JEFFERSON COLLEGE COURSE SYLLABUS. EMT and EMT Paramedic I and Paramedic II. 20 credit hours each (Total of 40)

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1 JEFFERSON COLLEGE COURSE SYLLABUS EMT and EMT Paramedic I and Paramedic II 20 credit hours each (Total of 40) Prepared by: Gary M. Stefan Temporary EMS Program Director January 15,

2 Mary Beth Ottinger, Division Chair/Dean 2

3 Course Number and Title I. Catalogue Description The paramedic will be prepared to effectively handle all types of medical and trauma emergencies. These courses consist of 40 weeks of instruction, flexible schedule of two days per week, and arranged clinical and internship experiences. Successful completion of these courses will enable the student to take the practical and written examinations with the NREMT for certification as an Emergency Medical Technician-Paramedic. This certification will then be recognized by the Missouri Department of Health Bureau of Emergency Medical Services for licensure as a Paramedic. A. Prerequisites: EMT 111 ENG 101 English Comp I COMPASS pre-algebra score of at least 33, or ACT math of 16 or higher BIO 116 Anatomy & Physiology for Healthcare Providers OR BIO 212 EMT 206 Pre Paramedic Training Additionally: Immunizations: MMR, PPD, DPT, Hepatitis B series, Criminal Background and applicant acceptance into the program after formal interview. B. Paramedic, consisting of two semesters consecutively, EMT Paramedic I (20 hours) and EMT EMT Paramedic II (20 hours) C. EMT Paramedic I offered each Fall semester; EMT Paramedic II offered each Spring semester. Prerequisites to Paramedic II is successful completion of Paramedic I. II. Expected Learning Outcomes of the course are in compliance with the learning outcomes outlined in the National Standards See National EMS Education Standards for the complete and concise breakdown of all didactic objectives needed to successfully complete the Paramedic I and Paramedic II. See National EMS Education Standards Paramedic for the complete and concise outline of all didactic objectives needed to successfully complete the Paramedic I and Paramedic II. The following tables show the expected outcomes for psychomotor skills needed for Paramedic I and Paramedic II. The tables show progression from EMT through to Paramedic, and include areas such as EMR (First Responder) and AEMT (EMT- 3

4 Intermediate which is not taught in Missouri). All objective for both EMT and EMT Paramedic must be mastered, for successful completion of the program. The website provides standardized skills performance sheets that are utilized to prove competency on individual required skills. These are on the website under Coordinator Documents, and are subdivided into Basic Skills and Advanced Skills. The following two and a half pages list the minimum skills set for Airway and Breathing, Assessment, Trauma Care, Medical/Cardiac Care, and Pharmacological Interventions: 4

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7 III. Course Outline with Unit Objectives (denote optional content parenthetically) The course is designed to be examined in modules. Each module consists of specific objectives for didactic, psychomotor and affective domains. Each must be passed individually before progressing to the next. Each module is as follows, and includes a summation of the goals for each: Module I Preparatory Roles and Responsibilities: Are defined and analyzed. The paramedic student must understand his or her legal and ethical responsibilities, demonstrate a high level of professionalism, and strive for a standard of care that places the patient above all else. EMS Systems: Paramedic students will review basic components and their relationships in the EMS system. Emphasis is made on the importance of commitment, cooperation, and communication between participatory members and agencies. Medicolegal Considerations/Ethics: An examination of the patient's rights and protections, as well as the protections and obligations of the paramedic student. Though the intricacies of legal definitions vary from state to state, the following explanation represents a faithful attempt to convey the essence of these concepts. A thorough understanding of medicolegal terms and their implication to "hands-on" patient care is of the utmost importance. Well Being of the Paramedic/Illness and Injury Prevention: Brief overview of stress, its causes, and our reactions to it while focusing on job-related stresses faced by paramedics. Discussion of how to appropriately manage stress. Also, techniques on how to build physical strength and lead a healthier lifestyle. These changes will allow the professional to better handle the physical and mental challenges that EMS demands. Ethics: Define ethics and compare and contrast ethics, morals, and values. Discussion of ethical dilemmas that paramedics typically encounter will take place. Finally groups will analyze the relationship between the law and ethics in EMS. Module II Pharmacology Pharmacology is a division of preparatory, but due to the vast knowledge base and clinical significance, the study of pharmacodynamic and pharmacokinetics will be discussed and practiced as it s own module. Additional analysis will occur with other modules; integration of foundational principles learned in this module will be applied practically in other modules where pharmacology can be utilized in specific situations. Paramedic students are entrusted with the administration of drugs, having both beneficial and lethal potential when given. An understanding of prehospital pharmacological standards and practices regarding the basic principles, drug chemical and classes, as well as medication administration will be discussed. 7

