DATE OF LAST REVIEW: 2016 CIP CODE: 51.0904 Paramedic Hospital Clinical Practice Syllabus COURSE TITLE: COURSE NUMBER: Paramedic Hospital Clinical Practice PMED-0245 CREDIT HOURS: 5 INSTRUCTOR: Jeff Smith OFFICE LOCATION: 2613 TELEPHONE: 913-288-7208 EMAIL: jsmith@kckcc.edu PREREQUISITES: PMED 0260 CO-REQUISITES: PMED 0229 REQUIRED TEXT AND MATERIALS: Please check with the KCKCC bookstore, http://www.kckccbookstore.com for the required text for your particular class. COURSE DESCRIPTION: This course provides the student an opportunity to apply didactic content and lab practice to the clinical environment. Activities are directed so that students gain familiarity with initiating and continuing care for injured and ill patients in a variety of adult-child acute care settings. Emphasis is placed on professional clinical practice guidelines for basic Paramedic procedures. Students will practice safe operation of equipment, and appropriate technology selection for desired therapeutic effects. Clinical areas to be included are Behavioral Health, Burn Unit, Cardiac Cath Lab, Dialysis, Emergency Department, Intensive Care, Labor & Delivery, Respiratory Therapy, Surgery and Pediatrics. Prerequisite: Successful completion of PMED0260 with a grade of C or higher; Co-Requisite PMED0229. METHOD OF INSTRUCTION: A variety of instructional methods may be used depending on content area. These include but are not limited to: lecture, multimedia, cooperative/collaborative learning, labs, simulation labs and demonstrations, projects and presentations, speeches, debates, and panels, conferencing, performances, and learning experiences outside the classroom. Methodology will be selected to best meet student needs.
COURSE OUTLINE: I. Obtain a pertinent medical history A. Components of a pertinent medical history. B. History of present illness or injury C. Pertinence of past medical history to present situation D. Pertinence of medications and allergies II. III. IV. Perform a complete physical assessment A. Review body systems B. Components of vital signs C. Importance of each vital sign Implement appropriate care for patients A. Drawing subcutaneous medication. B. Administer a subcutaneous medication C. Proper technique for an intramuscular injection D. Complications of giving an intramuscular injection E. Cleansing and dressing wounds F. Obtain a venous blood sample G. Establish intravenous/intra-osseous access H. Complications of intravenous/intra-osseous access I. Proper technique for administering nebulized breathing treatment Demonstrate the ability to correctly interpret EKG s A. Electrode application B. Correlate EKG, 12-Lead findings with patient s status C. Proper treatment for arrhythmias D. Procedure for using a transcutaneous pacer, performing cardioversion E. Distinguish between dysrhythmia and external electrical interference V. Demonstrate the ability to institute appropriate airway management techniques A. Airway suctioning, ventilations B. Placement of OPA, NPA, supraglottic airway, performing endotracheal intubation C. Oxygen administration D. Evaluate respiratory pattern and quality E. Monitor and interpret SpO2, ETCO2 findings F. Performing CPAP VI. Demonstrate knowledge of medications A. Class B. Indications and contraindications
C. Actions D. Side effects and adverse reactions, patients at risk for drug toxicities E. Dosages and routes of administrations F. Drug calculations and drip rates. VII. Demonstrate the ability to recognize cardiopulmonary arrest and to institute appropriate treatment modalities A. Demonstrate effective CPR B. Electrical therapy pad placement B. Safety considerations before applying electrical therapy C. Forms of electrical therapy available for arrest and peri-arrest situations D. ACLS and PALS guidelines E. Post-resuscitation care VIII. Demonstrate the ability to recognize and apply appropriate infection control procedures. A. Demonstrate an understanding of infection control concepts B. Demonstrate the ability to recognize level of protection needed based on patient care setting. C. Demonstrate appropriate pre and post care hygiene. D. Demonstrate appropriate donning and doffing of gloves, masks and gowns. E. Demonstrate appropriate cleaning of equipment. F. Demonstrate appropriate handling and disposal of sharps. EXPECTED LEARNER OUTCOMES: Upon successful completion of this course, on written, practical examination and clinical practice: A. The student will be able to demonstrate the ability to obtain a pertinent medical history on a variety of patients. B. The student will be able to demonstrate the ability to perform a complete physical assessment on a patient. C. The student will be able to, under the direct supervision of a clinical preceptor and/or physician, implement appropriate care for patients encountered in the clinical setting. D. The student will be able to demonstrate the ability to correctly interpret EKG s obtained from patients in the clinical setting. E. The student will be able to demonstrate the ability to institute appropriate airway management techniques including oxygen therapy and endotracheal intubation. F. The student will be able to demonstrate knowledge of medications used in the treatment of patients in emergency settings to include the medication; its mechanism of action, indications, contraindications, side effects, and overdose treatment, if any. G. The student will be able to demonstrate the ability to recognize cardiopulmonary arrest and to institute appropriate treatment modalities. H. The student will be able to demonstrate the ability to recognize the need and perform
