Standard

EMS 126 - Introduction to the Paramedic Profession

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Course Description

Introduces the student to the paramedic profession. Discussion centers on functions that extend beyond the EMT scope of practice. Topics include: the EMS system/roles and responsibilities, well-being of the paramedic, illness and injury prevention, medical/legal considerations, ethics, ambulance operations, medical incident command, rescue awareness/operations, hazardous materials incidents and crime scene awareness. This course provides instruction on topics in Division 1, Sections 1-5, Division 7, Section 1 and Division 8 sections 1-5 of the USDOT/NHTSA Paramedic National Standard Curriculum.

Competency Areas		Hours
EMS System/Roles and Responsibilities		Class	3
Well-Being of the Paramedic		D. Lab	1
Illness and Injury Prevention		P. Lab/O.B.I.	0
Medical/Legal Issues Ethics Ambulance Operations Medical Incident Command Rescue Awareness/Operations Hazardous Materials Crime Scene Awareness		Credit	3
Prerequisite:	Program admission
Corequisites:	ENG 101, MAT 101, AHS 101, SCT 100

Course Guide

Competency	After completing this section, the student will:	Hours
		Class	D.Lab	P.Lab/ O.B.I.
EMS SYSTEM/ROLES AND RESPONSIBILITIES		6	2	0
	Define the following terms: 1. EMS Systems 2. Licensure 3. Certification 4. Registration 5. Profession 6. Professionalism 7. Health care professional 8. Ethics 9. Peer review 10. Medical direction k. Protocols
	Describe key historical events that influenced the development of national Emergency Medical Services (EMS) systems.
	Identify national groups important to the development, education, and implementation of EMS.
	Differentiate among the four nationally recognized levels of EMS training/education, leading to licensure/ certification/ registration.
	Describe the recognized levels of EMS training/ education, leading to licensure/certification in his or her state.
	Describe the attributes of a paramedic as a health care professional.
	Explain paramedic licensure/certification, recertification, and reciprocity requirements in his or her state.
	Evaluate the importance of maintaining one’s paramedic license/certification.
	Describe the benefits of paramedic continuing education.
	List current state requirements for paramedic education in his/her state.
	Discuss the role of national associations and of a national registry agency.
	Discuss current issues in his/her state impacting EMS.
	Discuss the roles of various EMS standard setting agencies
	Identify the standards (components) of an EMS System as defined by the National Highway Traffic Safety Administration.
	Describe how professionalism applies to the paramedic while on and off duty.
	Describe examples of professional behaviors in the following areas: integrity, empathy, self-motivation, appearance and personal hygiene, self-confidence, communications, time management, teamwork and diplomacy, respect, patient advocacy, and careful delivery of service.
	Provide examples of activities that constitute appropriate professional behavior for a paramedic.
	Describe the importance of quality EMS research to the future of EMS.
	Identify the benefits of paramedics teaching in their community.
	Describe what is meant by "citizen involvement in the EMS system."
	Analyze how the paramedic can benefit the health care system by supporting primary care to patients in the out-of-hospital setting.
	List the primary and additional responsibilities of paramedics.
	Describe the role of the EMS physician in providing medical direction.
	Describe the benefits of medical direction, both on-line and off-line.
	Describe the process for the development of local policies and protocols.
	Provide examples of local protocols.
	Discuss pre-hospital and out-of-hospital care as an extension of the physician.
	Describe the relationship between a physician on the scene, the paramedic on the scene, and the EMS physician providing on-line medical direction.
	Describe the components of continuous quality improvement.
	Analyze the role of continuous quality improvement with respect to continuing medical education and research.
	Define the role of the paramedic relative to the safety of the crew, the patient, and bystanders.
	Identify local health care agencies and transportation resources for patients with special needs.
	Describe the role of the paramedic in health education activities related to illness and injury prevention.
	Describe the importance and benefits of research.
	Explain the EMS provider’s role in data collection.
	Explain the basic principles of research.
	Describe a process of evaluating and interpreting research.
	Assess personal practices relative to the responsibility for personal safety, the safety of the crew, the patient, and bystanders.
	Serve as a role model for others relative to professionalism in EMS.
	Value the need to serve as the patient advocate inclusive of those with special needs, alternate life styles and cultural diversity.
	Defend the importance of continuing medical education and skills retention.
	Advocate the need for supporting and participating in research efforts aimed at improving EMS systems.
	Assess personal attitudes and demeanor that may distract from professionalism.
	Value the role that family dynamics play in the total care of patients.
