an amputation. X4-2.28 Describe the emergency care for a chemical burn. X4-2.29 Describe the emergency care for an electrical burn.

X4-2.30Demonstrate the steps in the emergency medical care of closed soft tissue injuries

X4-2.31Demonstrate completing a prehospital care report for patients with soft tissue injuries.

MUSCULOSKELETAL CARE 4 0 0X4-3.1 Describe the function of the muscular system. X4-3.2 Describe the function of the skeletal system.

X4-3.3List the major bones or bone groupings of the spinal column; the thorax; the upper extremities; the lower extremities.



X4-3.4Differentiate between an open and a closed painful, swollen, deformed extremity.

X4-3.5 State the reasons for splinting. X4-3.6 List the general rules of splinting. X4-3.7 List the complications of splinting.

X4-3.8List the emergency medical care for a patient with a painful, swollen, deformed extremity.

X4-3.9 Explain the rationale for splinting at the scene versus load and go.

X4-3.10Explain the rationale for immobilization of the painful, swollen, deformed extremity.

X4-3.11Demonstrate completing a prehospital care report for patients with musculoskeletal injuries.

INJURIES TO THE HEAD AND SPINE 4 0 0X4-4.1 State the components of the nervous system. X4-4.2 List the functions of the central nervous system.

X4-4.3Define the structure of the skeletal system as it relates to the nervous system.

X4-4.4 Relate mechanism of injury to potential injuries of the head and spine.

X4-4.5Describe the implications of not properly caring for potential spine injuries.

X4-4.6 State the signs and symptoms of a potential spine injury.

X4-4.7Describe the method of determining if a responsive patient may have a spine injury.

X4-4.8Relate the airway emergency medical care techniques to the patient with a suspected spine injury.

X4-4.9 Describe how to stabilize the cervical spine.

X4-4.10Discuss indications for sizing and using a cervical spine immobilization device.

X4-4.11Establish the relationship between airway management and the patient with head and spine injuries.

X4-4.12 Describe a method for sizing a cervical spine immobilization device.

X4-4.13 Describe how to log roll a patient with a suspected spine injury. X4-4.14 Describe how to secure a patient to a long spine board. X4-4.15 List instances when a short spine board should be used.

X4-4.16 Describe how to immobilize a patient using a short spine board. X4-4.17 Describe the indications for the use of rapid extrication. X4-4.18 List steps in performing rapid extrication.

X4-4.19 State the circumstances when a helmet should be left on the patient.

X4-4.20 Discuss the circumstances when a helmet should be removed. X4-4.21 Identify different types of helmets. X4-4.22 Describe the unique characteristics of sports helmets. X4-4.23 Explain the preferred methods to remove a helmet. X4-4.24 Discuss alternative methods for removal of a helmet.

X4-4.25 Describe how the patient's head is stabilized to remove the helmet.



X4-4.26Differentiate how the head is stabilized with a helmet compared to without a helmet.

X4-4.27Explain the rationale for immobilization of the entire spine when a cervical spine injury is suspected.

X4-4.28Explain the rationale for utilizing immobilization methods apart from the straps on the cots.

X4-4.29Explain the rationale for utilizing a short spine immobilization device when moving a patient from the sitting to the supine position.

X4-4.30Explain the rationale for utilizing rapid extrication approaches only when they indeed will make the difference between life and death.

X4-4.31Defend the reasons for leaving a helmet in place for transport of a patient.

X4-4.32Defend the reasons for removal of a helmet prior to transport of a patient.

X4-4.33Demonstrate completing a prehospital care report for patients with head and spinal injuries.

X4-4.34Describe the mechanism of injury, assessment and management of injuries for the head injury patient

X4-4.35Distinguish between the types of traumatic brain injury based upon an understanding of pathophysiology and assessment

TRAUMA PRACTICAL SKILL LAB 0 8 0

X4-5.1Demonstrate opening the airway in a patient with suspected spinal cord injury.(P-1,2)

X4-5.2Demonstrate evaluating a responsive patient with a suspected spinal cord injury.(P-1,2)

X4-5.3 Demonstrate stabilization of the cervical spine.(P-1,2)

X4-5.4Demonstrate the four person log roll for a patient with a suspected spinal cord injury. (P-1,2)

X4-5.5Demonstrate how to log roll a patient with a suspected spinal cord injury using two people.(P-1,2)

X4-5.6 Describe how the patient is immobilized on the backboard. X4-5.7 Demonstrate securing a patient to a long spine board.(P-1,2)

X4-5.8Describe how the patient is immobilized to the stretcher, and to the ambulance.

X4-5.9Demonstrate using the short board immobilization technique.(P-1,2)

X4-5.10 Demonstrate procedure for rapid extrication.(P-1,2)

X4-5.11Demonstrate preferred methods for stabilization of a helmet. (P-1,2)

X4-5.12 Demonstrate helmet removal techniques.(P-1,2)

X4-5.13Demonstrate alternative methods for stabilization of a helmet.(P-1,2)

X4-5.14Demonstrate the emergency medical care of a patient with a painful, swollen, deformed extremity.(P-1,2)

X4-5.15Demonstrate the steps in the emergency medical care of open soft tissue injuries.(P-1,2)

X4-5.16Demonstrate the steps in the emergency medical care of a patient with an open chest wound.(P-1,2)

X4-5.17Demonstrate the steps in the emergency medical care of a patient with open abdominal wounds.(P-1,2)



X4-5.18Demonstrate the steps in the emergency medical care of a patient with an impaled object.(P-1,2)

X4-5.19Demonstrate the steps in the emergency medical care of a patient with an amputation.(P-1,2)

X4-5.20Demonstrate the steps in the emergency medical care of an amputated part.(P-1,2)

X4-5.21Demonstrate the steps in the emergency medical care of a patient with superficial burns.(P-1,2)

X4-5.22Demonstrate the steps in the emergency medical care of a patient with partial thickness burns.(P-1,2)

X4-5.23Demonstrate the steps in the emergency medical care of a patient with full thickness burns.(P-1,2)

X4-5.24Demonstrate the steps in the emergency medical care of a patient with a chemical burn.(P-1,2)

X4-5.25Demonstrate direct pressure as a method of emergency medical care of external bleeding. (P-1,2)

X4-5.26Demonstrate the use of diffuse pressure as a method of emergency medical care of external bleeding.(P-1,2)

X4-5.27Demonstrate the use of pressure points and tourniquets as a method of emergency medical care of external bleeding.(P-1,2)

X4-5.28Demonstrate the care of the patient exhibiting signs and symptoms of internal bleeding.(P-1,2)

X4-5.29Demonstrate the care of the patient exhibiting signs and symptoms of shock (hypoperfusion).(P-1,2)

Emergency Medical Response to Weapons of Mass Destruction 2 0 0X4-6-1 Recognize the patient experiencing exposure to a Weapon of Mass Destruction, to include chemicals and radiation X4-6.2 Describe the emergency medical care of the patient. experiencing exposure to a Weapon of Mass Destruction X4-6.3 List signs/symptoms associated with Weapons of Mass Destruction. X4-6.4 State the medication forms, dose, administration, action, and contraindications for the Mark I kit, Potassium Iodide, and Amyl Nitrite X4-6.5 Differentiate between the general category of those patients exposed to a Weapon of Mass Destruction and those requiring immediate medical care, including immediate use of the Mark I kit, Potassium Iodide, and Amyl Nitrite. X4-6.6 Explain the rationale for administering the Mark I kit, Potassium Iodide, and Amyl Nitrite X4-6.7 Demonstrate the emergency medical care of the patient exposed to a Weapon of Mass Destruction. X4.6-8 Demonstrate the use of a Mark I Kit, Potassium Iodide, and Amyl Nitrite. X4-6.9 Perform the necessary steps required to provide a patient with a Mark I Kit, Potassium Iodide, and Amyl Nitrite X4-6.10 Demonstrate the assessment and documentation of patient response to a Weapon of Mass Destruction. X4-6.11 Demonstrate the proper disposal of the Mark I Kit. Module 5 Review and Practical Skills Lab 2 2 0 Demonstrate competency of module components FINAL EXAM for Trauma Emergencies for the EMT 1 3 0