appropriate infection control procedures. COURSE COMPETENCIES: The student will be able to demonstrate the ability to obtain a pertinent medical history on a variety of patients. 1. List the components of a pertinent medical history. 2. Determine history of present illness or injury. 3. Relate pertinence of past medical history to present situation. 4. Relate pertinence of medications and allergies The student will be able to demonstrate the ability to perform a complete physical assessment on a patient. 5. Review body systems to be included in a complete patient assessment. 6. Identify what comprise the vital signs. 7. Determine characteristics important to each vital sign. The student will be able to, under the direct supervision of a clinical preceptor and/or physician, implement appropriate care for patients encountered in the clinical setting. 8. Correctly draw up a given amount of subcutaneous medication. 9. Demonstrate the proper technique to administer a subcutaneous medication. 10. Demonstrate the proper technique for an intramuscular injection. 11. List possible complications of giving an intramuscular injection. 12. Assist in the cleansing and dressing wounds. 13. Correct obtain a venous blood sample. 14. Establish intravenous/intra-osseous access 15. Complications of intravenous/intra-osseous access 16. Proper technique for administering nebulized breathing treatment The student will be able to demonstrate the ability to correctly interpret EKG s obtained from patients in the clinical setting. 17. Perform electrode application for continuous monitoring. 18. Correlate EKG and 12-Lead findings with the patient s clinical status. 19. Provide proper treatment for arrhythmias. 20. Demonstrate the procedure for using a transcutaneous pacer, performing cardioversion. 21. Identify potentially lethal dysrhythmias and distinguish between these and simple, external electrical interference (artifact). The student will be able to demonstrate the ability to institute appropriate airway management techniques including oxygen therapy and endotracheal intubation 22. Recognize the need for and perform airway suctioning. 23. Recognize the need for and perform ventilations, application of CPAP. 24. Recognize the need for placement of an OPA, NPA or supraglottic airway device. 25. Recognize the need for and perform endotracheal intubation. 26. Apply oxygen and understand the indications for percentage and flow rates administered.
27. Evaluate the patient for respiratory pattern and quality, including chest wall movement, skin color and temperature, and pulse rate, rhythm, and quality and then relate these findings to the expected course of treatment. 28. Monitor and interpret SpO2, ETCO2 findings. The student will be able to demonstrate knowledge of medications used in the treatment of patients in clinical settings to include the medication, class, mechanism of action, indications, contraindications, side effects, dosage, administration route and overdose treatment, if any. 29. Discuss the common medications used in the clinical setting. 30. Identify the class, actions of the medication. 31. Identify the indications and contraindications of the medication 32. Identify side effects, adverse reactions that me be seen with the medication. 33. Identify those patients at risk for drug toxicities. 34. Identify proper drug dosage, calculations and appropriate administration routes. The student will be able to demonstrate the ability to recognize cardiopulmonary arrest and to institute appropriate treatment modalities. 35. Demonstrate effective CPR. 36. Recognize the importance of clearing the patient before applying electrical therapy to the patient. 37. Differentiate among the various forms of electrical therapy available for arrest and periarrest situations. 38. Demonstrate knowledge of ACLS and PALS guidelines in given situations. 39. Demonstrate appropriate post-resuscitation care. The student will be able to demonstrate the ability to recognize the need and perform appropriate inflection control procedures. 40. Demonstrate appropriate pre and post care hygiene. 41. Demonstrate appropriate donning and doffing of gloves, masks and gowns. 42. Demonstrate appropriate cleaning of equipment. 43. Demonstrate appropriate handling and disposal of sharps. SKILL AND CONTACT REQUIREMENTS: It is expected that through the use of skills labs, clinical experiences and field internship the student will, at a minimum, meet the following program terminal competencies, which include specific Kansas Board of EMS enrichment requirements: 1. Safely Administer seventy (70) Medications 2. Perform five (5) live intubations 3. Safely Gain fifty (50) Venous Access 4. Ventilate ten (10) Patients 5. Perform five(5) Assessment of Newborns 6. Perform five (4) Assessment of Infants
7. Perform five (5) Assessment of Toddlers 8. Perform five (5)Assessment of Preschoolers 9. Perform four (4) Assessment of School Agers 10. Perform six (6) Assessment of Adolescents 11. Perform thirty (30) Assessment of Pediatrics 12. Perform seventy-five (75) Assessment of Adults 13. Perform forty (40) Assessment of Geriatrics 14. Perform ten (10) Assessment of Obstetric Patients 15. Perform thirty (30) Assessment of Trauma Patients 16. Perform fifteen (15) Assessment of Psychiatric Patients 17. Perform fifty (50) Assessment of Medical Patients 18. Perform thirty (30) Assess & Plan RX of Chest Pain 19. Perform twenty-five (25) Assess & Plan RX of Breathing Problem 20. Perform ten (10) Assess & Plan RX of Change in Responsiveness 21. Perform twenty-five (25) Assess & Plan RX of Abdominal Pain 22. Perform twenty (20)Assess & Plan RX of Altered Mental Status 23. Perform fifty (50) Field Internship Team Leads 24. Perform five (5) intraosseous infusions 25. Administer five (5) nebulized breathing treatment on live patients 26. Competently perform one (1) cardiac emergency simulation 27. Competently perform one (1) medical emergency simulation 28. Competently perform one (1) trauma emergency simulation 29. Observe or assist in three (3) vaginal-delivered childbirths during clinical training. 30. Perform Ten (10) intramuscular or subcutaneous injections. 31. Write a minimum of thirty (30) patient charts during clinical and field internship training. 32. Monitor and interpret the electrocardiogram of a minimum thirty (30) patients during clinical and field internship training. Should a student be unable to meet the program requirements in the normally scheduled clinical or field internship activities, the program will extend the student s clinical and field internship as needed, as well as provide additional SimLab opportunities as appropriate. ASSESSMENT OF LEARNER OUTCOMES: Assessment methods include, but may not be limited to written tests, laboratory practicals, homework assignments and observation of professional behavior. Clinical preceptor evaluations of students are included when determining a grade. Students will perform a specific number of clinicals determined by the Medical Director, Director and Clinical Coordinator.
