Paramedic Clinical Manual 2017

Transcription

1 Paramedic Clinical Manual Paramedic Clinical Manual 2017 Topic Page Clinical Progress Table 1 Scenario Progress Log 2 The Clinical Experience 3 FISDAP 3 Rules in the clinical Environment 4 Clinical Uniform and Appearance Standards 5 Attendance Policy for Clinicals 6 Clinical Obligation 7 Clinical Site Directions 8 Clinical Objectives Ambulance 9 Clinical Objectives Emergency Room 11 Clinical Objectives Anesthesiology 12 Clinical Objectives Labor and Delivery 12 Clinical Objectives Cardiac Cath Lab 12 Clinical Documentation Forms 13-end 0

2 Great Lakes EMS Academy/Davenport University Consortium 1

3 Paramedic Clinical Manual Clinical Obligation Assurance I, understand that I am required to complete a minimal number of hours in the clinical environment as part of my EMS training at Great Lakes EMS Academy/Davenport University Consortium. I understand that the hours listed below are the minimal requirements for the Paramedic Course at Initials GLEMS/DU. Initials Initials Initials Initials Initials Initials Initials All my clinical hours need to be completed and all the documentation entered (paper and internet) before I can start the internship. That internship must be completed within 90 days after the last day of time spent in the classroom. While attending clinicals I am required to complete EMS Run Reports (Patient Care Documentation) for patient for every patient experience. My clinical documentation record that documents the clinical exposure will include the originals or copies of my EMS Run Reports that I complete for each patient interaction. My experience in the clinical environment needs to be tracked via tables that are provided by the Academy in this clinical manual. I must also keep my internet based clinical tracking account up-todate with my lab and clinical experience. I have read and understand the Clinical Uniform and Appearance Standards and I will follow these guidelines while in the clinical environment and whenever I am wearing the GLEMSA/DU uniform (class and clinical). If a student is found in the clinical environment in inappropriate dress or with body piercing, or excess facial hair, they may be immediately asked to leave the clinical and could possibly be dis-enrolled from the Academy I understand that I am obligated to first learn about skills in the classroom, then practice that skill in lab followed by using that skill in scenarios and testing on that skill with an instructor. I will not practice a skill on a patient in the clinical environment until I have been successfully completed an evaluation by an instructor at the Academy. All clinical hours and experience must be completed while attending a clinical as a GLEMSA /DU Student. I may work for a company that may require me to complete some of the skills that I practice as an EMS student, those skills, hours, or experiences cannot be counted towards my experience as a student. I am not to perform ALS skills until I am licensed and authorized by an employer to perform ALS skills while working for that employer. Signature: _ Date: _ 2

4 Great Lakes EMS Academy/Davenport University Consortium Paramedic Module 404 hours Clinical 250 hours Internship Clinical hours Module 1: Specialist Module 2: Cardiology Anesthesiology (8 hours) Module 3: Medical Emergencies I 1 visit to Heart Cath Lab (8 hours) Module 4: Medical Emergencies II OB / Delivery (8 hours) Module 5: Trauma Management Anesthesiology (8 hours) Psychiatric (8 hours) Module 6: Review and Integration Internship 12 hours Helen DeVos ICU PACU (8 hours) 250 hours Student Name: Signature: _ Date: _ 3

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6 Great Lakes EMS Academy/Davenport University Consortium Clinical Progress Table The student must have the immunizations and exposure control items signed off before going into the clinical environment. The other items are to be signed off after the students shows a basic level of competency and the instructor believes it is safe for the student to perform the skill in the clinical environment with minimal supervision. The student s initials contend that the student feels comfortable with the skill. In the clinical environment the preceptor can use this table as a reference when establishing whether a student has the didactic and practical instruction before attempting various skills on patients. Item Handed in Proof Immunizations _ Staff Initials Date Exposure Control AHA BLS / AED Staff Initials Staff Initials _ Date _ Date Preparatory Skills Progress Skill Successful Evaluation Supraglottic Airway Staff Initials Date IV Therapy Staff Initials Date Intraosseous Staff Initials Date IV Drug Administration SQ / IM Administration Staff Initials Staff Initials Date Date CPAP Staff Initials Date Nebulizer Staff Initials Date MAD (Intranasal) Staff Initials Date Glucometer Staff Initials Date 1

