Course Description

Emphasizes the study of gynecological, obstetrical, pediatric and neonatal emergencies. Maternal/Child combines the unique relationships and situations encountered with mother and child. Provides a detailed understanding of anatomy/physiology, pathophysiology, assessment, and treatment priorities for the OB/GYN patient. Pediatric and neonatal growth and development, anatomy and physiology, pathophysiology, assessment and treatment specifics are covered in detail. Successful completion of a PLS/PALS course is required. This course provides instruction on topics in Division's 5 (Medical), Sections 13 (Obstetrics) & 14 (Gynecology) and 6 (Special Considerations), Sections 1 (Neonatology) and 2 (Pediatrics) of the USDOT/NHTSA Paramedic National Standard Curriculum.

Competency Areas	Hours
Anatomy and Physiology of the Female Reproductive System	Class	4
Pathophysiology of the Female Reproductive System	D. Lab	2
Anatomy and Physiology of the Pediatric and Neonatal Patient	P. Lab/O.B.I.	0
Pathophysiology of the Pediatric and Neonatal Patient	Credit	5
Assessment of the OB/GYN Patient
Assessment of the Pediatric and Neonatal Patient
Treatment Modalities of the OB/GYN Patient
Treatment Modalities of the Pediatric and Neonatal Patient
Successful Completion of either PALS and/or PLS