Written Examination



Practical Examination TOTAL HOURS 20 14 0

EMS XX5 – Summative Evaluations for the EMT-Basic

Course DescriptionThe course serves as the exit point for students taking only the EMT-Basic program. Students continuing on to the EMT-Intermediate portion of the curriculum, must pass this course in order to continue. The course will include clinical hours to be spent in both Hospital Emergency Departments and on Ambulance Clinical Rotations. This class will also contain a Comprehensive review of the US DOT EMT-Basic 1994 Curriculum, as well as portions of the NSC EMT-Intermediate 1985 Curriculum that were covered in EMS XX1 and EMS XX2, and a comprehensive written and practical exam that will serve to verify the students competencies before proceeding to the EMT-Intermediate Courses.


EMT-Basic Clinical Skills RequirementsEMT-Basic Didactic Review Class 12EMT-Basic Skills Review D. Lab 20Ambulance/Emergency Department Clinical Rotations P. Lab/O.B.I. 32EMT-Basic Comprehensive Written Exam Credit 3EMT-Basic Comprehensive Practical ExamRoles And Responsibilities Of The EMT-Intermediate* EMS Systems For the EMT-Intermediate*Medical/Legal Aspects For The EMT-Intermediate*Medical Terminology*EMS Communications For The EMT-Intermediate*Advanced Airway*Advanced Airway Practical Skills Lab*

Prerequisite: EMS XX1, EMS XX2Corequisite: EMS XX3, EMS XX4

Course Guide

Competency After completing this section, the student will:

Hours

Class D.LabP.Lab/O.B.I.

EMT-BASIC CLINICAL SKILLS REQUIREMENTS 0 0 32Baseline Vital Signs and SAMPLE History XX5-1.1 Demonstrate the skills involved in assessment of breathing.(P-1,2) [5] XX5-1.2 Demonstrate the skills associated with obtaining a pulse. (P-1,2) [5]

XX5-1.3Demonstrate the skills associated with assessing the skin color, temperature,

condition, and capillary refill in infants and children.(P-1,2) [5] XX5-1.4 Demonstrate the skills associated with assessing the pupils. (P-1,2) [5] XX5-1.5 Demonstrate the skills associated with obtaining blood pressure.(P-1,2) [5] XX5-1.6 Demonstrate the skills that should be used to obtain information from the patient, family, or bystanders at the scene. (P-1,2) [5] Lifting and Moving Patients XX5-2.1 Working with a partner, prepare each of the following devices for use,

transfer a patient to the device, properly position the patient on the device,

move the device to the ambulance and load the patient into the ambulance:

· Wheeled ambulance stretcher [2] · Portable ambulance stretcher · Stair chair · Scoop stretcher · Long spine board · Basket stretcher · Flexible stretcher (P-1,2) XX5-2.2 Working with a partner, the EMT-Basic will demonstrate techniques for the transfer of a patient from an ambulance stretcher to a hospital stretcher.(P-1,2) [2]

Airway

XX5-3.1Demonstrate the correct operation of oxygen tanks and regulators.(P-1,2) [1]

XX5-3.2Demonstrate the use of a nonrebreather face mask and state the oxygen flow

requirements needed for its use.(P-1,2) [1] XX5-3.3 Demonstrate the use of a nasal cannula and state the flow requirements needed for its use.(P-1,2) [1] Scene Size-Up XX5-4.1 Observe various scenarios and identify potential hazards. (P-1) [5] Initial Assessment XX5-5.1 Demonstrate the techniques for assessing mental status.(P-1,2) [5] XX5-5.2 Demonstrate the techniques for assessing the airway.(P-1,2) [5] XX5-5.3 Demonstrate the techniques for assessing the patient for external bleeding.(P-1,2) [5] XX5-5.4 Demonstrate the ability to prioritize patients.(P-1,2) [5] Focused History and Physical Exam-Trauma Patients XX5-6.1 Demonstrate the rapid trauma assessment that should be used to assess a patient based on mechanism of injury.(P-1,2) [1] Focused History and Physical Exam-Medical Patients [1 of two below] XX5-7.1 Demonstrate the patient care skills that should be used to assist with a patient who is responsive with no known history.(P-1,2) XX5-7.2 Demonstrate the patient care skills that should be used to assist with a patient who is unresponsive or has an altered metal status.(P-1,2) Detailed Physical Exam XX5-8.1 Demonstrate the skills involved in performing the detailed physical exam. (P-1,2) [1] On-Going Assessment XX5-9.1 Demonstrate the skills involved in performing the on-going assessment. P-1,2) [1] Communications XX5-10.1 Perform a simulated, organized, concise radio transmission.(P-2) [1] XX5-10.2 Perform an organized, concise patient report that would be given to the staff at a receiving facility.(P-2) [1] Documentation XX5-11.1 Complete a prehospital care report.(P-2) [5 of school/unofficial forms of documentation] EMT-Basic Didactic Review 8 0 0 Review all aspects of the EMT-Basic National Standard Curriculum. EMT-Basic Skills Review 0 16 0

Demonstrate all skills relevant in preparation for either taking the National Registry Basic Examination, or proceeding on to EMT-Intermediate Courses.

EMT-Basic Comprehensive Written Examination 4 0 0EMT-Basic Comprehensive Practical Examination 0 4 0

TOTAL HOURS 12 20 32

PLUS 19 additional contact hours for students who meet the below criteriaSub Note

All Current Basic EMTs must receive additional training for the following Intermediate training before entering Module XX6 ROLES AND RESPONSIBILITIES OF THE EMT-INTERMEDIATE

4 0 0EMS SYSTEMS FOR THE EMT-INTERMEDIATE X1-4.1 Discuss citizen access and the various mechanisms of obtaining it. X1-4.2 Discuss prehospital care as an extension of hospital care. X1-4.3 Define stabilization of patients. X1-4.4 Define and describe medical control X1-4.5 Describe physician responsibility for Medical Control X1-4.6 Describe the relationship between: - the physician on the scene, EMT-I and the physician on the radio - the physician who is with the patient when the EMT-I arrives

- the physician who arrives on the scene after the EMT-I’s have started evaluating and treating the patient

X1-4.7Describe the benefits of EMT-1 follow-up on patient condition, diagnosis, and retrospective review of prehospital care

X1-4.8 Describe GSA/KKK Ambulance standards

X1-4.9Define the American College of Surgeons Essential Equipment List and how it relates to local State laws.

X1-4.10Define the national standard levels of prehospital provider as defined by curriculum, respectively.

A: Discuss ambulance placement and the parameters that should be utilized in its development, including the differences in urban, suburban and rural settings.

X1-4.11 Discuss the medical community role in overseeing prehospital care. X1-4.12 Define protocols and standing orders. X1-4.13 Describe the development of protocols. X1-4.14 Define local training standards.