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8 Great Lakes EMS Academy/Davenport University Consortium The Clinical Experience All participants of a Paramedic Course at the Great Lakes EMS Academy/Davenport University Consortium must attend a certain number of hours in a clinical setting. This time will be spent at various hospitals and ambulances in the West Michigan area. The importance of experiential learning cannot be overstated. During the clinical exposure, it is expected that all students will conduct themselves in a professional way and show enthusiasm towards learning. Students will be required to sign up for all their clinical obligations early in the course. Throughout the course there may be occasions when the student will need to change the schedule. This will be done by contacting the Clinical Coordinator at the earliest possible time. Clinical scheduling can be very difficult. It is expected that the student will sign up for clinicals in such a manner that would avoid schedule changes or conflicts. All clinicals will be scheduled through the Clinical Coordinator. The student will use the FISDAP website to schedule the clinical experience. If students sign up for clinicals outside of the system used to schedule clinicals, the time spent at those clinicals will not count towards their clinical obligations. If a student has an emergency cancellation of a clinical, they should call the Clinical Coordinator or Director of Operations at the earliest possible time to advise her that they will not be able to make their clinical obligation. Students will need to complete documentation for all clinical experiences. When a student goes to an ambulance company or emergency room clinical, they will need to have the preceptor sign their daily evaluation. After the experience, it is vitally important for the student to go onto the Platinum Planner website and document all the patient encounters and skills practiced during the ride-along. Students are required to see a certain number of various patients. It is also necessary for them to successfully complete a certain number of ALS and BLS skills while in the clinical or internship environment. It behooves the student to record as much as possible. At the end of the course, the opportunity may not present itself again during the normal hours and the student must complete more hours to see a specific patient or complete a skill. FISDAP In June 2016, The Great Lakes EMS Academy will be using FISDAP for ALS clinical tracking and documentation. FISDAP is the website the students will use to: 1. Schedule their clinical experiences 2. Track their skills in lab 3. Document and Track their patient encounters How do I create a new FISDSAP account? All Students will need to have a FISDAP account before the first day of class. 1. Once you have a FIISDAP activation code, creating an account is easy. 2. Go to the FISDASP home page, 3. Click Create an Account. 4. Type or paste in your activation code (you get that from Melissa) and click Continue. 5. You will need to enter your billing information, then click Place Order. On the receipt page, click Create Your Account. 6. Enter your profile information, and choose a FISDAP username and password, then click Save & Continue. 7. Read and accept the User Agreement and click Continue. 8. You re all done! Click Continue to My FISDAP to log in and access your new account. 3

9 Paramedic Clinical Manual Rules in the Clinical Environment Rules in the Clinical Environment The rules listed below are set forth to assure the various clinical sites that students will be professional and will follow set policies. Students who violate these rules can be dismissed from the Academy without prospect of reclaiming their tuition. Many actions will warrant a verbal reprimand followed by a written reprimand and then finally dismissal (progressive discipline). However other actions may call for immediate dismissal. These actions must be proven and substantiated by witnesses or confession. 1. Falsifying records for time spent at clinical sites will not be tolerated. 2. An act of gross negligence in patient care during any clinical exposure. 3. Demonstrating lack of medical ethics such as disclosure of confidential information. 4. Harassing employees, patients or other individuals encountered at clinical sites. Harassment of a threatening nature may be grounds for immediate dismissal. 5. Stealing property owned or leased by the clinical site will mean immediate dismissal and charges will be pressed. 6. Bringing weapons to the clinical site. Again, this could be reason for immediate dismissal. 7. The use of illicit drugs or alcohol within 8 hours before a clinical experience will warrant dismissal from the Academy 8. As a student, you will not operate any radio or drive any vehicles. 9. You must plan to ride the entire shift. The ambulance company cannot jeopardize the coverage to return you to headquarters at your discretion. 10. Large purses and bulky items are cumbersome and cannot be accommodated in the ambulance. 11. The use of seatbelts is mandatory while the ambulance is in motion. 12. No eating, drinking, applying makeup or applying lip balm while in the patient compartment. 13. Students must comply with all clinical uniform standards. Failure to adhere to clinical uniform and appearance standards while at a clinical is reason for immediate dismissal from the program. 14. If the patient presents a possible exposure risk, i.e. open wounds, draining lesions, or persistent cough, the EMS student will follow appropriate infection control guidelines. Student ID Each student will have an ID badge created and distributed by the Academy. This badge will be completed and given to the Student before clinical observation begins. This will be a picture ID with general student information to include name, course, and student number. ID s must be worn during each clinical experience. Wearing uniforms to school. From time-to-time students will wear their uniform to class. This is usually the case on the practical (lab) days. When students are wearing the uniform, they are to adhere to all the clinical uniform guidelines. Hence, no tennis shoes, not brown boots, not beards (facial hair), no earrings. You must follow all the rules. Or, simply do not wear the uniform. 4

