EMT-Intermediate to Advanced EMT

1. EMT-Intermediate to Advanced EMT Lynette mccullough, mch, nrp

2. 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

3. 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

4. pretest 90 Minutes to complete

5. National EMS Education Standard Competencies 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

6. 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

7. 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)

8. Public Safety • Law Enforcement • Fire Services • Emergency Management • EMS • Animal Control • Water Supply/Waste Management

9. EMS System Components • Regulation and Policy • Resources Management • Human Resources and Training • Facilities • Communications • Transportation • Public Information and Education • Medical Direction • Evaluation • Trauma Systems

10. 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)

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

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

13. 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

14. Medical Direction • Online • Offline • Onsite • Direct • Indirect • Delegated authority

15. 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

16. 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

17. Research components • Hypothesis • Literature Review • Methodology • Findings • Discussion (includes identification of limitations) • Conclusions • Abstract

18. Workforce safety and wellness

19. 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

20. Infection control • Disease transmission • Handwashing • Standard precautions • Use of protective equipment, supplies • Decontaminating, disinfecting and sterilizing equipment • Exposure reporting • Postexposure activities

21. 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

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

23. 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

24. Medicolegal and ethical issues

25. Medicolegal issues • Scope of Practice • Standard of Care • Duty to Act • Good Samaritan • Breach of Duty (malfeasance, misfeasance, nonfeasance) • Abandonment • Proximate Cause • Negligence

26. 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

27. Workforce issues • Cultural diversity • Sexual harrassment • Substance abuse • Ethics and morality

28. Operations

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

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