EMC 103 – Patient Assessment and Airway for the EMT

Competency	After completing this section, the student will be able to:	Hours
Competency		Class	D.Lab	P.Lab/O.B.I.
SCENE SIZE-UP		1	0	0
X2-1.1*	Recognize hazards/potential hazards.
X2-1.2	Describe 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.
X2-1.7	Explain the rationale for crew members to evaluate scene safety prior to entering.
X2-1.8	Serve 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.
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	0
X2-2.1	Summarize the reasons for forming a general impression of the patient
X2-2.2	Discuss methods of assessing altered mental status
X2-2.3	Differentiate 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
X2-2.5	State 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.
X2-2.7	State what care should be provided to the adult, child and infant patient with adequate breathing.
X2-2.8	State 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.
X2-2.10	Distinguish between methods of assessing breathing in the adult, child and infant patient.
X2-2.11	Compare 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
X2-2.18	Describe 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.
X2-2.27	Demonstrate 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
X2-3.3	Recite examples and explain why patients should receive a rapid trauma assessment
X2-3.4	Describe the areas included in the rapid trauma assessment and discuss what should be evaluated.
X2-3.5	Differentiate 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
X2-3.7	Recognize 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.
X2-3.9	Demonstrate 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
X2-4.1	Describe 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.
X2-4.3	Describe 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.
X2-4.6	Demonstrate the patient care skills that should be used to assist with a patient who is responsive with no known history
X2-4.7	Demonstrate 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	0
X2-5.1	Discuss the components of the detailed physical exam
X2-5.2	State the areas of the body that are evaluated during the detailed physical exam
X2-5.3	Explain what additional care should be provided while performing the detailed physical exam
X2-5.4	Distinguish 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
X2-6.1	Discuss 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
X2-6.5	Recognize and respect the feelings that patients might experience during assessment
X2-6.6	Explain 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.
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.
X2-6.8	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.
X2-6.8	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.
COMMUNICATIONS		1	0	0
X2-7.1	List the proper methods of initiating and terminating a radio call.
X2-7.2	State the proper sequence for delivery of patient information
X2-7.3	Explain the importance of effective communication of patient information in the verbal report.
X2-7.4	Identify the essential components of the verbal report.
X2-7.5	Describe the attributes for increasing effectiveness and efficiency of verbal communications
X2-7.6	State legal aspects to consider in verbal communication.
X2-7.7	Discuss 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.

X2-7.10	Explain the rationale for providing efficient and effective radio communications and patient reports
X2-7.11	Perform a simulated, organized, concise radio transmission
X2-7.12	Perform an organized, concise patient report that would be given to the staff at a receiving facility
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.
X2-8.19	Demonstrate 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
X2-8.22	Describe 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.
DOCUMENTATION		1	0	0
X2-9.1	Explain 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
X2-9.3	Describe 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.
X2-9.10	Explain 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
X2-10.7	State 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.
X2-10.10	Describe 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.
X2-10.12	Describe 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.
X2-10.15	Describe the steps in artificially ventilating a patient with a flow restricted, oxygen-powered ventilation device.
X2-10.16	List 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.
X2-10.20	Identify a non-rebreather face mask and state the oxygen flow requirements needed for its use.
X2-10.21	Describe 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.
X2-10.23	Explain 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.
X2-10.28	Demonstrate 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.
X2-10.31	Demonstrate the steps in performing the skill of artificially ventilating a patient with a bag-valve-mask for one and two rescuers.
X2-10.32	Demonstrate the steps in performing the skill of artificially ventilating a patient with a bag-valve-mask while using the jaw thrust.
X2-10.33	Demonstrate 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.
X2-10.38	Demonstrate the use of a non-rebreather face mask and state the oxygen flow requirements needed for its use.
X2-10.39	Demonstrate 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
X2-11.1	Describe 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
X2-11.3	Describe the reasons for and mechanism of humidification and warming of the air as it passes through the naso-and oral pharynx

Competency Areas	Hours
Scene Size-Up	Class	2
Initial Assessment	D. Lab	1
Focused History And Physical Exam - Trauma Patients	P. Lab/O.B.I.	0
Focused History And Physical Exam – Medical Patients	Credit	3
Detailed Physical Exam
On-Going Assessment
Communications
EMS Communications For the EMT-Intermediate
Documentation
Airway
Advanced Airway
Advanced Airway Practical Skills Lab
Review And Practical Skills Lab

Prerequisite:	Program Admission
Corequisite:	EMC 100