X1-4.15 Describe the legislation in the EMT-I’s State as regards prehospital care.

X1-4.16Describe integration of prehospital care into the continuum of total patient care with the emergency department phase of hospital care

X1-4.17 Discuss replacement of equipment and supplies

X1-4.18 Discuss the EMT-I’s initial responsibilities when arriving on the scene.

X1-4.19 Discuss ambulance placement and the parameters that should be utilized in its

development, including the differences in urban, suburban, and rural settings.

X1-4.20 Discuss the varying philosophies between the management of medical patients and trauma patients, prehospital.

X1-4.21 Describe the transition of patient care from the EMT-Intermediate, including: a. Transfer of responsibility (legal and medical) b. Reporting of patient status to physician or nurse. X1-4.22 Describe basic concepts of incident management. X1-4.23 Define the fundamental components of extrication.

MEDICAL/LEGAL ASPECTS FOR THE EMT-INTERMEDIATE (GA-IM-3) (2 hrs) 2 0 0

X1-7.1

Discuss the significance and scope of the following in relationship to EMT practice: State Medical Practice Act (O.C.G.A. 31-11), Good Samaritan Act/Civil Immunity, state EMS statutes (Georgia), state motor vehicle codes (Georgia), and state and local guidelines for "Do Not Resuscitate."

X1-7.2 Define the following: - Negligence - Medical liability - Tort - Duty to act - Battery - Slander - Libel - Informed consent - Expressed consent - implied consent - Abandonment - Liable - Assault - False imprisonment - Borrowed Servant Doctrine

X1-7.3Describe the significance of accurate documentation and record keeping in substantiating incident. (Oral & Written)

X1-7.4Identify those situations that require the EMT-I to report those incidents to appropriate authorities.

X1-7.5 Describe the four elements to prove medical liability. X1-7.6 Describe the significance of obtaining expressed consent.

X1-7.7Describe the extent to which force and restraint may be used to protect the EMT, the patient, and the third party.

MEDICAL TERMINOLOGY (GA-I-M5) (1 hr) 1 0 0X1-10.1 Define and contrast Medical Terms X1-10.2 Provide three examples of each of the following: - word root - prefix - suffix - combining form - combining vowel

X1-10.3 Identify various medical terms given to various anatomical parts of the body

X1-10.4 Identify common medical abbreviations from a list X1-10.5 Identify common root words and determine their meaning. X1-10.6 identify and define common prefixes and suffixes X1-10.7 Locate one or more medical terms in a medical dictionary X1-10.8 Describe the four planes of the human body X1-10.9 Describe the main directional terms for the human body X1-10.10 Describe the six normal body movements X1-10.11 Describe the anatomic positions of the body X1-10.12 Define the following prefixes: (See Addendum A-1) X1-10.13 Define the following suffixes: (See Addendum A1)

EMS COMMUNICATIONS FOR THE EMT-INTERMEDIATE (GA-I-M4) (2 hrs) 2 0 0

X2-8.1 Describe the phases of communications necessary to complete a typical EMS event.

X2-8.2 Name the possible components of an EMS communications system and explain the function of each.

X2-8.3 Describe maintenance procedures for field radio equipment.

X2-8.4 Describe the position of the antenna on a portable transmitter/receiver that will deliver maximum coverage.

X2-8.5 Describe an advantage of a repeater system over a nonrepeater system.

X2-8.6 Describe basic functions and responsibilities of the Federal Communications Commission.

X2-8.7 Describe the responsibilities of an EMS dispatcher.

X2-8.8 Name information items that must be gathered from a caller by the dispatcher.

X2-8.9 Describe the ten-code used in the local community.

X2-8.10 Describe three communications techniques that influence the clarity of radio transmissions.

X2-8.11 Describe three communications techniques that influence the content of radio transmissions.

X2-8.12 Describe the importance of written medical protocols.

X2-8.13 Describe two purposes of verbal communication of patient information to the hospital.

X2-8.14 Describe information that should be included in patient assessment information verbally reported to the physician.

X2-8.15 Organize a list of patient assessment information in the correct order for radio transmission to the physician according to the format used locally.

X2-8.16 Demonstrate the proper use of a mobile transmitter/receiver to receive and transmit information.

X2-8.17 Demonstrate the proper use of a portable transmitter/receiver to receive and transmit information.

X2-8.18 Demonstrate the proper use of a digital encoder.

X2-8.19Demonstrate the proper use of a mobile or portable transmitter in a real or simulated patient situation to organize and transmit patient assessment information, using a standardized format.

X2-8.20 Describe proper use of both mobile and portable radios to receive and transmit information

X2-8.21 Describe the proper use of a digital encoder

X2-8.22Describe the interaction between the EMT-I and Medical Command authority in regard to: receiving hospital, family physician on the scene, bystander physician on the scene, orders for patient care, needs of the family, and needs of the patient.

X2-8.23 Identify and differentiate among the following communications systems: a. Simplex b. Multiplex c. Duplex d. Trunked e. Digital communications f. Cellular telephone g. Facsimile h. computer X2-8.24 Describe how the Emergency Medical Dispatcher functions as an integral part

of the EMS team.

X2-8.25 Identify the role of Emergency Medical Dispatch in a typical EMS event.

X2-8.26 List appropriate information to be gathered by the Emergency Medical Dispatcher.

X2-8.27 List factors which enhance verbal communications. X2-8.28 Describe the importance of written medical protocols.

X2-8.29 Describe the procedure of verbal communication of patient information to the hospital.

X2-8.30 Name five uses of the EMS patient care report. ADVANCED AIRWAY (GA-I-M7) (4 hrs minimum) 4 0 0

X2-11.1Describe the anatomy of the following: upper airway, tongue, hypopharynx, nasopharynx, oropharynx, larynx, vocal cords.

X2-11.2 Describe the flow of air from outside the body into the trachea

X2-11.3Describe the reasons for and mechanism of humidification and warming of the air as it passes through the naso-and oral pharynx

X2-11.4Recall the anatomic relationship of the larynx to the tongue, pharynx, epiglottis, vocal cords, esophagus

X2-11.5 Relate the difference between true and false vocal cords

X2-11.6Recall and demonstrate the essential elements of assessing airway patency, breathing effectiveness and oxygenation in the ill or injured patient

X2-11.7 Describe and demonstrate the procedures used to manually open the airway X2-11.8 Describe the methods and management of an obstructed airway

X2-11.9

Discuss indications, contraindications, methods of insertion and use of the following: oropharyngeal airway, nasopharyngeal airway, EOA, Combitube, EGTA, and pharyngotracheal lumen airway.

X2-11.10Discuss indications, contraindications, methods of insertion and use of the Laryngeal Mask Airway.

X2-11.11 Describe the anatomy of the following: Lungs Trachea Alveolus Diaphragm Thoracic wall Pleural space.

X2-11.12Describe how pulmonary ventilation (inhalation and exhalation) is accomplished

X2-11.13Describe the gaseous exchange across the alveoli-capillary membrane (02 and CO2)

X2-11.14

Describe the pulmonary problems that can complicate exhalation and inhalation, the mechanisms by which they reduce ventilation and management of each problem, including:

Open pneumothorax Diaphragmatic injury Closed pneumothorax (simple and tension) Flail chest X2-11.15 Describe the problems of ventilation X2-11.16 Define mouth-to-mask ventilation, its benefits and limitations X2-11.17 Discuss the bag-valve-mask (BVM), its benefits and limitations

X2-11.18 Discuss the techniques for evaluating the effectiveness of ventilation

X2-11.19Describe the anatomy of the following: upper airway, tongue, hypopharynx, nasopharynx, oropharynx, larynx, and vocal cords.