	Advocate the need for injury prevention, including abusive situations.
	Exhibit professional behaviors in the following areas: integrity, empathy, self-motivation, appearance and personal hygiene, self-confidence, communications, time management, teamwork and diplomacy, respect, patient advocacy, and careful delivery of service.
THE WELL-BEING OF THE PARAMEDIC		3	1	0
	At the completion of this unit, he paramedic student will understand and value the importance of personal wellness in EMS and serve as a healthy role model for peers.
	Discuss the concept of wellness and its benefits.
	Define the components of wellness.
	Describe the role of the paramedic in promoting wellness.
	Discuss the components of wellness associated with proper nutrition.
	List principles of weight control.
	Discuss how cardiovascular endurance, muscle strength, and flexibility contribute to physical fitness.
	Describe the impact of shift work on circadian rhythms.
	Discuss how periodic risk assessments and knowledge of warning signs contribute to cancer and cardiovascular disease prevention.
	Differentiate proper from improper body mechanics for lifting and moving patients in emergency and non-emergency situations.
	Describe the problems that a paramedic might encounter in a hostile situation and the techniques used to manage the situation.
	Given a scenario involving arrival at the scene of a motor vehicle collision, assess the safety of the scene and propose ways to make the scene safer.
	List factors that contribute to safe vehicle operations.
	Describe the considerations that should be given to: a. Using escorts b. Adverse environmental conditions c. Using lights and siren 1. Proceeding through intersections e. Parking at an emergency scene
	Discuss the concept of "due regard for the safety of all others" while operating an emergency vehicle.
	Describe the equipment available for self-protection when confronted with a variety of adverse situations.
	Describe the benefits and methods of smoking cessation.
	Describe the three phases of the stress response.
	List factors that trigger the stress response.
	Differentiate between normal/healthy and detrimental reactions to anxiety and stress.
	Describe the common physiological and psychological effects of stress.
	Identify causes of stress in EMS.
	Describe behavior that is a manifestation of stress in patients and those close to them and how these relate to paramedic stress.
	Identify and describe the defense mechanisms and management techniques commonly used to deal with stress.
	Describe the components of critical incident stress management (CISM).
	Provide examples of situations in which CISM would likely be beneficial to paramedics.
	Given a scenario involving a stressful situation, formulate a strategy to help cope with the stress.
	Describe the stages of the grieving process (Kubler-Ross).
	Describe the needs of the paramedic when dealing with death and dying.
	Describe the unique challenges for paramedics in dealing with the needs of children and other special populations related to their understanding or experience of death and dying.
	Discuss the importance of universal precautions and body substance isolation practices.
	Describe the steps to take for personal protection from airborne and blood borne pathogens.
	Given a scenario in which equipment and supplies have been exposed to body substances, plan for the proper cleaning, disinfection, and disposal of the items.
	Explain what is meant by an exposure and describe principles for management.
	Advocate the benefits of working toward the goal of total personal wellness.
	Serve as a role model for other EMS providers in regard to a total wellness lifestyle.
	Value the need to assess his/her own lifestyle.
	Challenge himself/herself to each wellness concept in his/her role as a paramedic.
	Defend the need to treat each patient as an individual, with respect and dignity.
	Assess his/her own prejudices related to the various aspects of cultural diversity.
	Improve personal physical well being through achieving and maintaining proper body weight, regular exercise and proper nutrition.
	Promote and practice stress management techniques.
	Defend the need to respect the emotional needs of dying patients and their families.
	Advocate and practice the use of personal safety precautions in all scene situations.
	Advocate and serve as a role model for other EMS providers relative to body substance isolation practices.
	Demonstrate safe methods for lifting and moving patients in emergency and non-emergency situations.
	Demonstrate the proper procedures to take for personal protection from disease.
ILLNESS AND INJURY PREVENTION		3	1	0
	At the completion of this unit, the paramedic student will be able to integrate the implementation of primary injury prevention activities as an effective way to reduce death, disabilities and health care costs.
	Describe the incidence, morbidity and mortality of unintentional and alleged unintentional events.
	Identify the human, environmental, and socioeconomic impact of unintentional and alleged unintentional events.
	Identify health hazards and potential crime areas within the community.
	Identify local municipal and community resources available for physical, socioeconomic crises.
	List the general and specific environmental parameters that should be inspected to assess a patient's need for preventative information and direction.
	Identify the role of EMS in local municipal and community prevention programs.
	Identify the local prevention programs that promote safety for all age populations.
	Identify patient situations where the paramedic can intervene in a preventative manner.