10 Great Lakes EMS Academy/Davenport University Consortium Clinical Uniform and Appearance Standards Paramedic students at the Academy wear a clinical uniform to all clinicals and to some of the classroom sessions. The Academy has earned a reputation for providing well-prepared and professional prehospital care providers. To maintain this reputation, the students must present themselves in a highly professional manner while in the public s eye and wearing the clinical uniform. Dark Blue Working Pants: These can be any brand. The student should consider purchasing the pants from a company that sells uniforms to EMS workers. These pants should be well fitted to the student. No holes, frayed edges or stains. No Nye Uniform has a very good pant with cargo pockets that most the students will buy. Students are not to wear blue jeans with the uniform shirt. Blue Uniform Shirt: The blue uniform shirt can be long or short sleeved. The shirt will be purchased at Nye Uniform across the street from the Great Lakes EMS Academy/Davenport University Consortium. This shirt should be clean, well-fitted to the student, and free of wrinkles when worn in public. If students have tattoos on their forearms they are not to be visible while wearing clinical uniform. So, long sleeve shirts should be worn. Students are not to wear shirts under the uniform shirt that has sleeves that are longer than the uniform shirt. Black Boots: Students will need to acquire and wear black working boots for use in the ALS ambulance clinicals. These boots are the standard footwear for people working in EMS. The shoe will be all black. The student may use a low cut (chuck-style) boot. If the boot has laces, the laces will be black. Running shoes and tennis shoes are not appropriate. Uniform Belt. The uniform will be worn with a belt. The belt will be black or dark blue. Students should use a belt that is typically used in EMS. No big belt buckles. White T-Shirt: Students should wear a T-shirt with the uniform. This t-shirt will be white and will be free of any writing or graphics that can be seen through the uniform shirt. Name Tags and assorted uniform Items: The student may elect to adorn their shirt with various accoutrements. Brass nameplates are common items worn on the uniform. These can be purchased at Nye Uniform for approximately $ Appearance Standards While wearing the uniform the student will adhere to all the uniform regulations. That would include the rules regarding facial hair, jewelry, and hygiene. This includes time spent in the classroom if the uniform is to be worn. Taking care of your uniform: Students should get used to the proper care and handling of uniform shirts. This would include ironing the uniform. Professionalism begins with an appearance of professionalism. The first impression that you make with your patients and your patient s family can be vital. Students should understand that when they are wearing the uniform they represent the Academy and the EMS industry. Students need to keep their uniforms clean, wrinkle-free, and professional looking. Haircuts/Hairstyles: Student s hair must be neat, clean, and secured away from the face. Male student s hair will be no longer than shoulder length. Hygiene: Students will practice good personal hygiene habits throughout the course. Students cannot smell bad while in the clinical environment. Use soap and shampoo and deodorant. Facial Hair: Mustaches will be neat, clean, and kept off the upper lip. No other facial hair will be authorized. No beards, no goatees, no long sideburns. Finger nails: Nails will be short and clean. Clear nail polish is preferred. No brightly colored nail polish. Acrylic nails are prohibited. Jewelry: Only two stud type earrings (one in each earlobe) are allowed during clinicals. If you are going to wear an earring you need to wear two earrings. No other visual piercing will be authorized. Nothing will be worn on the eyebrows, tongue, lip, cheek, nose, or around the exterior aspect of the ear. 5