X2-11.20 Describe the function of the vocal cords.

X2-11.21

Describe the pathological conditions that can occur in the nose, pharynx, and larynx to obstruct or retard air flow and identify the complications of laryngeal fracture.

X2-11.22 Explain the pathophysiology of airway compromise.(C-1) X2-11.23 Describe the proper use of airway adjuncts.(C-1) X2-11.24 Review the use of oxygen therapy in airway management.(C-1) X2-11.25 Discuss ventilation with an Advanced Airway. X2-11-26 Describe the methods of airway management.

X2-11.27Describe how the cervical spine is protected throughout these maneuvers.

X2-11.28 Describe the relationship between: Cords and larynx Esophagus and larynx Epiglottis and larynx Tongue and larynx True cords and false cords Pharynx and larynx X2-11.29 List factors which cause decreased oxygen concentrations in the blood.

X2-11.30List the factors which increase and decrease carbon dioxide production in the body.

X2-11.31 Describe the measurement of oxygen in the blood. X2-11.32 Describe the measurement of carbon dioxide in the blood.

X2-11.33Given a list of arterial oxygen concentrations, the student should be able to select the normal P0,, for a young adult breathing air

X2-11.34Given a list of arterial carbon dioxide concentrations, the student should be able to select the normal PCO2

X2-11.35

Given an. increase in arterial PCO2, the student should be able to name this condition and describe its effect on respiratory activity and on blood pH in the normal individual

X2-11.36 Given a decrease in arterial P02, the student should be able to name this condition and describe its effect on respiratory activity in the normal individual

X2-11.37Given an increase in CO2 production, the student should be able to list at least two ways in which this increase may occur

X2-11.38Given an increase in CO2 elimination, the student should be able to describe how this elimination can occur

X2-11.39Identify types of suction catheters, including hard or rigid catheters and soft catheters.

X2-11.40 Explain the purpose for suctioning the upper airway. X2-11.41 Identify types of suction equipment. X2-11.42 Describe the indications for suctioning the upper airway. X2-11.43 Identify special considerations of suctioning the upper airway.

X2-11.44Given a list of statements, the student should be able to identify the statement that best describes the purpose of suctioning a patient

X2-11.45

Given a diagram of a piston-powered suction unit, the student should be able to label and describe the operation and cleaning of each component and attached part

X2-11.46

Given that there are various types of suction units, the student should be able to list at least four different types of units determined by the method in which the suction effect is obtained

X2-11.47

Given that there are various types of suction catheters, the student should be able to list at least three different types, determined by difference in use and material composition

X2-11.48Given a list of situations describing patients who require suctioning, the student should indicate which type of catheter should be used

X2-11.49 Describe the indications, contraindications, advantages, disadvantages, complications, equipment, and technique for using a dual lumen airway.

X2-11.50 Explain the primary objective of airway maintenance.

X2-11.51

Given a list of statements, the student should be able to identify the statement that best describes the purpose of using the esophageal obturator airway/Dual Lumen Airway/Laryngeal Mask Airway.

X2-11.52

Given a list of Situations describing patients with airway maintenance problems or potential airway maintenance problems, the student should be able to identify situations in which the use of the esophageal obturator airway/Dual Lumen Airway/Laryngeal Mas

X2-11.53

Given a list of situations, the student should be able to identify those situations in which the esophageal airway/Dual Lumen Airway/Laryngeal Mask Airway may be removed

X2-11.54

Given a list of advantages, the student should be able to identify the advantages of using the esophageal obturator airway/Dual Lumen Airway/Laryngeal Mask Airway over other methods of airway control

X2-11.55

Given a list of airway adjuncts, advantages and disadvantages, the student should be able to identify the disadvantages of using the esophageal obturator airway/Dual Lumen Airway/Laryngeal Mask Airway over other methods of airway control

X2-11.56

Given a list of airway adjuncts, advantages, and disadvantages, the student should be able to match the airway adjuncts with the advantages and disadvantages

X2-11.57

Given a diagram of the esophageal obturator airway/Dual Lumen Airway/Laryngeal Mask Airway, the student should be able to label and describe the function of all component

X2-11.58Given a list of equipment and materials the student should be able to identify those items that must be available before esophageal obturation is begun

X2-11.59 Identify the commonly neglected prehospital skills related to airway. X2-11.60 Define normal tidal volumes for the adult. X2-11.61 List the concentration of gases which comprise atmospheric air. X2-11.62 Define normal respiratory rates for adult, child, and infant. X2-11.63 Define and differentiate between hypoxia and hypoxemia. X2-11.64 Describe the modified forms of respiration. X2-11.65 Define gag reflex. X2-11.66 List the factors which affect respiratory rate and depth. X2-11.67 Describe the voluntary and involuntary regulation of respiration. X2-11.68 Describe causes of upper airway obstruction. X2-11.69 Describe the use, advantages, and disadvantages of an oxygen humidifier.

X2-11.70Describe the indications, contraindications, advantages, disadvantages, complications, equipment, and technique for using a dual lumen airway.

X2-11.71 Explain the relationship between pulmonary circulation and respiration. X2-11.72 Demonstrate effective mouth-to-mask ventilation X2-11.73 Demonstrate effective bag-valve ventilations with Mask EOA Combitube Laryngeal Mask Airway (LMA) X2-11.74 Demonstrate the manual methods of airway management X2-11.75 Demonstrate the methods of management of an obstructed airway X2-11.76 Demonstrate the mechanical methods of airway management Nasal Oral Dual Lumen Airway Laryngeal Mask Airway

X2-11.77 Demonstrate the use of various types of portable and fixed suction devices

X2-11.78List complications associated with advanced airway management.(C11)

X2-11.79 Explain the rationale for confirming breath sounds.(A-2) X2-11.80 Explain the value of performing advanced airway procedures.(A12)

X2-11.81Defend the need for the EMT-Basic to perform advanced airway procedures.(A-3)

X2-11.82Recognize and respect the feelings of the patient and family during advanced airway procedures.(A-1)

ADVANCED AIRWAY PRACTICAL SKILLS LAB 0 2 0X2-12.1 Demonstrate effective mouth-to-mask ventilation. X2-12.2 Demonstrate effective bag-valve ventilations with - Mask - Advanced Airway Devices X2-12.3 Demonstrate the manual methods of airway management. X2-12.4 Demonstrate the methods of management of an obstructed airway. X2-12.5 Demonstrate the mechanical methods of airway management -Nasal -Oral

X2-12.6Demonstrate the use of various types of portable and fixed suction devices.

X2-12.7

Given that a patient requires an esophageal obturator airway/Dual Lumen Airway/Laryngeal Mask Airway. The student should be able to list the procedures for insertion of the esophageal airway, including all steps in the proper sequence

X2-12.7

Given a list of errors, the student should be able to identify common errors involved in the use of the esophageal obturator airway/Dual Lumen Airway/Laryngeal Mask Airway

X2-12.8 Discuss skill deterioration and methods of prevention X2-12.9 Discuss need for rapid placement of an advanced airway device.

X2-12.10 Discuss methods of assuring and maintaining correct placement of an ET tube X2-12.11 Discuss ventilation with an endotracheal tube.