8 Module III Airway Management & Ventilation The maintenance of a patent airway is the top priority in emergency airway management. All other considerations are secondary. Lack of adequate airway and ventilatory support is the major cause of nonsurvival and/or neurological, cardiac and pulmonary complications of medical and trauma patients in the prehospital arena. Paramedic students will review basic airway management, advanced airway management and surgical airway management. With this knowledge, the paramedic student will be able to solve any airway crisis under time pressures. Module IV Patient Assessment Patient Assessment: Accepted principles of emergency care mandate that life threatening situations are treated first. This often means simultaneous assessment and treatment. With medical patients, definitive care is begun in the prehospital setting, on the other hand, significant trauma patients are transported rapidly, while maintaining oxygenation, perfusion, and bleeding control until reaching the appropriate facility set up for providing definitive care. History Taking: Discussion on the purpose of taking a history, as well as the components of a comprehensive history will be discussed. The learned principles will be implemented throughout the program not only in theory and practice during labs, but also in actually practicality during clinical rotations with live patients. EMS Communications: Technical aspects of communications equipment (in the context of public safety radio) and the rules governing radio transmissions, communication through written or spoken words, and conveyance of patient information will be discussed at length. Documentation: Stressing: If it wasn t written down, it wasn t done. Missouri Ambulance Reporting Form will be dissected and studied. Focus will be on writing narratives for reports that later become legal documentation, sometimes being used against the paramedic when poorly written. Focus will be on proper grammar, spelling and actual structure of writing. Additional emphasis will be placed on the usage of proper medical terminology as well as accepted abbreviations. Module V Medical Emergencies Head, Eyes, Ears, Nose and Throat Disorders: An overview of specific medical disorders that affects any or all of the regions of the head and neck will be discussed. Pulmonology: Focused assessment specific for a particular pathophysiology will be addressed. Additionally, emphasis will be placed on understanding particular disease processes of the upper and lower airway, along with the proper management of these emergencies. 8

9 Cardiovascular: Initial impetus to train and equip medics was directly related to a high number of prehospital deaths from Coronary Artery Disease, and realizing that specialized early intervention in acute events could greatly reduce the mortality, myocardial damage and cardiac rehab times. Anatomy and physiology and the pathophysiology will be discussed in detail. A brief overview of ECG rhythm interpretations is also addressed. Endocrine: Overview of the endocrine glands and their specific purposes. Discussion of the effects on body organs and tissues by means of hormone being secreted. Nervous System: Discuss the Central Nervous System ( CNS )and the Peripheral Nervous System ( PNS ). Basic assessment of CNS dysfunction and prehospital management of CNS emergencies. Toxicology: Address the assessment and treatment of toxicological emergencies. Identify the routes of entry into the body and by determining the appropriate general treatment priorities, one can begin a systematic approach to management. Infectious Disease: Review the immune system and some specific infectious diseases. Discuss prehospital assessment and management of possible infectious diseases and safety of responding personnel. Hematology/Immune System Disorders: Examine blood and blood byproducts. This knowledge of how blood functions at the cellular level will allow one to understand various physiologiclal and pathophysiological events that occur in the body on an everyday basis. A better understanding of blood will allow the rescuer to more readily dispense blood products in an emergent situation. Additionally specific pathophysiology regarding the immune system will be discussed, along with the appropriate management of these cases. Abdominal and Genitourinary: Review the structures and organs in the abdomen and then concentrate on assessing and treating the life-threatening problems. The student will be required to lecture their fellow classmates on a topic pre selected by the instructor. This lecture will be graded as a major exam for the semester. Musculoskeletal Disorders: Non traumatic management of chronic complaints commonly dealt with in EMS will be discussed. Clinical management issues will be addressed. Cutaneous Disorders: Pathophysiology associated with the skill will be discussed, along with EMS management for specific situations. Psychiatric: Discuss how to make a significant difference in patient situations and outcomes, and the systematic, organized approach to evaluation of the emotionally disturbed. Emphasis is directed toward the top priority-- SCENE SAFETY. 9