Prerequisites:	EMS 126, EMS 127, EMS 128, EMS 129, AHS 101
Corequisite:	None

Course Guide

Competency	After completing this section, the student will:	Hours
Competency	After completing this section, the student will:	Class	D.Lab	P.Lab/ O.B.I.
ANATOMY AND PHYSIOLOGY OF THE FEMALE REPRODUCTIVE SYSTEM		2	1	0
	Review the anatomic structures and physiology of the female reproductive system.
	Identify the normal events of the menstrual cycle.
ASSESSMENT AND MANAGEMENT OF GYNECOLOGICAL EMERGENCIES		2	1	0
	Describe how to assess a patient with a gynecological complaint.
	Explain how to recognize a gynecological emergency.
	Describe the general care for a GYN
	Describe the pathophysiology, assessment, and management of specific gynecological emergencies.
	Demonstrate how to assess a patient with a gynecological complaint.
	Demonstrate how to provide care for a patient with: Excessive vaginal bleeding Abdominal pain Sexual assault
	Identify the need to provide care for a patient of sexual assault, while still preventing destruction of crime scene information.
NORMAL AND ABNORMAL PREGNANCY AND BIRTH PROCESS		4	2	0
	Identify the normal events of pregnancy.
	Identify the stages of labor and the paramedic's role in each stage.
	Differentiate between normal and abnormal delivery.
	Identify and describe complications associated with pregnancy and delivery.
	Describe and demonstrate how to assess an obstetrical patient.
	Identify predelivery emergencies.
	State indications of an imminent delivery.
	Explain the use of the contents of an obstetrics kit.
	Differentiate the management of a patient with predelivery emergencies from a normal delivery.
	State the steps in the predelivery preparation of the mother.
	Establish the relationship between body substance isolation and childbirth.
	State the steps to assist in the delivery of a newborn.
	Describe how to care for the newborn.
	Describe how and when to cut the umbilical cord.
	Discuss the steps in the delivery of the placenta.
	Describe the management of the mother post-delivery.
	Summarize neonatal resuscitation procedures.
	Describe the procedures for handling abnormal deliveries.
	Describe the procedures for handling complications of pregnancy.
	Describe the procedures for handling maternal complications of labor.
	Describe special considerations when meconium is present in amniotic fluid or during delivery.
	Describe special considerations of a premature baby.
	Advocate the need for treating two patients (mother and baby).
	Value the importance of maintaining a patient’s modesty and privacy during assessment and management.
	Serve as a role model for other EMS providers when discussing or performing the steps of childbirth.
	Demonstrate how to provide care for a patient with: Excessive vaginal bleeding Abdominal pain Hypertensive crisis
	Demonstrate how to prepare the obstetric patient for delivery.
	Demonstrate how to assist in the normal cephalic delivery of the fetus.
	Demonstrate how to deliver the placenta.
	Demonstrate how to provide post-delivery care of the mother.
	Demonstrate how to assist with abnormal deliveries.
	Demonstrate how to care for the mother with delivery complications.
ASSESSMENT AND MANAGEMENT OF THE NEONATE/NEWBORN		1	1	0
	Define the term neonate.
	Define the term newborn.
	Identify important antepartum factors that can affect childbirth.
	Identify important intrapartum factors that can term the newborn high risk.
	Identify the factors that lead to premature birth and low birth weight newborns.
	Demonstrate and advocate appropriate interaction with a newborn/neonate that conveys respect for their position in life.
	Recognize the emotional impact of newborn/neonate injuries/illnesses on parents/guardians.
	Recognize and appreciate the physical and emotional difficulties associated with separation of the parent/ guardian and a newborn/neonate
CARE OF THE NEWBORN		3	2	0
Resuscitation of the newborn/neonate	Distinguish between primary and secondary apnea.
	Discuss pulmonary perfusion and asphyxia.
	Identify the primary signs utilized for evaluating a newborn during resuscitation.
	Determine when ventilatory assistance is appropriate for a newborn.
	Prepare appropriate ventilation equipment, adjuncts and technique for a newborn.
	Determine when chest compressions are appropriate for a newborn.
	Discuss appropriate chest compression techniques for a newborn.
	Assess patient improvement due to chest compressions and ventilations.
	Determine when endotracheal intubation is appropriate for a newborn.
	Discuss appropriate endotracheal intubation techniques for a newborn.
	Assess patient improvement due to endotracheal intubation.
	Identify complications related to endotracheal intubation for a newborn.
	Determine when vascular access is indicated for a newborn.
	Discuss the routes of medication administration for a newborn.
	Determine when blow-by oxygen delivery is appropriate for a newborn.
	Discuss appropriate blow-by oxygen delivery devices and technique for a newborn.
	Assess patient improvement due to assisted ventilations.
	Determine when an orogastric tube should be inserted during positive-pressure ventilation.
	Discuss the signs of hypovolemia in a newborn.
	Discuss the initial steps in resuscitation of a newborn.
	Assess patient improvement due to blow-by oxygen delivery.
	Discuss the effects maternal narcotic usage has on the newborn.
	Determine the appropriate treatment for the newborn with narcotic depression.
	Discuss appropriate transport guidelines for a newborn.
	Determine appropriate receiving facilities for low and high risk newborns.
	Describe the epidemiology, including the incidence, morbidity/mortality, risk factors and prevention strategies for meconium aspiration.
	Discuss the pathophysiology of meconium aspiration.
	Discuss the assessment findings associated with meconium aspiration.