	Document primary and secondary injury prevention data.
	Value and defend tenets of prevention in terms of personal safety and wellness.
	Value and defend tenets of prevention for patients and communities being served.
	Value the contribution of effective documentation as one justification for funding of prevention programs.
	Value personal commitment to success of prevention programs.
	Demonstrate the use of protective equipment appropriate to the environment and scene.
MEDICAL/LEGAL ISSUES		3	1	0
	At the completion of this unit, the paramedic student will understand the legal issues that impact decisions made in the out-of-hospital environment.
	Differentiate between legal and ethical responsibilities.
	Describe the basic structure of the legal system in the United States.
	Differentiate between civil and criminal law as it pertains to the paramedic.
	Identify and explain the importance of laws pertinent to the paramedic.
	Differentiate between licensure and certification as they apply to the paramedic.
	List the specific problems or conditions encountered while providing care that a paramedic is required to report, and identify in each instance to whom the report is to be made.
	Define the following terms: a. Abandonment b. Advance directives c. Assault d. Battery e. Breach of duty f. Confidentiality g. Consent (expressed, implied, informed, involuntary) h. Do not resuscitate (DNR) orders i. Duty to act j. Emancipated minor k. False imprisonment l. Immunity m. Liability n. Libel o. Minor p. Negligence q. Proximate cause r. Scope of practice s. Slander t. Standard of care u. Tort
	Differentiate between the scope of practice and the standard of care for paramedic practice.
	Discuss the concept of medical direction, including off-line medical direction and on-line medical direction, and its relationship to the standard of care of a paramedic.
	Describe the four elements that must be present in order to prove negligence.
	Given a scenario in which a patient is injured while a paramedic is providing care, determine whether the four components of negligence are present.
	Given a scenario, demonstrate patient care behaviors that would protect the paramedic from claims of negligence.
	Explain the concept of liability as it might apply to paramedic practice, including physicians providing medical direction and paramedic supervision of other care providers.
	Discuss the legal concept of immunity, including Good Samaritan statutes and governmental immunity, as it applies to the paramedic.
	Explain the importance and necessity of patient confidentiality and the standards for maintaining patient confidentiality that apply to the paramedic.
	Differentiate among expressed, informed, implied, and involuntary consent.
	Given a scenario in which a paramedic is presented with a conscious patient in need of care, describe the process used to obtain consent.
	Identify the steps to take if a patient refuses care.
	Given a scenario, demonstrate appropriate patient management and care techniques in a refusal of care situation.
	Describe what constitutes abandonment.
	Identify the legal issues involved in the decision not to transport a patient, or to reduce the level of care being provided during transportation.
	Describe how hospitals are selected to receive patients based on patient need and hospital capability and the role of the paramedic in such selection.
	Differentiate between assault and battery and describe how to avoid each.
	Describe the conditions under which the use of force, including restraint, is acceptable.
	Explain the purpose of advance directives relative to patient care and how the paramedic should care for a patient who is covered by an advance directive.
	Discuss the responsibilities of the paramedic relative to resuscitation efforts for patients who are potential organ donors.
	Describe the actions that the paramedic should take to preserve evidence at a crime or accident scene.
	Describe the importance of providing accurate documentation (oral and written) in substantiating an incident.
	Describe the characteristics of a patient care report required to make it an effective legal document.
	Given a scenario, prepare a patient care report, including an appropriately detailed narrative.
	Advocate the need to show respect for the rights and feelings of patients.
	Assess his/her personal commitment to protecting patient confidentiality.
	Given a scenario involving a new employee, explain the importance of obtaining consent for adults and minors.
	Defend personal beliefs about withholding or stopping patient care.
	Defend the value of advance medical directives.
ETHICS		3	1	0
	At the completion of this unit, the paramedic student will understand the role that ethics plays in decision-making in the out-of-hospital environment.
	Define ethics.
	Distinguish between ethical and moral decisions.
	Identify the premise that should underlie the paramedic's ethical decisions in out-of hospital care.
	Analyze the relationship between the law and ethics in EMS.
	Compare and contrast the criteria that may be used in allocating scarce EMS resources.
	Identify the issues surrounding the use of advance directives, in making a pre-hospital resuscitation decision.
	Describe the criteria necessary to honor an advance directive in your state.
	Value the patient's autonomy in the decision-making process.
	Defend the following ethical positions: 1. The paramedic is accountable to the patient. 1. The paramedic is accountable to the medical director. 2. The paramedic is accountable to the EMS system. d. The paramedic is accountable for fulfilling the standard of care.