X2-12.12Describe the equipment and method of suctioning the airway, pharynx, and endotracheal tube.

X2-12.13

Given that a patient needs suctioning and already has an endotracheal tube in place, the student should be able to describe the difference between endotracheal suctioning and oropharyngeal suctioning including:

Dangers Precautions

X2-12.14

Given an adult manikin, oropharyngeal and nasopharyngeal airways, pocket mask, oxygen cylinder, and bag-valve-mask, the student should be able to demonstrate the procedure for administering intermittent positive pressure ventilation using:

Pocket mask Bag-valve-mask and oropharyngeal airway Bag-valve-mask with oxygen Nasopharyngeal airway with bag valve mask

X2-12.15Given a bag-valve mask, the student should be able to demonstrate the assembly, disassembly, and cleaning of the bag-valve mask unit.

X2-12.16

Given an adult manikin, an oropharyngeal airway, and a demand-valve unit, the student should be able to demonstrate the procedure for performing intermittent positive-pressure ventilation

X2-12.17Given a demand-valve unit, the student should be able to demonstrate the assembly, disassembly, and cleaning of the unit.

X2-12.18

Given an adult intubation manikin, an esophageal obturator airway/Dual Lumen Airway/Laryngeal Mask Airway. 30-cc syringe, and a bag-valve unit, the student should be able to demonstrate the technique for the insertion of an esophageal obturator airway/Dua

X2-12.19Perform body substance isolation (BSI) procedures during basic airway management, advanced airway management, and ventilation.

X2-12.20 Perform pulse oximetry.

X2-12.21 Demonstrate proper insertion of a dual lumen airway. MODULE WRITTEN SKILLS EVALUATION (GA Lessons 2-1 & 3-10) 2 2 0

EMS XX6 – Pharmacology and Shock/Trauma Management for the EMT-Intermediate

Course DescriptionThe course covers Section 8 of the National Highway Safety Transportation Administration, National Standard Curriculum, Emergency Medical Technician-Intermediate, 1985 standard. Topics Include: general pharmacology review, IV and IO therapy, shock/trauma assessment and management.


PharmacologyDiabetic Emergencies And D50 Administration Class 28Intravenous Infusion Therapy D. Lab 24Intravenous Infusion Therapy P. Lab/O.B.I. 0Intraosseous Infusion Therapy Credit 3IV/IO Infusion Therapy (Lab)Shock/TraumaShock ManagementShock Management/Patient Assessment LabDidactic Review And Practical Skills Lab

Prerequisite: EMS XX1, EMS XX2, EMS XX3, EMS XX4Corequisite: EMS XX5

Course Guide


Hours


PHARMOCOLOGY 4 2 0X6-1.1 Review the specific anatomy and physiology pertinent to pharmacology. X6-1.2 Discuss the standardization of drugs. X6-1.3 Differentiate among the chemical, generic (non-proprietary), and trade (proprietary) names of a drug. X6-1.4 Describe how drugs are classified. X6-1.5 List the authoritative sources for drug information. X6-1.6 Discuss special consideration in drug treatment with regard to pregnant, pediatric, and geriatric patients. X6-1.7 Discuss the EMT-Intermediates responsibilities and scope of management pertinent to the administration of medications. X6-1.8 List and describe general properties of drugs. X6-1.9 List and differentiate routes of drug administration. X6-1.10 Describe mechanisms of drug action. X6-1.11 Describe pharmacokinetics, pharmacodynamics, theories of drug action, drug-response relationship, factors altering drug responses, predictable drug responses, iatrogenic drug responses, and unpredictable adverse predictable drug responses, X6-1.12 Discuss considerations for storing drugs. X6-1.13 List the components of a drug profile. X6-1.14 List and describe drugs which the EMT-Intermediate may administer in a pharmacological management plan according to protocol.

X6-1.15 Review the specific anatomy and physiology pertinent to medication administration. X6-1.16 Review mathematical principles. X6-1.17 Review mathematical equivalents. X6-1.18 Differentiate temperature readings between the Centigrade and Fahrenheit scales. X6-1.19 Calculate Intravenous infusion rates for adults, infants, and children. X6-1.20 Discuss legal aspects affecting medication administration. X6-1.21 Discuss the “six rights” of drug administration and correlate these with the principles of medication administration. X6-1.22 Discuss medical asepsis and the differences between clean and sterile techniques X6-1.23 Describe the use of antiseptics and disinfectants. X6-1.24 Describe the use of universal precautions and body substance isolation (BSI) procedures when administering a medication. X6-1.25 Describe the indications, equipment needed, techniques utilized, precautions, and general principles of administering medications by the inhalation route. X6-1.26 Differentiate among the different dosage forms of oral medications. X6-1.27 Describe the equipment needed and general principles of administering oral medications. X6-1.28 Differentiate among the different parenteral routes of medication administration. X6-1.29 Describe the equipment needed, techniques utilized, complications, and general principles for the preparation and administration of parenteral medications. X6-1.30 Differentiate among the different percutaneous routes of medication administration. X6-1.31 Demonstrate preparation and administration of parenteral medications. DIABETIC EMERGENCIES AND D50 ADMINISTRATION 4 0 0X6-2.1 Discuss the function of insulin and it's relationship to glucose metabolism X6-2.2 Describe the pathophysiology of diabetes mellitus X6-2.3 List five signs of diabetic ketoacidosis X6-2.4 Identify the signs and symptoms of hypoglycemia X6-2.5 Describe the care given to patients with hypoglycemia

X6-2.6Determine if D/50/W is indicated in a given patient scenario with several signs and symptoms identified

X6-2.7List the complications or side effects associated with the administration of D/50/W

INTRAVENOUS INFUSION THERAPY 4 0 0X6-3.1 Discuss fluid replacement, the types of fluid that are available, the benefits and detrimental effects of each. X6-3.2 Discuss how fluid replacement is monitored and controlled. X6-3.3 Discuss the routes of fluid replacement and the advantages and disadvantages of each. X6-3.4 Describe the indications, equipment needed, techniques. utilized, precautions, and general principles of peripheral venous cannulation. X6-3.5 Describe the purpose, equipment needed, techniques utilized, complications, and general principles for obtaining a blood sample. X6-3.6 Describe disposal of contaminated items and sharps. X6-3.7 Define the term “intravenous cannulation”

X6-3.8 Recall the indications and contraindications for IV cannulation

X6-3.9Identify the equipment and supplies needed to perform an IV cannulation

X6-3.10Select preferred solutions for use in the management of both medical and trauma patients

X6-3.11Select the appropriate administration to be used for various medical and trauma patients

X6-3.12Describe the methods used to determine the proper IV flow rate

X6-3.13State the proper ratio of fluid replacement to blood loss in hypovolemic patients

X6-3.14List and discuss the advantages, disadvantages and complications associated with use of peripheral veins

X6-3.15 Identify the veins commonly used for IV sites X6-3.16 Recall the steps top be followed to establish a peripheral IV

X6-3.17

Determine problems associated with an IV that is not functioning properly to determine the cause and correct the problem

X6-3.18 Discuss complications associated with IV therapy INTRAOSSEOUS INFUSION THERAPY 4 0 0X6-4.1

Describe the indications, equipment needed, techniques utilized, precautions, and general principles of intraosseous needle placement and infusion.

