EMT-Basic

379 Pages·2012·1.35 MB·English

State of Wisconsin

Emergency Medical Technician:
A Practice Based Approach to
EMS Education

Review and Revision of the EMT Curriculum
with inclusion of the
National Emergency Medical Services
Education Standards

December 2011

Wisconsin Technical College
System Board Dept. of Health Services-
Division of Public Health-
Bureau of Communicable Diseases
and Emergency Response
This revised curriculum is the product of the following committee members:

Sandra K. Eustice, Chippewa Valley Technical College, Committee Chair
James Boland, Northeast Wisconsin Technical College
Michelle Bourget, Waukesha County Technical College
Michael Foster, Western Technical College
Jen Hanson, Baraboo Ambulance Training Center
Ray Lemke, DHS-DPH-BCDER-EMS Section
Gary E. Leyer, Gateway Technical College
Dan McCourt, Fox Valley Technical College
Linda Pace, Madison Area Technical College
Debra Slaby, Western Technical College

Special thanks and gratitude to the committee members for donating time and sharing their
expertise, and to Arleen Case, WTCS, for lending her assistance.
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TABLE OF CONTENTS

Project Perspectives ..................................................................................................... v

Module 1 – Preparatory
1-1 Introduction to Emergency Care ............................................................... 1-1
1-2 Workforce Safety and Wellness ............................................................... 1-8
1-3 Medical/Legal and Ethical Issues ........................................................... 1-15
1-4 Overview of the Human Body & Physiology ........................................... 1-23
1-5 Pathophysiology ..................................................................................... 1-30
1-6 Lifting and Moving Patients .................................................................... 1-36
1-7 Evaluation …………………………………………………………… ........... 1-45

Module 2 - Patient Assessment
2-1 Scene Size-up .......................................................................................... 2-1
2-2 Primary Assessment ................................................................................ 2-5
2-3 History-Taking, Vital Signs, Monitoring Devices ..................................... 2-11
2-4 Secondary Assessment ......................................................................... 2-22
2-5 Reassessment ....................................................................................... 2-29
2-6 EMS System Communication & Therapeutic Communication ................ 2-32
2-7 Documentation ....................................................................................... 2-41
2-8 Critical Thinking ...................................................................................... 2-47
2-9 Evaluation .............................................................................................. 2-53

Module 3 - Airway
3-1 Airway Management, Respiration, & Artificial Ventilation ......................... 3-1
3-2 Practical Lab .......................................................................................... 3-18
3-3 Advanced Airways and Practical Lab ..................................................... 3-20
3-4 Evaluation .............................................................................................. 3-23

Module 4 – Overview of Shock
4-1 Overview of Shock .................................................................................... 4-1
4-2 Evaluation ................................................................................................. 4-9

Module 5 – Medical
5-1 Medical Overview ..................................................................................... 5-1
5-2 Pharmacology and Medication Administration ......................................... 5-4
5-3 Respiratory Emergencies ......................................................................... 5-9
5-4 Cardiac Emergencies ............................................................................. 5-21
5-5 Hematology ............................................................................................ 5-33
5-6 Abdominal/Gastrointestinal & Genitourinary/Renal Disorders ................ 5-37
5-7 Endocrine Disorders & Neurology .......................................................... 5-42
5-8 Immunology ............................................................................................ 5-52
5-9 Toxicology .............................................................................................. 5-57
5-10 Psychiatric .............................................................................................. 5-67
5-11 Obstetrics & Gynecology ........................................................................ 5-73
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5-12 Practical Lab .......................................................................................... 5-12
5-13 Evaluation .............................................................................................. 5-85

Module 6 - Trauma
6-1 Trauma Overview .......................................................... …………………..6-1
6-2 Bleeding ......................................................................................... ………6-8
6-3 Soft Tissue Injuries & Burns; External Injuries to the Head,
Face & Neck; Injuries to the Chest, Abdomen & Genitalia ..................... 6-13
6-4 Orthopedic Trauma ................................................................................ 6-36
6-5 Nervous System, Head & Spine ............................................................. 6-45
6-6 Environmental Emergencies .................................................................. 6-60
6-7 Special Considerations in Trauma ......................................................... 6-73
6-8 Practical Lab .......................................................................................... 6-81
6-9 Evaluation .............................................................................................. 6-84