	Discuss the management/treatment plan for meconium aspiration.
	Demonstrate preparation of a newborn resuscitation area.
	Demonstrate appropriate assessment technique for examining a newborn.
	Demonstrate appropriate assisted ventilations for a newborn.
	Demonstrate appropriate endotracheal intubation technique for a newborn.
	Demonstrate appropriate meconium aspiration suctioning technique for a newborn.
	Demonstrate appropriate chest compression and ventilation technique for a newborn.
	Demonstrate appropriate techniques to improve or eliminate endotracheal intubation complications.
	Demonstrate vascular access cannulation techniques for a newborn.
	Demonstrate the initial steps in resuscitation of a newborn.
	Demonstrate blow-by oxygen delivery for a newborn.
PREMATURE INFANTS		1	0	0
	Describe the epidemiology, including the incidence, morbidity/ mortality and risk factors for premature infants
	Discuss the pathophysiology of premature infants.
	Discuss the assessment findings associated with premature infants.
	Discuss the management/treatment plan for premature infants.
CARE OF THE NEONATE		4	3	0
	Describe the epidemiology, including the incidence, morbidity/mortality, risk factors and prevention strategies for apnea in the neonate.
	Discuss the pathophysiology of apnea in the neonate.
	Discuss the assessment findings associated with apnea in the neonate.
	Discuss the management/treatment plan for apnea in the neonate.
	Describe the epidemiology, pathophysiology, assessment findings, and management/treatment plan for diaphragmatic hernia.
	Describe the epidemiology, including the incidence, morbidity/mortality and risk factors for bradycardia in the neonate.
	Discuss the pathophysiology of bradycardia in the neonate.
	Discuss the assessment findings associated with bradycardia in the neonate.
	Discuss the management/treatment plan for bradycardia in the neonate.
	Describe the epidemiology, including the incidence, morbidity/mortality and risk factors for respiratory distress/cyanosis in the neonate.
	Describe the epidemiology, including the incidence, morbidity/mortality and risk factors for respiratory distress/cyanosis in the neonate.
	Discuss the pathophysiology of respiratory distress/ cyanosis in the neonate.
	Discuss the assessment findings associated with respiratory distress/cyanosis in the neonate.
	Discuss the management/treatment plan for respiratory distress/cyanosis in the neonate.
	Describe the epidemiology, including the incidence, morbidity/mortality and risk factors for seizures in the neonate.
	Discuss the pathophysiology of seizures in the neonate.
	Discuss the assessment findings associated with seizures in the neonate.
	Discuss the management/treatment plan for seizures in the neonate.
	Describe the epidemiology, including the incidence, morbidity/mortality and risk factors for fever in the neonate.
	Discuss the pathophysiology of fever in the neonate.
	Discuss the assessment findings associated with fever in the neonate.
	Discuss the management/treatment plan for fever in the neonate.
	Describe the epidemiology, including the incidence, morbidity/mortality and risk factors for hypothermia in the neonate.
	Discuss the pathophysiology of hypothermia in the neonate.
	Discuss the assessment findings associated with hypothermia in the neonate.
	Discuss the management/treatment plan for hypothermia in the neonate.
	Describe the epidemiology, including the incidence, morbidity/mortality and risk factors for hypoglycemia in the neonate.
	Discuss the pathophysiology of hypoglycemia in the neonate.
	Discuss the assessment findings associated with hypoglycemia in the neonate.
	Discuss the management/treatment plan for hypoglycemia in the neonate.
	Describe the epidemiology, including the incidence, morbidity/mortality and risk factors for vomiting in the neonate.
	Discuss the pathophysiology of vomiting in the neonate.
	Discuss the assessment findings associated with vomiting in the neonate.
	Discuss the management/treatment plan for vomiting in the neonate.
	Describe the epidemiology, including the incidence, morbidity/mortality and risk factors for diarrhea in the neonate.
	Discuss the pathophysiology of in diarrhea the neonate.
	Discuss the assessment findings associated with diarrhea in the neonate.
	Discuss the management/treatment plan for diarrhea in the neonate.
	Describe the epidemiology, including the incidence, morbidity/mortality and risk factors for common birth injuries in the neonate.
	Discuss the pathophysiology of common birth injuries in the neonate.
	Discuss the assessment findings associated with common birth injuries in the neonate.
	Discuss the management/treatment plan for common birth injuries in the neonate.
	Describe the epidemiology, including the incidence, morbidity/mortality and risk factors for cardiac arrest in the neonate.
	Discuss the pathophysiology of cardiac arrest in the neonate.
	Discuss the assessment findings associated with cardiac arrest in the neonate.
	Discuss the management/treatment plan for cardiac arrest in the neonate.
	Discuss the pathophysiology of post arrest management of the neonate.
	Discuss the assessment findings associated with post arrest situations in the neonate.
	Discuss the management/treatment plan to stabilize the post arrest neonate.
EMS ROLE IN PREVENTION OF PEDIATRIC ILLNESS/INJURY		3	1	0
	Discuss the paramedic's role in the reduction of infant and childhood morbidity and mortality from acute illness and injury.
	Identify methods/mechanisms that prevent injuries to infants and children.
	Describe Emergency Medical Services for Children (EMSC).
	Discuss how an integrated EMSC system can affect patient outcome.
	Demonstrate and advocate appropriate interactions with the infant/child that conveys an understanding of their developmental stage.