11 Paramedic Clinical Manual Attendance Policy for the Clinicals Students must be prompt and dependable in regards to their clinical schedule. Tardiness is unacceptable. If a student misses a clinical and does not give any notice of such conduct, they will be placed on probation for the rest of the module. A second occurrence during that module will lead to a failing grade for the clinical obligation. The student will be allowed to enroll into the next class available. Students who attend a future class will pay normal tuition fees. 1. If a student is unable to attend a clinical experience as scheduled, they must call or page the Clinical Coordinator at least 1 hour before the anticipated absence. 2. If a student fails to come to a clinical unit as assigned and doesn t call ahead of time to notify the Clinical Coordinator of his or her anticipated absence, the student will receive an unexcused absence. 3. A student who, through personal error, goes to the wrong clinical unit on the wrong day or time will NOT be allowed to perform the clinical and will be instructed to leave the clinical area. The student will receive an unexcused absence. 4. If a student arrives more than 30 minutes late to the clinical area without calling or paging the Clinical Coordinator, the lateness will be noted as unexcused. 5. Highly unusual or extenuating circumstances occasionally occur, causing a student to be absent or late without opportunity to provide notice. We believe these situations to be rare. The acceptance of such unusual circumstances as adequate for an excused absence is the sole responsibility of the Clinical Coordinator. 6. Two unexcused absences and/or late arrivals may be grounds for dismissal from the program. The attendance infraction will be evaluated by the Director of the Academy. 7. Rescheduling of clinical experiences can only be done based on unit availability. A student may delay graduating and not be eligible be included on the roster for successful completion if they do not finish the clinical component on time. 8. No student may leave a clinical unit before completing the assigned shift unless permission is granted by the Clinical Coordinator or they are dismissed by the preceptor as having completed all objectives and/or there is continuing opportunity to provide patient care. 6

12 Great Lakes EMS Academy/Davenport University Consortium Clinical Obligations There is a minimal requirement for the hours a student spends in the clinical environment. Each module of the Paramedic curriculum has at least 60 hours of clinical obligation. At the end of each module the student will need to show proof of their clinical progress. If the student does not have the required hours, they will be given an additional module (8 to 11 weeks) to complete the obligation. Upon the end of the next module, the student is required to be completely caught up with their clinical hours. Failure to complete the clinical obligation will mean failure of the module. Module Module 1: Specialist Clinical hours Module 2: Cardiology Module 3: Medical Emergencies I Module 4: Medical Emergencies II Module 5: Trauma Management Module 6: Review and Integration Internship Anesthesiology (8 hours) I visit to Cardiac Cath Lab OB / Delivery (8 hours) Anesthesiology (8 hours) Psychiatric rotation 12 hours Helen DeVos ICU/PACU rotation 250 hours Clinical Observation forms and Assessment/Management Log The student must complete a clinical observation form for every clinical experience. The form should be filled out and signed by the preceptor. Forms not signed by the preceptor will not be acceptable. If a student is caught falsifying clinical documentation they will be immediately dismissed. It is the student s responsibility to keep up-to-date on the Patient Assessment/Management Log. The best advice is to transfer all the information from the Patient Care Documentation to the Assessment Management Log towards the end of the clinical or just after the clinical while you are winding down. 7