10 Crisis Intervention: A brief look at the dying process of the patient and how they cope with the emotions associated with death and dying. Module VI Shock Profound shock is an extreme emergency, one that paramedics must recognize and treat early. An understanding of cellular metabolism, acid base balance, and fluid and electrolytes is crucial to understanding shock. The student will be able to diagram the important components of the shock pathophysiology; The methodical management of all types of shock. Module VII Special Patient Populations OB/GYN: Overview of the female reproductive system, pertinent definitions, gynecological dysfunctions, obstetric complications, normal and abnormal births, specific treatment for all, and care for the neonate. Module VII Special Patient Populations Neonatology: Discussions and practice of special regimes of basic and aggressive treatments in caring for postpartum fetal care. Pediatrics: Discuss specific pediatric problems pertaining especially to the airway and ventilatory status and the management and special treatment techniques associated with the pediatric age group. Geriatrics: Outline the principle problems involved when treating the "older" patient. The elderly have their own special set of problems that must be considered when rendering emergency care, especially when attempting to make an accurate assessment of illness and/or injury. Abuse and Assault: Focus will be on safety in a hostile environment. Epidemiology and overall care of the battered victim will be reviewed and practiced. Patients with Special Challenge: Roadblocks in communication, mental acuity and physical limitations can be frustrating to the paramedic, especially with tensions being high in acute situations. Discussion will focus on how to overcome these barriers and to better provide for these types of patients. 10

11 Acute Int. in CCP: Insurance dictates a lot about how long patients can stay in hospitals. More and more patients are coming home to be cared for by family members or home health nurses. With them they bring high-tech diagnostic machines, implanted IV ports, defibrillators, feeding tubes, ventilators and so forth. Class will focus how to interact with these gadgets and how to more confidently manage patients who are dependent upon these life-prolonging devices. Module VIII Trauma Trauma: Discussions of the paramedic s role in obtaining the goal of emergency trauma care by utilizing its ongoing pathologic process and begin to reverse it as soon as possible. All standards of trauma treatment are based upon standards drawn up by Prehospital Trauma Life Support, NEMT. Burns: Examine the source of burns and evaluate the burn's severity and extent, then prioritize prehospital treatment and transport to the appropriate burn facility. Multisystems: Discussion of the paramedic s responsibilities on rapid assessment and treatments in caring for patients with specific trauma: head, spinal, chest, abdominal and extremity. Each section will be reviewed for injuries for each specific body region and the most appropriate, definite treatments for these injuries. Environmental: Examine the effects of the environment( hyperthermia and hypothermia ) on the body and evaluate the treatments. Additional study and review will include submersion and drowning, atmospheric and weather related illness. Farm Response: Machinery and industrial accidents are common place in rural and urban-rural EMS. Practical knowledge will be reinforced with issues such as farm equipment, confined space and chemical emergencies. Wilderness EMS: (Practical exposure will be afforded to students regarding issues of EMS in the wild, along with care of patients under hostile situations.) Module IX Putting it All Together Assessment-Based Management/Critical Thinking: This section will be presented throughout the course and particularly reviewed and tested during the trauma section. Stress will be placed on critical thinking and not linear thinking. Students will be faced with many scenario, or roll-playing situations and real situations in which they must take book knowledge and use it in a dynamic environment. Focus will be placed on rule out diagnosis, or differential diagnosis. 11

12 Module X Operations Rescue: Review the principles involved with rescue in general. The specialized nature of rescue education demands methodical "hands-on" training, therefore, our treatment of rescue is conceptual only. The following areas are addressed: o Safety o Assessment o Gaining Access o Emergency Care o Disentanglement o Preparation for Removal o Removal. Mass Casualty Incident/Haz Mat Incidents: Brief overview of the components of a successful "major incident response". Incident command and individual disaster preplanning are all dependent upon individual responding agencies. Hazardous Materials incidents will be reviewed and a basic methodical approach will be reviewed. Special focus will be on terrorism in the United States. This class will delve into the world of explosive devices, poisonous gasses and biological means terrorists use to reek havoc and fear on the innocent. Vehicle Ops: Day to day operations regarding the cleaning and maintenance, inventory, routing, and due regard to the safety of the crew, the general public with strict accordance to the law will be discussed. Additionally, operation of a vehicle in a controlled simulator will be provided. Command and Control: Elements of the Incident Command System will be addressed and practiced. Principles of triage will also be implemented. Module X Operations Rescue: Safety in rescue operations will be addressed and practiced. Overview of various rescue situations will be either case studied, or simulated throughout the year. Crime Scene Awareness: Responding to this sort of scene will take place in your career. Knowledge from years of exposure to these situations will be shared. Contamination of a scene or disruption in the chain of evidence can be crucial to the outcome of a case. Once we put ourselves behind the yellow line, knowledge of what can and will go wrong can prevent a bad relationship with outside agencies. Tactical EMS: Those interested in SWAT medic will benefit from exposure of treatment of patients under fire. This portion of the program will be strenuous physical activity while being actively targeted by live paintball rounds. Safety will be taken seriously! 12