X6-4.2Identify the five conditions that must exist prior to considering intraosseous needle place

X6-4.3From a list of l0 patient situations, determine those in which an intraosseous infusion is indicated

X6-4.4 Identify on a diagram the proper location for needle placement

X6-4.5

Identify on a diagram the pertinent anatomical landmark (s ) referenced in performing intraosseous needle placement including the tibial tuberosity, the epiphyseal plate and the medial malleolus

X6-4.6 Identify on a diagram the internal anatomy of a bone to include: the periosteum, the yellow marrow cavity, the red marrow cavities, and the emissary veins

X6-4.7From a list of equipment, select the appropriate devices and supplies for performing an intraosseous infusion

X6-4.8

From a list of drugs and fluids, identify those which should not be infused or should be infused with caution via the intraosseous route

X6-4.9Identify four potential complications of intraosseous infusion therapy

X6-4.10Identify three relative or absolute contraindications to intraosseous infusion therapy

X6-4.11List, in proper sequence, the steps in performing an intraosseous infusion

X6-4.12Affirm the rationale for placement of an intraosseous needle in an infant or toddler

X6-4.13

Describe which laboratory samples are drawn in the field when the IV is started and their usefulness.

IV/IO INFUSION THERAPY (Lab) 0 8 0X6-5.1 Demonstrate cannulation of peripheral veins.

X6-5.2 Demonstrate the proper technique to insert an intravenous catheter.

X6-5.3Demonstrate the steps involved in establishing and discontinuing an IV

X6-5.4 Demonstrate intraosseous needle placement and infusion.

X6-5.5Demonstrate how to locate the primary and three alternate sites for establishing an I.O. infusion

X6-5.6Demonstrate preparing the patient and necessary equipment for an I.O. infusion

X6-5.7Using an I.O. mannequin demonstrate correct placement of an I.O. infusion and infuse 5cc of fluid

X6-5.8Demonstrate at least two methods of rapid infusion of fluids through an intraosseous site

X6-5.9Demonstrate how to properly troubleshoot a malfunctioning I.O. infusion

X6-5.10Demonstrate the steps in properly discontinuing an I.O. infusion

X6-5.11 Perfect disposal of contaminated items and sharps. SHOCK/TRAUMA 8 0 0X6-6.1 Describe the problems that occur with decreased perfusion. X6-6.2 Define shock based on aerobic and anaerobic metabolism X6-6.3 Discuss the prevention of anaerobic metabolism.

X6-6.4Discuss red blood cell oxygenation in the lungs based on alveolar O2 levels and transportation across the alveolar capillary wall.

X6-6.5Discuss tissue oxygenation based on tissue perfusion and release of oxygen.

X6-6.6Discuss the role played by respiration, inadequate ventilation in the management of shock.

X6-6.7Describe perfusion and the mechanisms of improvement of cardiac output based on the strength and rate of contractions.

X6-6.8Discuss the fluid component of the cardiovascular system and the relationship between the volume of the fluid and the size of the container.

X6-6.9

Discuss the systemic vascular resistance, the relationship of diastolic pressure to the SVR and the effect of diastolic pressure on coronary circulation.

X6-6.10Discuss the container size in its relationship to the fluid volume and the effect on blood returning to the heart.

X6-6.11Discuss body fluids based on total body water, intracellular fluid, and extracellular fluid.

X6-6.12 Identify the significant anions and cations in the body. X6-6.13 Describe the role of protein.

X6-6.14Discuss osmosis. Define semi-permeable membranes, and discuss their function.

X6-6.15 Define isotonic fluids, hypotonic fluids, and hypertonic fluids. X6-6.16 Define and discuss diffusion. X6-6.17 Define active transport. X6-6.18 Describe the mechanisms of concentration of electrolytes. X6-6.19 Define acid-base balance.

X6-6.20Discuss acid-base balance based on hydrogen concentration, pH, and buffer systems.

X6-6.21 Define and discuss the following: - Respiratory acidosis - Respiratory alkalosis

- Metabolic acidosis - Metabolic alkalosis. X6-6.22 Describe the mechanism of the body response to perfusion change. X6-6.23 Identify the role of the baroreceptor.

X6-6.24Describe how the actions of the baroreceptor affect blood pressure and perfusion.

X6-6.25 Describe compensated shock. X6-6.26 Describe uncompensated shock, both cardiac and peripheral effects.

X6-6.27

Describe the information provided by the following in physical examination: pulse, blood pressure, diastolic pressure, systolic pressure, skin color, appearance, temperature, and respiration.

X6-6.28 Define the following terms that refer to cardiac physiology: - Stroke volume - Starling’s Law - Preload - Afterload - Cardiac output - Blood pressure X6-6.29 Discuss the assessment of the patient’s perfusion status, based on

physical observations within the initial assessment, including pulse, skin, temperature, and capillary refill time.

X6-6.30 List three signs associated with a skull fracture

X6-6.31Discuss the relationship of the neurological exam to assessment of hypoperfusion and oxygenation.

X6-6.32 Describe Cheyne-Stokes respirations X6-6.33 Describe the Cushing reflex X6-6.34 Describe decorticate and decerebrate posturing X6-6.35 Describe a flail chest X6-6.36 List three signs of a pneumothorax

X6-6.37List two early and three late signs or symptoms of a tension pneumothorax

X6-6.38Describe the position for a pregnant trauma patient to be placed to optimize the venous return to her heart

X6-6.39Discuss the benefits and complications of hemorrhage control by the following means:

- Direct pressure - Tourniquets - Hemostats

X6-6.40Describe the anatomy of the skin, bones, vessels, and subcutaneous tissue as it relates to hemorrhage control.

SHOCK MANAGEMENT/PT ASSESSMENT LAB 0 8 0X6-7.1 Discuss management of a patient in shock, to include: red cell oxygenation, tissue ischemic sensitivity, IV fluids, and the pneumatic anti-shock garment

X6-7.2Describe the beneficial and detrimental effects of the pneumatic antishock garment.

X6-7.3Describe the indications and contraindications for the pneumatic antishock garment.

X6-7.4Discuss fluid replacement, the types of fluid that are available, the benefits and detrimental effects of each.

X6-7.5 Discuss how fluid replacement is monitored and controlled.

X6-7.6Discuss the routes of fluid replacement and the advantages and disadvantages of each.

X6-7.7 Demonstrate in order of priority the steps of shock resuscitation.

X6-7.8 Demonstrate the use of the pneumatic antishock garment (PASG).

X6-7.9

Describe how a patient is packaged and stabilized for transportation to the hospital, including airway ventilation, IV fluids, pneumatic anti-shock garment, fracture stabilization, bandaging.

X6-7.10 Identify the need for intervention and transport of the patient patient with compensated shock. X6-7.11 Discuss the treatment plan and management of compensated shock. Didactic Review and Practical Skills Lab 2 2 0 Demonstrate competency of module components FINAL EXAM for Medical Emergencies for the EMT-Intermediate 2 4 0

Written Examination Practical Examination

TOTAL HOURS 28 24 0

EMS XX7 Hazardous Materials, Vehicle Extrication Process, Patient Assessment/ Initial Management

Course DescriptionThis course covers the U.S. Department of Transportation 1985 Emergency Medical Technician - Intermediate Curriculum. Topics include: hazardous material awareness level I (GEMA), patient handling (FTO), vehicle extrication lab (FTO) and General Patient Assessment and Initial Management


Hazardous Material Awareness Level I (GEMA) Class 33Patient Handling (FTO) D. Lab 15Vehicle Extrication Lab (FTO) P. Lab/O.B.I. 0General Patient Assessment and Initial Management Credit 3

Prerequisite: EMS XX1, EMS XX2, EMS XX3, EMS XX4, EMS XX5, EMS XX6Corequisite:

Course Guide


Hours


Hazardous Material Awareness Level I (GEMA) 6 2 0

X7-1.1Define the different types of hazardous substances and identify the risks associated with each in an incident

X7-1.2 Given simulated incident, identify the potential outcomes

X7-1.3Given the data available during an incident response, identify hazardous substances present

X7-1.4

Define the role of the first responder awareness individual in an employing agency’s emergency response plan including site security and control and the U.S. D. O.T. Emergency Response Guidebook

X7-1.5Given a simulated incident, determine the need for additional resources and make appropriate notifications to the communications center.