13 Paramedic Clinical Manual Clinical Site Directions and Instructions *Students participating in Clinicals at a Rural or Slow Service, i.e. 24-hour shifts, must have 5 patient contacts to qualify for a 12-hour shift. If you will be arriving late to a Clinical, do not go. You will need to reschedule. American Medical Response-Grand Rapids 517 South Division, Grand Rapids: 131 to Wealthy, East on Wealthy to Division, South on Division to Logon, West on Logon, immediate Left into AMR Back Parking Lot. Go to back door and pick up phone, this will ring into dispatch. Tell them you are there for a Clinical and they will let you in and direct you. American Medical Response-Holland 2629 N. Park Drive, Holland: In Walmart Parking lot, at James and 131. Go to whatever door is open and knock or use bell. Life EMS 1275 Cedar NE, Grand Rapids: 196 to Fuller Ave, North on Fuller to Cedar, East on Cedar to Life EMS on Left. Park in parking lot or in parking lot next door. Go to front door or back door if after business hours. *For other ambulance service instructions, contact Melissa or Amy Saint Mary s Hospital Emergency Room (Mercy Health Services): 200 Jefferson, SE, Grand Rapids: Park in Visitors Lot (there may be a fee for parking) go to emergency room entrance and check in at registration or security desk. Saint Mary s Hospital OR: 200 Jefferson, SE, Grand Rapids. Park in the lot designated to you at OR orientation (students must participate in an orientation at Saint Mary s to attend clinical). You MUST have your ID badge and a stethoscope or you will not be allowed entrance into the OR. Use the public elevator (or stairs) to get to the 3 rd floor. When you get to the third floor, check in with Millie at the desk. She will contact Andy Pigorsh or Craig McEwan (OR Techs) to escort you to the dressing rooms and change into scrubs, shoe covers and a sweet surgery hat. Do not bring valuables with you. Proceed to the OR. The OR Tech will explain the schedule board to you and try to plan your day for you. The Anesthesiologist or and RN should come to meet you and bring you to patients. Please take time to thank everyone who helps you with this experience. Holland Hospital Emergency Room: 602 Michigan Ave, Holland: Go to emergency department entrance and check in at registration or security desk Spectrum Health Butterworth and Helen Devos Emergency Rooms 100 Michigan NE, Grand Rapids: Parking is available in ramps located across from the Hospital. There may be a fee charged for parking here. Go to the Emergency Room entrance and check in at the triage desk. They will direct you. 8

14 Great Lakes EMS Academy/Davenport University Consortium Clinical Objectives The purpose of the ALS experience is to enable students to observe and participate in the clinical assessment and emergency interventions for acutely ill or injured patients. This experience must be facilitated by a Paramedic preceptor. The student can maximize the learning potential of this experience by (1) observing care of acutely ill and injured patients; (2) asking pertinent questions of the ambulance crew; (3) correlating information /material learned in class to how things are done on the streets ; and (4) participating in care while directly supervised. Scope of Practice A Paramedic student enrolled in Great Lakes EMS Academy/Davenport University Consortium, while fulfilling the clinical training and in-field supervised experience, shall be able to perform at the EMT-Basic level with minimal supervision and perform various ALS skills inherent to pre-hospital medicine under direct supervision by a Paramedic, Nurse (RN), Physician Assistant or Physician Ambulance Clinicals Procedure for Reporting to the Ambulance Co. A. In West Michigan, the ambulance companies run a high-performance system, which demands that the ambulances that are scheduled be ready to roll at the time scheduled. Students should arrive at least 15 minutes early for their shift to meet the crew get acquainted with the ambulance and help the paramedics get ready for the shift. Early is on time On time is late B. For most ambulance companies, the procedure will involve contacting their communication center to advise that you are there for an ALS clinical shift. The dispatcher will advise you of your crew and usually tell the crew that you are in the building. C. Report to the preceptor. Show the preceptor a copy of this instruction plan to remind them of your objectives and scope of practice. D. Initiate the paperwork for the ALS clinical experience. Student Objectives A. Gain competence and strengthen skill in scene management and patient assessment. This can best be accomplished by working with the paramedic crew. Usually the first few shifts are focused on observation during the initial patient contact. During the call, you may be expected to help with procedures, complete BLS skills, or simply fetch equipment. As the crew becomes more comfortable with your level of competence, you should start initiating patient contacts and finally directing care of the patient. Practice history taking and performing the steps of inspection, palpation, and auscultation. Systematically divide the stages of assessment. Correlate the kinematics of injury or the nature of the illness with the patient s history to begin forming an impression of their status. Recognize the importance of frequent reassessments in planning patient care. B. Observe and perform BLS skills as directed. These skills include CPR, non-invasive airway management and suctioning, application of oxygen, ventilatory support with BVM; wound bandaging, obtaining vital signs, management of the patient requiring PASG, and techniques of splinting, C. Observe and perform ALS skills as directed including: airway access maneuvers; IV access and administration of isotonic crystalloid IV fluids; administration of approved EMS medications; ECG monitor application and rhythm interpretation and capillary glucose testing. You may not perform any ALS skills unless you are under the direct supervision of a Paramedic. D. Observe comprehensive care of acutely ill and injured patients after you turn care over to an emergency department. By observing total patient care, the student will achieve greater knowledge of disease processes and definitive interventions, which will improve the quality of care provided in the field. E. Observe the effect and side effects of medication and/or treatment that is rendered in the field and ED. This promotes an introductory understanding of pharmacodynamics. Assist in calculating drug doses and IV drip rates. 9