13 IV. Method(s) of Instruction Lecture Psychomotor Practice & Simulations Affective Clinical Rotations Lecture: 400 clock hours of Lecture. Traditional lecture with the use of power point lecture format, digital AV and case base studies are presented over the course of two semesters. Psychomotor Practice: 200 hours of simulation, experiential learning through scenarios based training, as well as simulations with Sim Man, Mega Code Kelly humanoid simulators; Virtual IV simulation and ACLS simulation. Affective Clinical Rotations: 264 hours of clinical rotations through various departments of the hospital and 375 hours of field internship on an ALS ambulance. Affective domain is measured by predetermined preceptors and direct supervision of the student s skills; utilizing the 11 points of professionalism recognized by the EMS profession. V. Required Textbook(s) (with publication information; denote if different text is used for online sections) Paramedic Practice Today-Above and Beyond Volume 1 & 2 Paramedic Practice Today-Above and Beyond Workbook EKGs Made Easy Third Edition B. Aehlert B. Aehlert B. Aehlert VI. VII. Required Materials (student) Uniform for lecture; Sand color polo with EMS logo embroidered, dark EMS pants, dark socks, black shoes, belt and name ID badge. Uniform for lab; Navy Blue color polo with EMS logo embroidered, dark EMS pants, dark socks, black shoes, belt and name ID badge. Medical Liability Insurance (Purchased as an Umbrella Policy through NPSO) Stethoscope FISDAP online tracking of clinical skills, and national standards test review. Computer for extracurricular homework. Supplemental References None 13

14 VIII. Method of Evaluation (basis for determining course grade) Didactic o Quizzes/Workbook: Scheduled and unscheduled quizzes serve as a formative assessment tool of the currently covered objectives from didactic material. The workbook assignment is due each exam day, and is used to reinforce summative learning. 25% of the overall grade o Exams: Scheduled module exams are a summative assessment to verify the goals of each module have been met. 50% of the overall grade o Homework: Is outlined throughout both semesters. Homework is reproduced from the student s text book to reinforce areas of weakness or to further establish learning in areas not fully covered during didactic lecture. 10% of the overall grade o Project: Various projects are assigned to promote teamwork and diplomacy. Although done as a group, points for following direction and completion of the assigned work are awarded individually. 5% of the overall grade o Final Exam: The final exam is given at the end of the semester as a Summative exam for all modules. 25% of the overall grade. Didactic grades are not distributed until the end of the semester. Each MODULE is graded as a summative grade. The student cannot fail a module and continue with the program. Modules are consecutive and are not able to be repeated within the semester. Other factors such as attendance and overall professionalism also play a key role. Absenteeism is not tolerated. Excessive absenteeism, even with an average grade, is deemed justification for dismissal. This is clearly outlined in the beginning of class and is documented throughout the program. (excessive tardiness and absenteeism would not allow a student to maintain an average grade in reality; the accelerated pace of the course would not allow a student to be competent) Psychomotor o NREMT skills sheets: Scheduled practice labs are utilized throughout the semester to help students master competency upon summative examination at the end of each module. All skills are graded with a cut score, and that grade is merely a reflection of Pass/Fail for skills. The grade given for skills is not part of the didactic grade, but students must prove 75% or higher in skills competency. A student with average to above average didactic skills is not allowed to progress through the program if they are unable to maintain 75% or higher on skills. o Computer Virtual Reality: Students work at their own pace to complete the skills and certification of both Advanced Cardiac Life Support as well as Intravenous Placement. These are completed upon our virtual reality computer based simulators. These skills must be completed before clinical rotations may be started. No grades are issued. 14

15 o Final Practical Examination: Each semester is concluded with the passing of practical skills learned in each semester. The skills are assessed using NREMT skills sheet. Paramedic II final exit examination is a randomized skills review (Oral Examination) used to assess the affective treatment of either a traumatic patient or a medical patient. Remediation is done the same day. The parameters of this examination are very similar to those seen at their State practical examinations. o Professionalism: Affective domain is assessed during a student s clinical rotation. Each student schedules clinical at various pre approved clinical sites, and is under the direct supervision of a licensed medical professional. The objective is to assess a student s psychomotor performance in a real clinical setting. Adjustments to style and professionalism are addressed on a continual basis. The student is subjected to nationally accepted hours as well as exposures to specific pathophysiology, age based complaints and skills. Affective domain is not assigned a letter grade, but affective domain and clinical times/exposures must be completed by December of the following year of initial enrollment. The student who does not complete, will get awarded their earned letter grade, but will not get a course completion statement allowing them to test for licensure. IX. ADA Statement Any student requiring special accommodations should inform the instructor and the Coordinator of Disability Support Services (Library; phone , ext. 169). X. Academic Honesty Statement All students are responsible for complying with campus policies as stated in the Student Handbook (see College Website, All students review and sign a contract of understanding, regarding the additional rules applied to Paramedic I and Paramedic II. 15