LY N E TT E M C C U L LO U G H , M C H , N R P

EMT-INTERMEDIATE TO ADVANCED EMT

PROGRAM OVERVIEW

• Introductions• Course Purpose• National and State Curriculum/Scope of Practice and

Licensure Revisions• Requirements for AEMT Licensure

• Course Requirements• Attendance• Cognitive competency• Skills competency• Clinical requirements

CURRICULUM OUTLINE

• Module 1: Pretest, Preparatory, Operations• Module 2: Anatomy, Physiology, Pathophysiology• Module 3: Pharmacology• Module 4: Patient Assessment and Resuscitation• Module 5: Medical, Trauma, and Special Patients• Module 6: Integration and Practical Applications• Module 7: Clinical Experience

PRETEST90 MINUTES TO COMPLETE

Preparatory• Applies fundamental knowledge of the

emergency medical services (EMS) system, safety/well-being of the advanced emergency medical technician (AEMT), medical/legal, and ethical issues to the provision of emergency care

EMS Operations• Knowledge of operational roles and

responsibilities to ensure patient, public, and personnel safety

NATIONAL EMS EDUCATION STANDARD COMPETENCIES

Public Health• Uses simple knowledge of the principles of the

role of EMS during public health emergencies

Medicine• Applies fundamental knowledge to provide basic

and selected advanced emergency care and transportation based on assessment findings for an acutely ill patient

NATIONAL EMS EDUCATION STANDARD COMPETENCIES

COMPREHENSIVE HEALTHCARE

• Individualized Care• Preventative and Primary Care• Emergency and Urgent Care (Includes EMS)• Acute and Critical Care• Specialty, Rehabilitative and Longterm Care

• Public and Community Healthcare• Epidemiology• Inspections (Restaurants, playgrounds, schools, etc)• Response to threats (May include EMS)

PUBLIC SAFETY

• Law Enforcement• Fire Services• Emergency Management• EMS• Animal Control• Water Supply/Waste Management

EMS SYSTEM COMPONENTS

• Regulation and Policy• Resources Management• Human Resources and Training• Facilities• Communications• Transportation• Public Information and Education• Medical Direction• Evaluation• Trauma Systems

EMS CHAIN OF CARE

• Recognition of emergency event• System access and bystander care• Dispatch (with bystander instruction)• Response (preplanning)• On-scene care• Transport• Transfer to in-facility care• In-facility care and rehabilitation (as required)

EMS RESPONDERS

• Bystander care• Emergency Medical Responders• Emergency Medical Technicians• Advanced Emergency Medical Technicians• Paramedics• Scope of Practice Document (review)

PUBLIC HEALTH

• Study of the occurrences of illness, injury, and death• Epidemiologic terms• Morbidity• Mortality• Endemic• Epidemic• Pandemic• Primary prevention• Secondary prevention• Tertiary prevention

EMS IN PUBLIC HEALTH

• Provide public education• CPR, First aid, emergency evacuation procedures• Injury prevention (bicycle safety, water safety, car seat

use)• Assist in wide-spread immunization programs• Respond to major public health events to include

multiple or mass casualty events

MEDICAL DIRECTION

• Online• Offline• Onsite• Direct• Indirect• Delegated authority

QUALITY MANAGEMENT

• Prospective (vehicle and equipment checks, continuing education, skills practice, protocol development and review)• Concurrent (protocol adherence, on-site

supervision, effective team dynamics)• Retrospective (run review, peer debriefing)• Goal is to minimize errors

RESEARCH

• Evidenced-based decision making• Historically, much EMS practice is anecdotal• Resuscitation medicine spearheaded the efforts

for evidence-based decision-making• Need for EMS research is increased as a result• Research evidence and conclusions must be

critically evaluated• Review the evidence and discussions, not the

abstracts• EMS professionals should resist the temptation to

universally apply research conclusions to all conditions

RESEARCH COMPONENTS

• Hypothesis• Literature Review• Methodology• Findings• Discussion (includes identification of limitations)• Conclusions• Abstract

WORKFORCE SAFETY AND WELLNESS

WELLNESS

• Diet and nutrition• Exercise, relaxation and sleep• Immunizations• Wellness practices (infection control, body

mechanics)• Stress management• Safety hazard recognition and control• Use of personal protection devices

INFECTION CONTROL

• Disease transmission• Handwashing• Standard precautions• Use of protective equipment, supplies• Decontaminating, disinfecting and sterilizing

equipment• Exposure reporting• Postexposure activities

BODY MECHANICS

• Power Lift• Shoulder over hips, back straight, feet shoulder-width

apart• Power Grip• Palms up, hands about 10” apart

• Emergency Moves• Urgent Moves• Non-urgent Moves• Moving equipment

STRESS

• Causes of stress• Stress responses• Abnormal stress responses• Coping mechanisms• Signs of distress• Stress management• Post trauma stress debriefings

DEATH AND DYING

• Dying patients• Desire for autonomy• Accept patients expressions of fear, uncertainty• Be honest, allow hope

• Grief reactions• Post-death activities• Dealing with death to children

MEDICOLEGAL AND ETHICAL ISSUES

MEDICOLEGAL ISSUES

• Scope of Practice• Standard of Care• Duty to Act• Good Samaritan• Breach of Duty (malfeasance, misfeasance,

nonfeasance)• Abandonment• Proximate Cause• Negligence

MEDICOLEGAL ISSUES

• Assault• Battery• False imprisonment• Consent (and refusal)• Advanced directives and organ donation• Confidentiality and HIPAA• Forcible restraint• Mandatory reporting requirements• Medical Examiner cases

WORKFORCE ISSUES

• Cultural diversity• Sexual harrassment• Substance abuse• Ethics and morality

OPERATIONS

OPERATIONS

• Vehicle operations• Air-medical operations• Extrication and Special Rescue Operations• Hazardous Materials Exposures• Multiple-Casualty Operations• Terrorism

SUMMARY

• EMS Systems• Public Health• Research• Workforce safety and wellness• Medicolegal• Operations