	Given a scenario, defend or challenge a paramedic's actions concerning a patient who is treated against his/ her wishes.
	Given a scenario, defend a paramedic's actions in a situation where a physician orders therapy the paramedic feels to be detrimental to the patient's best interests.
AMBULANCE OPERATIONS		3	1	0
	At the completion of this unit, the paramedic will understand standards and guidelines that help ensure safe and effective ground and air medical transport.
	Identify current local and state standards which influence ambulance design, equipment requirements and staffing of ambulances.
	Discuss the importance of completing an ambulance equipment/supply checklist.
	Discuss the factors to be considered when determining ambulance stationing within a community.
	Describe the advantages and disadvantages of air medical transport.
	Identify the conditions/situations in which air medical transport should be considered.
	Assess personal practices relative to ambulance operations, which may affect the safety of the crew, the patient and bystanders.
	Serve as a role model for others relative to the operation of ambulances.
	Value the need to serve as the patient advocate to ensure appropriate patient transportation via ground or air.
	Demonstrate how to place a patient in, and remove a patient from, an ambulance.
MEDICAL INCIDENT COMMAND		3	1	0
	At the completion of this unit, the paramedic student will be able to integrate the principles of general incident management and multiple casualty incident (MCI) management techniques in order to function effectively at major incidents.
	Explain the need for the incident management system (IMS)/incident command system (ICS) in managing emergency medical services incidents.
	Define the term multiple casualty incident (MCI).
	Define the term disaster management.
	Describe essential elements of scene size-up when arriving at a potential MCI.
	Describe the role of the paramedics and EMS systems in planning for MCIs and disasters.
	Define the following types of incidents and how they affect medical management: a. Open or uncontained incident b. Closed or contained incident
	Describe the functional components of the incident management system in terms of the following: a. Command b. Finance c. Logistics d. Operations e. Planning
	Differentiate between singular and unified command and when each is most applicable.
	Describe the role of command.
	Describe the need for transfer of command and procedures for transferring it.
	Differentiate between command procedures used at small, medium and large scale medical incidents.
	Explain the local/regional threshold for establishing command and implementation of the incident management system including threshold MCI declaration.
	List and describe the functions of the following groups and leaders in ICS as it pertains to EMS incidents: a. Safety b. Logistics c. Rehabilitation (rehab) d. Staging e. Treatment f. Triage g. Transportation h. Extrication/rescue i. Disposition of deceased (morgue) j. Communications
	Describe the methods and rationale for identifying specific functions and leaders for these functions in ICS.
	Describe the role of both command posts and emergency operations centers in MCI and disaster management.
	Describe the role of the physician at multiple casualty incidents.
	Define triage and describe the principles of triage.
	Describe the START (simple triage and rapid treatment) method of initial triage.
	Given a list of 20 patients with various multiple injuries, determine the appropriate triage priority with 90% accuracy.
	Given color coded tags and numerical priorities, assign the following terms to each: a. Immediate b. Delayed c. Hold d. Deceased
	Define primary and secondary triage.
	Describe when primary and secondary triage techniques should be implemented.
	Describe the need for and techniques used in tracking patients during multiple casualty incidents.
	Describe techniques used to allocate patients to hospitals and track them.
	Describe modifications of telecommunications procedures during multiple casualty incidents.
	List and describe the essential equipment to provide logistical support to MCI operations to include: a. Airway, respiratory and hemorrhage control b. Burn management c. Patient packaging/immobilization
	List the physical and psychological signs of critical incident stress.
	Describe the role of critical incident stress management sessions in MCIs.
	Describe the role of the following exercises in preparation for MCIs: a. Table top exercises b. Small and large MCI drills
	Understand the rationale for initiating incident command even at a small MCI event.
	Explain the rationale for having efficient and effective communications as part of an incident command/ management system.
	Explain why common problems of an MCI can have an adverse effect on an entire incident.
	Explain the organizational benefits for having standard operating procedures (SOPs) for using the incident management system or incident command system.
	Demonstrate the use of local/regional triage tagging system used for primary and secondary triage.
	Given a simulated tabletop multiple casualty incident, with 5-10 patients: a. Establish unified or singular command b. Conduct a scene assessment c. Determine scene objectives d. Formulate an incident plan e. Request appropriate resources f. Determine need for ICS expansion and groups g. Coordinate communications and groups leaders h. Coordinate outside agencies
	Demonstrate effective initial scene assessment and update (progress) reports.
	Given a classroom simulation of a MCI with 5-10 patients, fulfill the role of triage group leader.