15 Paramedic Clinical Manual Skills to Perform while on the Ambulance A. Patient assessments including a SAMPLE history and completing a physical exam consistent with EMS principles. The assessment should include taking vital signs, auscultating breath sounds, evaluating mental status using AVPU and/or the Glasgow Coma Scale as appropriate, and performing a neurologic assessment of pupils. B. Airways access maneuvers - observe, assist, perform basic and advanced airway placement and management C. Oxygen delivery via the various administration devices D. Needle chest decompression. E. Cardiac monitoring/resuscitation 1. Apply leads and interpret a ECGs 2. Assist in cases of cardiac arrest 3. Perform monitored defibrillation 4. Perform cardioversion 5. Perform transcutaneous pacing F. Peripheral venous cannulation or insertion of an IO line and Infusion of IV crystalloid solutions G. Hemorrhage control H. Preparation, administration, and monitoring the response to common medications. I. Eye and/or skin irrigation following chemical burns J. Burn/wound management to include application of dressings and bandages K. Spinal immobilization and application of musculoskeletal splinting devices L. Wound management M. Proper restraining techniques N. Psychological support of patients/significant others 10

16 Great Lakes EMS Academy/Davenport University Consortium Emergency Department The purpose of the Emergency Department (ED) experience is to enable students to observe and participate in the clinical assessment and emergency interventions for acutely ill or injured patients. This experience must be facilitated by a nurse preceptor (see below). The student can maximize the learning potential of this experience by (1) observing care of acutely ill and injured patients; (2) asking pertinent questions of the ED team; (3) correlating EMS assessments and interventions to those completed in the ED; and (4) participating in care while directly supervised. Procedure for Reporting to Department A. Some hospitals require an orientation to the hospital. Questions regarding how to report for the clinical for that specific hospital is best answered at the orientation. B. At most emergency rooms, the student will enter the hospital through the public entrance for the emergency room. The student will then go to the security desk or triage nurse and advise them of their scheduled clinical. C. Report to the hospital at least 15 minutes prior to the scheduled start. D. Inform the charge nurse of your arrival and he or she will provide a preceptor. E. Report to the preceptor. Have a conversation with the preceptor regarding your objectives and scope of practice. Student Objectives A. Gain competence and strengthen patient assessment skills. This can best be accomplished by working with the physician or RN. Practice performing the steps of inspection, palpation, and auscultation. Systematically divide the stages of assessment. Recognize the importance of frequent reassessments in planning patient care. If a physician is available, question him/her about the patient s clinical presentation. Interaction with the ED staff can improve your performance in the field and can be a great learning experience. But don t expect them to seek you out; you must initiate the interchange. B. Observe and perform BLS skills as directed. These skills include CPR, non-invasive airway management and suctioning, application of oxygen, ventilatory support with BVM; wound bandaging, obtaining vital signs, management of the patient requiring PASG, techniques of limb splinting, and spinal immobilization. C. Observe and perform ALS skills as directed including: airway access maneuvers; IV access and administration of isotonic crystalloid IV fluids; administration of approved EMS medications via the PO, SL, topical, IV, IM, SQ, ET, and inhaled routes; obtaining blood samples; ECG monitor application and rhythm interpretation and capillary glucose testing. D. You may not perform any ALS skills unless you are under the direct supervision of a nurse or physician. E. Develop diagnostic skills by reviewing the accuracy of your initial impressions. Observe the process followed by the physician in arriving at his/her medical diagnosis. Learn to use critical judgment skills in making a differential diagnosis based on clinical presentation and history. F. Observe comprehensive care of acutely ill and injured patients. By observing total patient care, the student will achieve greater knowledge of disease processes and definitive interventions, which will improve the quality of care provided in the field. G. Observe the effect and side effects of medication and/or treatment that is rendered in the field and ED. This promotes an introductory understanding of pharmacodynamics. Assist in calculating drug doses and IV drip rates. H. Enhance knowledge of anatomy and pathophysiology by asking to interpret x-rays and lab results. Accompany patients to special procedures, i.e., C-T scans, angiography, ultrasound, surgery, etc., whenever possible. 11