X7-1.6Given the data available during an incident response, demonstrate recognition of the presence of hazardous substances

PATIENT HANDLING (FTO) 0 4 0

X7-2.1

Given a scenario, and working as a team, demonstrate the rapid trauma assessment that should be used to assess a patient based on mechanism of injury.

X7-2.2

Given a scenario, and working as a team, demonstrate the patient assessment skills that should be used to assist a patient who is responsive with no known history.

X7-2.3

Given a scenario, and working as a team, demonstrate the patient assessment skills that should be used to assist a patient who is unresponsive or has an altered metal status.

X7-2.4

Given a scenario and working with a team of partners, The student shall demonstrate the ability to prepare a patient for transfer to any of the following appropriate devices, properly position the patient on the device, move the device to the stretcher for

Wheeled ambulance stretcher KEB/ Short spinal immobilization device Long spine board

Basket stretcher Vehicle Extrication Lab (FTO) 0 4 0X7-3.1 Describe the purpose of extrication

X7-3.2Identify what equipment for personal safety is required for the EMT-Basic/EMT-Intermediate

X7-3.3 Define the fundamental components of extrication

X7-3.4State the steps that should be taken to protect the patient during an extrication procedure

X7-3.5 Demonstrate the safety procedures during an extrication operation.

X7-3.6Demonstrate the various tools and techniques used to accomplish an extrication operation.

General Patient Assessment and Initial Management 24 0 0X7-4.1 Discuss the importance of body substance isolation (BSI). X7-4.2 Describe the steps the EMT-Basic/Intermediate should take for personal protection from airborne and bloodborne pathogens. X7-4.3 List the personal protective equipment necessary for each of the following situations: - Hazardous materials - Rescue operations - Violent scenes - Crime scenes - Exposure to bloodborne pathogens - Exposure to airborne pathogens X7-4.4 Describe orthostatic vital signs and evaluate their usefulness in assessing a patient in shock. X7-4.5 Describe the anatomy and function of the following major body systems: Respiratory circulatory musculoskeletal nervous endocrine X7-4.6 Apply the techniques of physical examination to the medical patient. X7-4.7 Apply the techniques of a physical examination to the trauma patient. X7-4.8 Discuss the reason for performing a focused history and physical exam X7-4.9 Describe when and why a detailed physical examination is necessary. X7-4.10 Describe the normal and abnormal assessment findings of the head (including the scalp, skull, face, and skin). X7-4.11 Describe the examination of the head (including the scalp, skull, face, and skin). X7-4.12 Describe the examination of the neck and cervical spine. X7-4.13 Differentiate normal and abnormal assessment findings of the neck and cervical spine. X7-4.14 Describe the inspection, palpation, percussion, and auscultation of the chest. X7-4.15 Describe the examination of the thorax and ventilation. X7-4.16 Describe the examination of the anterior and posterior chest. X7-4.17 Differentiate normal and abnormal assessment findings of the chest examination. X7-4.18 Describe the examination of the abdomen. X7-4.19 Differentiate normal and abnormal assessment findings of the abdomen.

X7-4.20 Describe the examination of the female external genitalia. X7-4.21 Differentiate normal and abnormal assessment findings of the female external genitalia. X7-4.22 Describe the examination of the male genitalia. X7-4.23 Differentiate normal and abnormal findings of the male genitalia. X7-4.24 Describe the examination of the extremities. X7-4.25 Differentiate normal and abnormal findings of the extremities. X7-4.26 Describe the examination of the peripheral vascular system. X7-4.27 Differentiate normal and abnormal findings of the peripheral vascular system. X7-4.28 Describe the examination of the nervous system. X7-4.29 Differentiate normal and abnormal findings of the nervous system. X7-4.30 Identify the general principles regarding the importance of EMS documentation and ways in which documents are used. X7-4.31 Develop, execute, and evaluate a treatment plan based on the field impression for the hemorrhage or shock patient. X7-4.32 Define the term “cardiac arrest.” X7-4.33 Describe the purpose, equipment needed, techniques utilized, complications, and general principles for obtaining a blood sample. X7-4.34 Discuss the pathophysiology of injury to the lung, including: a. Simple pneumothorax b. Open pneumothorax c. Tension pneumothorax X7-4.35 Discuss the management of lung injuries. X7-4.36 Discuss the pathophysiology of diaphragmatic injuries. X7-4.37 Discuss the management of diaphragmatic injuries. X7-4.38 Discuss the epidemiology and pathophysiology of specific chest wall injuries, including a Flail segment. X7-4.39 Discuss the management of chest wall injuries. X7-4.40 State methods of emergency medical care of external bleeding. Didactic Review and Practical Skills Lab 2 2 0 Demonstrate competency of module components FINAL EXAM for Medical Emergencies for the EMT-Intermediate 1 3 0 Written Examination Practical Examination TOTAL HOURS 33 15 0

EMS XX8 – Summative Evaluations for the EMT-Intermediate

Course DescriptionThis is the final course for those pursuing EMT-Intermediate Certification. The course will include clinical hours to be spent in both Hospital Emergency Departments and on Ambulance Clinical Rotations. This class will also contain a Comprehensive review of the US DOT EMT-Basic 1994 Curriculum as well as the US DOT EMT-Intermediate 1985 Curriculum. The course will include a comprehensive written and practical exam that will serve to verify the students’ competencies before being allowed to sit for the National Registry Intermediate-1985 Exam. Topics will include review of both the EMT-B 1994 and EMT-I 1985 Curricula, Assessment/Management Review for Trauma & Medical & OB/Peds and a NREMT examination review.


Intermediate Clinical Skills Requirements Class 12Program Didactic Review D. Lab 22Trauma Emergencies – Assessment/Management Review P. Lab/O.B.I. 32Medical Emergencies – Assessment/Management Review Credit 3OB/Peds Emergencies – Assessment/Management ReviewNational Registry Skills Review

Prerequisite: EMS XX1, EMS XX2, EMS XX3, EMS XX4, EMS XX5, EMS XX6Corequisite: EMS XX7