	Given a classroom simulation of a MCI with 5-10 patients, fulfill the role of treatment group leader.
	Given a classroom simulation of a MCI with 5-10 patients, fulfill the role of transportation group leader.
RESCUE AWARENESS/OPERATIONS		3	1	0
	At the completion of this unit, the paramedic student will be able to integrate the principles of rescue awareness and operations to safely rescue a patient from water, hazardous atmospheres, trenches, highways, and hazardous terrain.
	Define the term rescue.
	Explain the medical and mechanical aspects of rescue situations.
	Explain the role of the paramedic in delivering care at the site of the injury, continuing through the rescue process and to definitive care.
	Describe the phases of a rescue operation.
	List and describe the types of personal protective equipment needed to safely operate in the rescue environment to include: a. Head protection b. Eye protection c. Hand protection d. Personal flotation devices e. Thermal protection/ layering systems f. High visibility clothing g. Specialized footwear
	Explain the differences in risk between moving water and flat water rescue.
	Explain the effects of immersion hypothermia on the ability to survive sudden immersion and self rescue.
	Explain the phenomenon of the cold protective response in cold water drowning situations.
	Identify the risks associated with low head dams and the rescue complexities they pose.
	Given a picture of moving water, identify and explain the following features and hazards associated with: a. Hydraulics b. Strainers c. Dams/hydro-electric sites
	Explain why water entry or go techniques are methods of last resort.
	Explain the rescue techniques associated with reach-throw-row-go.
	Given a list of rescue scenarios, identify the victim survivability profile and which are rescue versus body recovery situations.
	Explain the self rescue position if unexpectedly immersed in moving water.
	Given a series of pictures, identify which would be considered "confined spaces" and potentially oxygen deficient.
	Identify the hazards associated with confined spaces and risks posed to potential rescuers to include: a. Oxygen deficiency b. Chemical/ toxic exposure/ explosion c. Engulfment d. Machinery entrapment e. Electricity
	Identify components necessary to ensure site safety prior to confined space rescue attempts.
	Identify the poisonous gases commonly found in confined spaces to include: a. Hydrogen sulfide (H2S) b. Carbon dioxide (C02) c. Carbon monoxide (CO) d. Low/high oxygen concentrations (Fi02) e. Methane (CH4) f. Ammonia (NH3) g. Nitrogen dioxide (NO2)
	Explain the hazard of cave-in during trench rescue operations.
	Describe the effects of traffic flow on the highway rescue incident including limited access superhighways and regular access highways.
	List and describe the following techniques to reduce scene risk at highway incidents: a. Apparatus placement b. Headlights and emergency vehicle lighting c. Cones, flares d. Reflective and high visibility clothing
	List and describe the hazards associated with the following auto/truck components: a. Energy absorbing bumpers b. Air bag/supplemental restraint systems c. Catalytic converters and conventional fuel systems d. Stored energy e. Alternate fuel systems
	Given a diagram of a passenger auto, identify the following structures: a. A, B, C, D posts b. Fire wall c. Unibody versus frame designs
	Describe methods for emergency stabilization using rope, cribbing, jacks, spare tire, and come-a-longs for vehicles found on their: a. Wheels b. Side c. Roof d. Inclines
	Describe the electrical hazards commonly found at highway incidents (above and below ground).
	Explain the difference between tempered and safety glass, identify its locations on a vehicle and how to break it safely.
	Explain typical door anatomy and methods to access through stuck doors.
	Explain SRS or “air bag” systems and methods to neutralize them.
	Define the following terms: a. Low angle b. High angle c. Belay d. Rappel e. Scrambling f. Hasty rope slide
	Describe the procedure for stokes litter packaging for low angle evacuations.
	Explain the procedures for low angle litter evacuation to include: a. Anchoring b. Litter/ rope attachment c. Lowering and raising procedures
	Explain techniques to be used in non-technical litter carries over rough terrain.
	Explain non-technical high angle rescue procedures using aerial apparatus.
	Develop specific skill in emergency stabilization of vehicles and access procedures and an awareness of specific extrication strategies.
	Explain assessment procedures and modifications necessary when caring for entrapped patients.
	List the equipment necessary for an "off road" medical pack.
	Explain specific methods of improvisation for assessment, spinal immobilization and extremity splinting.
	Explain the indications, contraindications and methods of pain control for entrapped patients.
	Explain the need for and techniques of thermal control for entrapped patients.
	Explain the pathophysiology of "crush trauma" syndrome.
	Develop an understanding of the medical issues involved in providing care for a patient in a rescue environment.