17 Paramedic Clinical Manual Skills to Perform while in the Emergency Room A. Patient assessments including a SAMPLE history and completing a physical exam consistent with EMS principles. The assessment should include taking vital signs, auscultating breath sounds, evaluating mental status using AVPU and/or the Glasgow Coma Scale as appropriate, and performing a neurologic assessment of pupils. B. Airways access maneuvers - observe, assist, perform basic and advanced airway placement and management C. Oxygen delivery via the various administration devices D. Oxygen delivery/ventilatory support via NC, NRBM, or BVM. E. Cardiac monitoring/resuscitation F. Peripheral IV or IO insertion G. Hemorrhage control using direct pressure/pressure dressings H. Preparation, administration, and monitoring the response to common medications. I. Eye and/or skin irrigation following chemical burns J. Burn/wound management K. Application of dressings and bandages L. Application of musculoskeletal splinting devices M. Proper restraining techniques N. Psychological support of patients/significant others Anesthesiology Clinical Before students can attend the anesthesiology clinical they must intubate an advanced airway mannequin several times. An instructor signs off on their ability to perform intubation after observing the student s successful completion of a skills lab. Students spend time in the Operating Room with two main goals in mind. First, ventilate a non-intubated patient to the feel for using a bag-valve-mask on a patient who is breathing and learn from the anesthesiologist explain the procedure of intubation. Secondly, intubate under professional supervision. Objectives 1. Ventilate non-intubated patient under general anesthetics 2. Observing health care provider and patient interactions / communication 3. Observe medical professional working around sterile fields / medical aseptic techniques 4. Observe the intubation of patients under general anesthetics 5. Intubate patients under direct supervision by operating room staff 6. Observe the use of an LMA or another airway devise Labor and Delivery Objectives When assigned to the labor/delivery unit, the paramedic student should gain knowledge by observing the following: 1. Recognition of the signs and symptoms of labor. 2. Recognition of the signs of imminent delivery. 3. Assessment of the physical and emotional status of patients during labor. 4. Observation of normal and abnormal vaginal deliveries and/or delivery by C-section. 5. Assessment of the newborn to include APGAR scoring. 6. Appropriate therapeutic communication with patients and families. 7. Recognition and resuscitation of the newborn in distress. 8. Recognition and treatment of maternal postpartum complications. Heart Catheterization Lab While participating in the cardiac cath lab, the paramedic student should gain knowledge in the following: 1. EKG interpretation and the hemodynamic effect of individual rhythms 2. Effects of cardiac drugs on the electrical system of the heart as well as their hemodynamic effects 3. Basic principles of anatomy and physiology of the cardiovascular system, with emphasis on the coronary arteries 4. Appropriate application and techniques of defibrillation and/or cardioversion 5. Application of sterile technique principles 12