Module 7-Special Patient Populations
7-1 Pediatric ................................................................................................... 7-1
7-2 Geriatric .................................................................................................. 7-16
7-3 Patients with Special Challenges ........................................................... 7-26
7-4 Evaluation .............................................................................................. 7-32

Module 8-EMS Operations
8-1 Ambulance Operations ............................................................................. 8-1
8-2 Air Medical & Advanced Life Support Intercept ........................................ 8-9
8-3 Gaining Access ...................................................................................... 8-13
8-4 Hazardous Materials .............................................................................. 8-17
8-5 Mass Casualty Incident, Incident Command System, &
National Incident Command System ...................................................... 8-20
8-6 Weapons of Mass Destruction ............................................................... 8-23
8-7 Evaluation .............................................................................................. 8-27
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State of Wisconsin
Emergency Medical Technician: A Practice Based
Approach to EMS Education
with inclusion of the
National Emergency Medical Services
Education Standards
Preface
EMS is continually evolving not only in the prehospital care that is given to patients but,
naturally, also in the education necessary for the EMS provider. In 1996 the EMS
Agenda for the Future (the Agenda) released a vision statement for integration of EMS
into the healthcare system. From that point to the publishing of the National Emergency
Medical Services Education Standards in 2009, there have been many elements
incorporated into the education system proposed by the Agenda. The vision for EMS
education in the Agenda included that which “employs sound educational principles,”
“based on research,” and “conducted by qualified instructors.”

This committee undertook the task of comparing the 2006 EMT-Basic WI Practice
Based curriculum to these Education Standards. The goal, then, was to revise the 2006
version as it was merged with the new content from the Education Standards. It is
desired that the outcome of this project will assist the qualified EMS educator in
providing sound EMS education. This is the final product of those efforts.

Much of the curriculum looks the same. Wisconsin continues to include practice
based/critical thinking in EMT education, realizing the value of these components. It is
a given that qualified educators and adequate instructional staff will be used to ensure
student competencies are met and safety in the classroom is maintained.
Changes
However, there are also major changes noted in this revision. The length and rigor of
EMT training has increased. Greater emphasis is now placed on anatomy, physiology
and pathophysiology. To assist those that use this document, material not previously
included or changes in the format are represented in red type.

The Education Standards indicate that course length should be based on competencies,
not hours. This committee estimates that the content of this curriculum can be
adequately delivered in a maximum of 180 hours, possibly less.

The Education Standards provide for 10 clinical patient assessments compared to the 5
patient contacts in the 2006 curriculum. It is suggested by the Standards that these be
accomplished in an emergency department, ambulance, clinic, nursing home, doctor’s
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office or on standardized patients if clinical settings are not available. Also, in a
program approved by the medical director and program director, students must
participate in and document their patient contacts in field experience.

It is also suggested by this committee that all portions of the didactic content be
considered for alternative delivery methods. Nationwide, EMS education is being
presented in multiple formats-asynchronous as well as synchronous instruction, co- and
pre-requisites, face-to-face instruction. It is desired that Wisconsin EMS training
centers wishing to use alternative formats receive permission to participate in this trend.
Future
With the disappearance of the National Standard Curriculum and the replacement of
this with the Education Standards, Wisconsin should experience increased flexibility in
the delivery of quality EMT education along with the potential to make changes as
necessary. It will no longer be necessary to wait for a national curriculum change.

This will enable educators and providers to keep pace with the Scope of Practice and
the ever-advancing profession of Emergency Medical Services. Keeping abreast of
these changes and still staying within a national standard allows for greater
understanding across state boundaries and from system to system. With the use of this
document and the other components of the Agenda, it is anticipated that Wisconsin’s
EMS education will continue to be of the high quality necessary to bring entry-level
EMTs to the prehospital arena.
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State of Wisconsin EMT: A Practice Based
Approach to EMS Education (edited version 2011)
MODULE 1
Preparatory
Lesson 1-1
Introduction to
Emergency Care
State of Wisconsin EMT: A Practice Based
Approach to EMS Education (edited version 2011)
OBJECTIVES
OBJECTIVES LEGEND
C=Cognitive P=Psychomotor A=Affective
1 = Knowledge level
2 = Application level
3 = Problem-solving level