Course Guide


Hours


INTERMEDIATE CLINICAL SKILLS REQUIREMENTS 0 0 32X8-8.1 Demonstrate the skills involved in assessment of breathing.(P-1,2) [5] X8-8.2 Demonstrate the skills associated with obtaining a pulse. (P-1,2) [5] X8-8.3 Demonstrate the skills associated with assessing the skin color, temperature, condition, and capillary refill in infants and children.(P-1,2) [5] X8-8.4 Demonstrate the skills associated with assessing the pupils. (P-1,2) [5] X8-8.5 Demonstrate the skills associated with obtaining blood pressure.(P-1,2) [5] X8-8.6 Demonstrate the skills that should be used to obtain information from the patient, family, or bystanders at the scene. (P-1,2) [5] X8-8.7 Working with a partner, prepare each of the following devices for use, transfer a patient to the device, properly position the patient on the device move the device to the ambulance and load the patient into the ambulance: · Wheeled ambulance stretcher [2] · Portable ambulance stretcher · Stair chair · Scoop stretcher · Long spine board · Basket stretcher · Flexible stretcher (P-1,2) X8-8.8 Working with a partner, the EMT-Intermediate will demonstrate techniques for the transfer of a patient from an ambulance stretcher to a hospital stretcher.(P-1,2) [2] X8-8.9 Demonstrate the correct operation of oxygen tanks and regulators.(P-1,2) [1] X8-8.10 Demonstrate the use of a nonrebreather face mask and state the oxygen flow

requirements needed for its use.(P-1,2) [1]

X8-8.11 Demonstrate the use of a nasal cannula and state the flow requirements

needed for its use.(P-1,2) [1] X8-8.12 Observe various scenarios and identify potential hazards. (P-1) [5] X8-8.13 Demonstrate the techniques for assessing mental status.(P-1,2) [5] X8-8.14 Demonstrate the techniques for assessing the airway.(P-1,2) [5]

X8-8.15Demonstrate the techniques for assessing the patient for external bleeding.(P-1,2) [5]

X8-8.16 Demonstrate the ability to prioritize patients.(P-1,2) [5] X8-8.17 Demonstrate the rapid trauma assessment that should be used to assess a patient based on mechanism of injury.(P-1,2) [1] X8-8.18 Demonstrate the patient care skills that should be used to assist with a patient who is responsive with no known history.(P-1,2) [1] X8-8.19 Demonstrate the patient care skills that should be used to assist with a patient who is unresponsive or has an altered metal status.(P-1,2) [1]

X8-8.20Demonstrate the skills involved in performing the detailed physical exam.(P-1,2) [1]

X8-8.21 Demonstrate the skills involved in performing the on-going assessment.(P-1,2) [1] X8-8.22 Perform a simulated, organized, concise radio transmission.(P-2) [1] X8-8.23 Perform an organized, concise patient report that would be given to the staff at a receiving facility.(P-2) [1]

X8-8.24Complete a prehospital care report.(P-2) [5 of school/unofficial forms of documentation]

PROGRAM DIDACTIC REVIEW 8 0 0 Review the EMT-B 1994 and EMT-I 1985 Curriculums, didactic components. Trauma Emergencies – Assessment/Management Review 0 2 0Medical Emergencies – Assessment/Management Review 0 2 0OB/Peds Emergencies – Assessment/Management Review 0 2 0National Registry Skills Review 0 10 0

Demonstrate all skills consistent with those that will be tested on the practical portion of the NREMT I-85 Exam.

EMT-INTERMEDIATE COMPREHENSIVE PROGRAM FINAL WRITTEN EXAM 4 0 0EMT-INTERMEDIATE COMPREHENSIVE PROGRAM FINAL PRACTICAL EXAM 0 4 0

TOTAL HOURS 12 20 32

Curriculum ModelSuggested Course Sequences

The standard curriculums for Enter Program Name, Award Level(s), program are set up on the quarter system. A suggested sequence for the programs is given below with area of specialization. Technical colleges may implement the program by using the sequences listed below or by using a locally developed sequence designed to reflect course prerequisites and/or corequisites.

Suggested SequencesEnter Program Name, Award Level

This is a proposed 4 quarter EMT-Intermediate Program, with a EMT-Basic Exit Point after the end of the Second Quarter.

First Quarter

Course Code Occupational Course Title

ClassHours

DLab

Hours

P/Lab/O

BIHours

Contact

HoursCreditHours

EMS XX1 Introduction to the EMT Profession 32 8 0 40 3

EMS XX2 Patient Assessment and Airway for the EMT 24 20 0 44 3

Minimum Required Hours: 56 28 0 88 6

Second Quarter


ClassHours

DLab

Hours

P/Lab/O

BIHours

Contact

HoursCreditHours

EMS XX3

Medical/Behavrioal and OB/Peds Emerengcy for the EMT 31 21 0 52 4

EMS XX4 Trauma Emergencies for the EMT 20 14 0 34 2

EMS XX5 Summative Evaluations for the EMT – Basic 12 20 32 64 3


Third Quarter


ClassHours

DLab

Hours

P/Lab/O

BIHours

Contact

HoursCreditHours

EMS XX6

Pharmacology and Shock/Trauma Management for the EMT - Intermediate 25 24 0 52 3


Fourth Quarter


ClassHours

DLab

Hours

P/Lab/O

BIHours

Contact

HoursCreditHours

EMS XX7 Medical Emergency for the EMT- Intermediate 33 15 0 48 3

EMS XX8

Summative Evaluations for the EMT- Intermediate 12 20 32 64 3


This is the preferred 4 quarter proposal. EMT-Basic 1994 NSC curriculum is 2 qtrs. and 3 1/2 weeks of 3rd (XX1-XX5). Qtr. And totals 15 credits hrs. The intermediate 1985 NSC curriculum entails the last 6 1/2 weeks of 3rd qtr. And all of 4th quarter (XX6-XX8) for a total of 9 credits hrs. Total Program is still 24 credit hrs.

First Quarter


ClassHours

DLab

Hours

P/Lab/O

BIHours

Contact

HoursCreditHours




Second Quarter


ClassHours

DLab

Hours

P/Lab/O

BIHours

Contact

HoursCreditHours

EMS XX3




Third Quarter


ClassHours

DLab

Hours

P/Lab/O

BIHours

Contact

HoursCreditHours


EMS XX6



Fourth Quarter


ClassHours

DLab

Hours

P/Lab/O

BIHours

Contact

HoursCreditHours


EMS XX8



Under This 3 Qtr Format, Classes would meet 3 nights/week (4 HR Sessions) in 1st and 3rd qtrs. with two 7 hr Saturdays in each qtr. In 2nd qtr classes could meet two nights/week for 3HRS each session.

First Quarter


ClassHours

DLab

Hours

P/Lab/O

BIHours

Contact

HoursCreditHours



EMS XX3



Second Quarter


ClassHours

DLab

Hours

P/Lab/O

BIHours

Contact

HoursCreditHours




Third Quarter


ClassHours

DLab

Hours

P/Lab/O

BIHours

Contact

HoursCreditHours

EMS XX6



EMS XX8



Under an Accelerated format, the program could be taught in 41- 8Hr sessions plus 8-8hr clinical rotations. A 5 day per week format could complete the program in 9 weeks and 4 days. A 3 day per week format could be taught in 16 weeks and 2 days.


ClassHours

DLab

Hours

P/Lab/O

BIHours

Contact

HoursCreditHours


EMS XX2 Patient Assessment and Airway For the EMT 24 20 0 44 3

EMS XX3

Medical/Behavioral & OB Peds Emergencies for the EMT 30 20 0 50 4


EMS XX5 Summative Evaluations for EMT Basic 12 20 32 64 3

EMS XX6

Pharmacology and Shock/Trauma Management for the EMT Intermediate 28 24 0 52 3

EMS XX7

Medical Emergencies for the EMT Intermediate 33 15 0 48 3

EMS XX8 Summative Evaluations for EMT Intermediate 12 20 32 64 3


Documents

Proposed Term Year Standards Revisions · Web viewEmergency Medical Technician - Intermediate. Technical Certificate of Credit Proposed Revisions: In the spring of 2004, a group