Preceptors evaluate students utilizing evaluation forms provided assessing the cognitive, psychomotor and affective domains while in the clinical setting based on the following scale: 0 Not competent 1 Not yet competent (partially competent) 2 Competent Clinical rotations covered in this course include: Dialysis 4 hours minimum Labor & Delivery 36 hours minimum Respiratory Therapy 24 hours minimum Pediatrics Emergency Department 48 hours minimum Pediatric ICU 12 hours minimum Burn Unit 24 hours minimum Behavioral Health 8 hours minimum Cath Lab 8 hours minimum Emergency Department 192 hours minimum Intensive Care Unit 24 hours minimum Surgery - 24 hours minimum Repeating/Readmission Privileges Returning students will need to complete an application form just the same as new applicants. Failed courses (grades of a D or F ) in a Paramedic core course may be repeated only once. Failure of any of the core courses (PMED 227, PMED 228. PMED 229, PMED 230) will result in dismissal from the program. Repeating privileges regarding withdrawal from an PMED course with a passing grade may be made without penalty. However, withdrawal with a failing grade ( D or F ), regardless of reasons, will be considered as having taken the course. Permission for readmission will be granted on a space available basis. Readmission will occur the next school year only. Students who fail out of PMED 228 will be required to start the sequence with PMED 227; Students who fail out of PMED 229 will be readmitted to the program by going into PMED 229; prior to readmission they will be required to pass the final written and practical examinations for PMED 228. Students failing out of PMED 230 will be readmitted to the program by going into PMED 229; prior to readmission they will be required to pass the final written and practical examinations for PMED 228. These students, at the discretion of the primary instructor, program director, and program medical director, may be allowed to re-enter the program at the PMED 0230 level provided that they have made sufficient academic and psychomotor progress to be judged to be able to be successful should they gain re-entry to PMED 0230; these students will have to take and pass the written and practical final for PMED 0229 as the final step for re-entry to PMED 0230, the final semester of the program. Failure to pass either the written or practical examination will cause the student to not be readmitted; they will then have to go through the process as would any student seeking admission for the first time. Students desiring to return after a longer absence will need to go through the entire admissions process as if they were a new student. A student who
is readmitted after any length of absence is required to have all licenses and certifications current at the time of readmission. A student who is readmitted to the Paramedic Program and does not successfully complete the course they are readmitted to will be dismissed from the Paramedic program. This will count as the second failure in the Paramedic program. A student who has failed out of the program for a second time is not eligible to return to the program. SPECIAL NOTES: This syllabus is subject to change at the discretion of the instructor. Material included is intended to provide an outline of the course and rules that the instructor will adhere to in evaluating the student s progress. However, this syllabus is not intended to be a legal contract. Questions regarding the syllabus are welcome any time. Kansas City Kansas Community College is committed to an appreciation of diversity with respect for the differences among the diverse groups comprising our students, faculty, and staff that is free of bigotry and discrimination. Kansas City Kansas Community College is committed to providing a multicultural education and environment that reflects and respects diversity and that seeks to increase understanding. Kansas City Kansas Community College offers equal educational opportunity to all students as well as serving as an equal opportunity employer for all personnel. Various laws, including Title IX of the Educational Amendments of 1972, require the college s policy on non-discrimination be administered without regard to race, color, age, sex, religion, national origin, physical handicap, or veteran status and that such policy be made known. Kansas City Kansas Community College complies with the Americans with Disabilities Act. If you need accommodations due to a documented disability, please contact the disabilities services office at (913) 288-7664. All enrolled students at Kansas City Kansas Community College are subject to follow all rules, conditions, policies and procedures as described in both the Student Code of Conduct as well as the Student Handbook. All Students are expected to review both of these documents and to understand their responsibilities with regard to academic conduct and policies. The Student Code of Conduct and the Student Handbook can be found on the KCKCC website.