COGNITIVE OBJECTIVES
At the completion of this lesson, the EMT student will be able to:
1-1.1 Define Emergency Medical Services (EMS) systems. (C-1)
1-1.2 Identify the importance of the National EMS Education Agenda for the
Future as it pertains to the EMT. (C-1)
1-1.3 Differentiate the roles and responsibilities of the EMT from other pre-
hospital care providers. (C-3)
1-1.4 Describe the roles and responsibilities related to personal safety. (C-1)
1-1.5 Discuss the roles and responsibilities of the EMT towards the safety of the
crew, the patient and bystanders. (C-2)
1-1.6 Describe the process of critical thinking as it pertains to the roles and
responsibilities of the EMT (C-1)
1-1.7 Define quality improvement and discuss the EMT's role in the process.
(C-1)
1-1.8 Describe how the actions of one crew member can affect those of others.
(C-2)
1-1.9 Define medical direction and discuss the EMT's role in the process. (C-1)
1-1.10 State the specific statutes and regulations in your state regarding the EMS
system. (C-1)
1-1.11 Explain employer policies and procedures pertaining to the EMT. (C-1)
1-1.12 Identify the role of public health as it pertains to the EMT. (C-1)
AFFECTIVE OBJECTIVES
At the completion of this lesson, the EMT student will be able to:
1-1.13 Assess areas of personal attitude and conduct of the EMT. (A-3)
1-1.14 Characterize the various methods used to access the EMS system in your
community. (A-3)
1-1.15 Value the need for evidence-based research. (A-3)
PSYCHOMOTOR OBJECTIVES
No psychomotor objectives identified.
State of Wisconsin EMT: A Practice Based
Approach to EMS Education (edited version 2011)
PRESENTATION
Declarative (What)
I. Course Overview
A. Paperwork
1. Local
2. State
B. Course description and expectations
C. Immunizations/physical exam
D. Review criteria for certification
1. Successful course completion
2. Mentally/physically meet criteria of safe and effective practice of job
functions
3. Written examination
4. Practical examination
5. State and local provisions
E. Implications of Americans with Disabilities Act (ADA) - state and local
policies
F. Implications of harassment - state and local policies
II. The Emergency Medical Services System and the Emergency Medical
Technician
A. Overview of the Emergency Medical Services system
1. National Highway Traffic Safety Administration Technical
Assistance Program Assessment Standards
a. Regulation and policy
b. Resource management
c. Human resources and training
d. Transportation
e. Facilities
f. Communications
g. Public information and education
h. Medical direction
i. Trauma systems
j. Evaluation
2. Access to the system
a. 9-1-1
b. Non 9-1-1
3. Education
a. Levels of training (current use and potential changes in
training and titles)
(1) First Responder (Emergency Medical Responder)
(2) EMT-Basic (EMT)
(3) Intermediate Technician (WI)
(4) AEMT
(5) EMT-Intermediate
(6) EMT-Paramedic (Paramedic)
State of Wisconsin EMT: A Practice Based
Approach to EMS Education (edited version 2011)
b. National EMS Education Agenda for the Future: A Systems
Approach
4. The health care system
a. Emergency departments
b. Specialty facilities
(1) Trauma centers
(2) Burn centers
(3) Pediatric centers
(4) Poison centers
(5) Other specialty centers - locally dependent
c. Home Healthcare providers
5. Hospital personnel
a. Physicians
b. Nurses
c. Other health professionals
6. Liaison with other public safety workers
a. Local law enforcement
b. State and federal law enforcement
c. Emergency Management
7. Overview of the local EMS system
B. Roles and Responsibilities of the EMT
1. Gather, analyze and process information to determine an
appropriate course of action in managing (thinking critically about)
a. Personal safety
b. Safety of crew, patient and bystanders
c. Provide scene leadership
d. Patient assessment
e. Patient care based on assessment findings
f. Provide emotional support to patients, patient’s family, other
responders
g. Lifting and moving patients safely
h. Transport/transfer of care
i. Integration with other professionals and continuity of care
(1) Medical personnel
(2) Law enforcement
(3) Emergency management
(4) Home healthcare providers
(5) Other responders
j. Patient Safety
(1) Significant – one of the most urgent health care
challenges
(2) High-risk activities
(a) Hand-off
(b) Communication issues
(c) Dropping patients
(d) Ambulance crashes