	Recognize the emotional dependence of the infant/child to their parent/guardian.
	Recognize the emotional impact of the infant/child injuries and illnesses on the parent/guardian.
	Demonstrate the ability to provide reassurance, empathy and compassion for the parent/guardian.
GROWTH AND DEVELOPMENT		1	0	0
	Identify key growth and developmental characteristics of infants and children and their implications.
	Identify key anatomical and physiological characteristics of infants and children and their implications.
	Demonstrate an appropriate assessment for different developmental age groups.
ASSESSMENT OF THE PEDIATRIC PATIENT		3	2	0
	Describe techniques for successful assessment of infants and children.
	Describe techniques for successful treatment of infants and children.
	Identify the common responses of families to acute illness and injury of an infant or child.
	Describe techniques for successful interaction with families of acutely ill or injured infants and children.
	Outline differences in adult and childhood anatomy and physiology.
	Identify "normal" age group related vital signs.
	Discuss the appropriate equipment utilized to obtain pediatric vital signs.
	Demonstrate the appropriate approach for treating infants and children.
	Demonstrate appropriate intervention techniques with families of acutely ill or injured infants and children.
	Demonstrate an appropriate technique for measuring pediatric vital signs.
	Describe the primary etiologies of altered level of consciousness in infants and children.
AIRWAY/RESPIRATORY MANAGEMENT OF THE PEDIATRIC PATIENT		4	2	0
	Determine appropriate airway adjuncts for infants and children.
	Discuss complications of improper utilization of airway adjuncts with infants and children.
	Discuss appropriate ventilation devices for infants and children.
	Discuss complications of improper utilization of ventilation devices with infants and children.
	Discuss appropriate endotracheal intubation equipment for infants and children.
	Identify complications of improper endotracheal intubation procedure in infants and children.
	List the indications and methods for gastric decompression for infants and children.
	Define respiratory distress.
	Define respiratory failure.
	Define respiratory arrest.
	Differentiate between upper airway obstruction and lower airway disease.
	Describe the general approach to the treatment of children with respiratory distress, failure, or arrest from upper airway obstruction or lower airway disease.
	Describe the epidemiology, including the incidence, morbidity/mortality, risk factors and prevention strategies for respiratory distress/failure in infants and children.
	Discuss the pathophysiology of respiratory distress/failure in infants and children.
	Discuss the assessment findings associated with respiratory distress/failure in infants and children.
	Discuss the management/treatment plan for respiratory distress/failure in infants and children.
	Demonstrate the use of a length-based resuscitation device for determining equipment sizes, drug doses and other pertinent information for a pediatric patient.
	Demonstrate the appropriate approach for treating infants and children with respiratory distress, failure, and arrest.
	Demonstrate proper technique for administering blow-by oxygen to infants and children.
	Demonstrate the proper utilization of a pediatric non-rebreather oxygen mask.
	Demonstrate proper technique for suctioning of infants and children.
	Demonstrate appropriate use of airway adjuncts with infants and children.
	Demonstrate appropriate use of ventilation devices for infants and children.
	Demonstrate endotracheal intubation procedures in infants and children.
	Demonstrate appropriate treatment/management of intubation complications for infants and children.
	Demonstrate appropriate needle cricothyroidotomy in infants and children.
	Demonstrate proper placement of a gastric tube in infants and children.
	Demonstrate appropriate interventions for infants and children with a partially obstructed airway.
	Demonstrate age appropriate basic airway clearing maneuvers for infants and children with a completely obstructed airway.
	Demonstrate proper technique for direct larnyngoscopy and foreign body retrieval in infants and children with a completely obstructed airway.
	Demonstrate appropriate airway and breathing control maneuvers for infant and child trauma patients.
	Demonstrate appropriate treatment of infants and children requiring advanced airway and breathing control.
CARDIOVASCULAR ASSESSMENT AND TREATMENT		4	3	0
	Discuss the common causes of hypoperfusion in infants and children.
	Evaluate the severity of hypoperfusion in infants and children.
	Identify the major classifications of pediatric cardiac rhythms.
	Discuss the primary etiologies of cardiopulmonary arrest in infants and children.
	Discuss age appropriate vascular access sites for infants and children.
	Discuss the appropriate equipment for vascular access in infants and children.
	Identify complications of vascular access for infants and children.
	Discuss basic cardiac life support (CPR) guidelines for infants and children.
	Identify appropriate parameters for performing infant and child CPR.
	Integrate advanced life support skills with basic cardiac life support for infants and children.
	Discuss the indications, dosage, route of administration and special considerations for medication administration in infants and children.
	Describe the epidemiology, including the incidence, morbidity/mortality, risk factors and prevention strategies for hypoperfusion in infants and children.
	Discuss the pathophysiology of hypoperfusion in infants and children.
	Discuss the assessment findings associated with hypoperfusion in infants and children.
	Discuss the management/treatment plan for hypoperfusion in infants and children.