18 Great Lakes EMS Academy/Davenport University Consortium Great Lakes EMS Academy/Davenport University Consortium Ambulance Clinical Documentation Student and clinical site Information Student Name Clinical Site Date # hours today Remarkable patient encounters (completed by student) Pt Care Doc # Chief Complaint Priority Description of patient contact (assessment, treatment and disposition) Preceptor evaluation (completed by Paramedic, Nurse, or Doctor) 1=disagree with statement, 2= agree with statement, 3=student exceeds expectations regarding EMS student Showed up on time and seemed ready to work / learn Dressed and acts professionally Motivated to study and/or asks questions Seeks out patient contact in ER / studies between calls while on the ambulance Able to initiate patient contact (first one to talk to the patient) Able to form an action plan or treatment plan for patients Remained involved during patient care interactions Seems confident with skills that have been learned in class Preceptor trusts the student to start IVs (3=with minimal supervision) Preceptor trusts the student to intubate (3=with minimal supervision) Preceptor comments Student comments regarding the clinical experience and lessons learned Preceptor Name Preceptor Signature If you have a comment about the clinical program, feel free to call the Academy during normal business hours: (616) or us at: steve@greatlakesems.com. 13

19 Paramedic Clinical Manual Patient Care Documentation for Ambulance Form # Students will complete this form while on the ambulance. Then, later, upload this form and enter the information regarding skills and patient age and complaint into Platinum Planner PMH: Meds: Chief Complaint: Age: Sex: Allergies: History: Assessment: Time Blood Pressure Pulse Rate Quality Respiratory Rate Tidal Eyes SaO 2 Cardiac Rhythm Rx Treatment Transportation (how did the patient do after treatment) Analysis of the patient interaction Basic skills observed by student: Airway Ventilation Basic Trauma Immobilization Basic skills completed by student: Airway Ventilation Basic Trauma Immobilization Advanced skills observed by student: ETT IV and IO ECG/Defib Drug Admin Advanced skills completed by student: ETT IV and IO ECG/Defib Drug Admin What went well during this EMS call? What would have made this call run more smoothly? What did you learn during the call? Preceptor Student Name Date 14

20 Great Lakes EMS Academy/Davenport University Consortium Great Lakes EMS Academy/Davenport University Emergency Room Clinical Documentation Student and Clinical Information Student Name Clinical Site Date # hours today Remarkable patient encounters (completed by student) Pt Care Doc # Chief Complaint Priority Description of patient contact (assessment, treatment and disposition) Preceptor evaluation (completed by Nurse, or Doctor) 1=disagree with statement, 2= agree with statement, 3=student exceeds expectations regarding EMS student Showed up on time and seemed ready to work / learn Wrote out the objectives before coming to clinical Dressed and acts professionally Motivated to study and/or asks questions Seeks out patient contact in the emergency department Remained involved during patient care interactions Seems confident with skills that have been learned in class Preceptor comments (completed by Nurse, or Doctor) Student comments regarding the clinical experience and lessons learned Preceptor Name Preceptor Signature If you have a comment about the clinical program, feel free to call the Academy during normal business hours: (616) or us at: steve@greatlakesems.com. 15

21 Patient Care Documentation for Emergency Room Paramedic Clinical Manual Form # Students will complete this form while taking care of patients in the ED. Then, later, upload this form and enter the information regarding skills and patient age and complaint into FISDAP. You should use this form for at least 5 patients that you see in the ED. Be sure to use this for the most interesting cases and the all of the pediatrics. PMH: Meds: Chief Complaint: Age: Sex: Allergies: Assessment: Time Blood Pressure Pulse Rate Qual Respiratory Rate Tidal Eyes SaO2 Cardiac Rhythm Rx Treatment Disposition Patient Care Documentation for Emergency Room Form # PMH: Meds: Chief Complaint: Age: Sex: Allergies: Assessment: Time Blood Pressure Pulse Rate Qual Respiratory Rate Tidal Eyes SaO2 Cardiac Rhythm Rx Treatment Disposition 16