	Describe the epidemiology, including the incidence, morbidity/mortality, risk factors and prevention strategies for cardiac dysrhythmias in infants and children.
	Discuss the pathophysiology of cardiac dysrhythmias in infants and children.
	Discuss the assessment findings associated with cardiac dysrhythmias in infants and children.
	Discuss the management/treatment plan for cardiac dysrhythmias in infants and children.
	Demonstrate an appropriate technique for insertion of peripheral intravenous catheters for infants and children.
	Demonstrate an appropriate technique for administration of intramuscular, inhalation, subcutaneous, rectal, endotracheal and oral medication for infants and children.
	Demonstrate an appropriate technique for insertion of an intraosseous line for infants and children.
	Demonstrate proper infant CPR.
	Demonstrate proper child CPR.
	Demonstrate proper techniques for performing infant and child defibrillation and synchronized cardioversion.
SUDDEN INFANT DEATH SYNDROME (SIDS)		1	0	0
	Define sudden infant death syndrome (SIDS).
	Discuss the parent/caregiver responses to the death of an infant or child.
	Describe/Discuss the epidemiology, including the incidence, morbidity/mortality, risk factors and prevention strategies for SIDS infants.
	Discuss the pathophysiology of SIDS in infants.
	Discuss the assessment findings associated with SIDS infants.
	Discuss the management/treatment plan for SIDS in infants.
	Demonstrate appropriate parent/caregiver interviewing techniques for infant and child death situations.
CHILD ABUSE/NEGLECT AND TRAUMA		4	0	0
	Define child abuse.
	Define child neglect.
	Identify common lethal mechanisms of injury in infants and children.
	Discuss anatomical features of children that predispose or protect them from certain injuries.
	Describe aspects of infant and children airway management that are affected by potential cervical spine injury.
	Identify infant and child trauma patients who require spinal immobilization.
	Discuss fluid management and shock treatment for infant and child trauma patient.
	Determine when pain management and sedation are appropriate for infants and children.
	Describe the epidemiology, including the incidence, morbidity/mortality, risk factors and prevention strategies for trauma in infants and children.
	Discuss the pathophysiology of trauma in infants and children.
	Discuss the assessment findings associated with trauma in infants and children.
	Discuss the management/treatment plan for trauma in infants and children.
	Describe the epidemiology, including the incidence, morbidity/mortality, risk factors and prevention strategies for abuse and neglect in infants and children.
	Discuss the pathophysiology of abuse and neglect in infants and children.
	Discuss the assessment findings associated with abuse and neglect in infants and children.
	Discuss the management/treatment plan for abuse and neglect in infants and children, including documentation and reporting.
	Demonstrate appropriate immobilization techniques for infant and child trauma patients.
	Demonstrate treatment of infants and children with head injuries.
	Demonstrate appropriate treatment of infants and children with chest injuries.
	Demonstrate appropriate treatment of infants and children with abdominal injuries.
	Demonstrate appropriate treatment of infants and children with extremity injuries.
	Demonstrate appropriate treatment of infants and children with burns.
	Describe the epidemiology, including the incidence, morbidity/mortality, risk factors and prevention strategies for neurological emergencies in infants and children.
	Discuss the pathophysiology of neurological emergencies in infants and children.
	Discuss the assessment findings associated with neurological emergencies in infants and children.
	Discuss the management/treatment plan for neurological emergencies in infants and children.
CHILDREN WITH SPECIAL HEALTHCARE NEEDS AND TECHNOLOGY ASSISTED PATIENTS		2	2	0
	Define children with special health care needs.
	Define technology assisted children.
	Describe the epidemiology, including the incidence, morbidity/mortality, risk factors and prevention strategies for children with special health care needs, including technology assisted children.
	Discuss the pathophysiology of children with special health care needs, including technology assisted children.
	Discuss the assessment findings associated with children with special health care needs, including technology assisted children.
	Discuss the management/treatment plan for children with special health care needs, including technology assisted children.
	Recognize and appreciate the physical and emotional difficulties associated with separation of the parent/ guardian of a special needs child.
TRANSPORT OF INJURED/ILL CHILDREN		1	0	0
	Discuss appropriate transport guidelines for infants and children.
	Discuss appropriate receiving facilities for low and high risk infants and children.

Suggested Resources

Bledsoe, et al; Essentials of Paramedic Care 1^st ed., 2003; Brady Prentice Hall Publishing, Upper Saddle River, NJ 07458; ISBN: 0-13-098792-1

Sanders, et al; Mosby’s Paramedic Textbook 2^nd ed., 2002; Mosby Publishing, Philadelphia, PA 19106; ISBN: 032301416X

Bledsoe, et al; Paramedic Care: Principles & Practice- Vol. 5-Special Considerations/Operations 1^st ed.; 2001; Brady-Prentice Hall Publishing, Upper Saddle River, NJ 07458; ISBN: 0-13-021599-6

American Heart Association PALS Provider Manual 2002, American Heart Association; Dallas, TX; ISBN: 0-87493-322-6

Kattwinkel; Textbook of Neonatal Resuscitation 4^th ed; 2000; American Academy of Pediatrics; ISBN: 1581100566

Markensen; Pediatric Prehospital Care 1^st ed; 2001; Brady Prentice Hall Publishing, Upper Saddle River, NJ 07458; ISBN: 0-13-022618-1

Course Description

Hours

D.Lab

1

1

NORMAL AND ABNORMAL PREGNANCY AND BIRTH PROCESS

2

1

2

0

3