|
Emergency Medical Technicians
PREFACE
I. General
Provisions
Each EMT education
program shall:
A. Assure the course
is approved through the Initial Program Application
process as outlined
by MDCIS, Bureau of Health Services.
1. Students who
complete an unapproved program course will not
be eligible for
licensure.
B. Utilize clearly
stated behavioral objectives and performance criteria for the
didactic, practical,
affective and clinical activities.
C. Provide clinical
training in a hospital and basic or advanced life support
agency. Each
clinical site shall be capable of meeting the clinical
educational
objectives developed by the Instructor-Coordinator.
Course Requirements
Once a course has
been approved, the EMS Instructor-Coordinator is responsible to
provide each student
with, or make available for their review and study, the following
information:
A. A copy of the
MDCIS course approval
B. EMT program
objectives
C. A copy of the
current EMS legislation; P.A. 368 of 1978 as amended and
administrative rules
D. All student
policies and relevant operational policies as outlined in the
Initial Program
Approval process
The education
program sponsor is responsible for notifying the Regional
Coordinator of any
modifications to their program schedule on the Approved
Education Program
Sponsor Notification of Interim Courses (BHS-EMS 136A).
As Regional
Coordinators conduct periodic on-site visits to evaluate courses, any
changes to an
approved education program must be reported.
II. Course Length
and Organization
It is recommended
that the initial course comprise a minimum of 194 clock hours.
This includes
didactic presentations, practical demonstrations, skills practice,
examination time,
and clinical experience. A minimum of 32 clinical hours are
required. The
sequence in which lessons are presented is left to the discretion of
the I-C. It is
expected, however, that Module 1 Preparatory (Roles/Responsibilities,
Well Being of EMT,
Medical/Legal Considerations, etc.) will be presented first.
Clinical Objectives
At a minimum, the
EMT student shall complete 32 hours of clinical experience. The
clinical experience
shall include the Emergency Department (minimum 8 hours) and
TA-3
BLS or ALS vehicle
rotations (minimum 8 hours). Although other clinical areas such
as Post-Operating
Recovery, Geriatric care, Pediatrics, Labor and Delivery,
Psychiatric Unit,
and Respiratory Therapy are desirable and strongly encouraged,
they may not be
practical in some medical facilities.
The IC should
develop clinical objectives for the EMT student to be utilized for
this
portion of the
program. The objectives should be specific to the clinical area.
III. Document
Format and Utilization
Objectives
The information
included is required in order to meet the established educational
objectives for an
EMT education program. I-Cs and other instructors shall use this
minimum required
material in their education programs, as the licensure
examination is based
on these objectives.
The objectives are
written in the behavioral objective style and flow from cognitive
information, to
affective behaviors and then psychomotor objectives. The objectives
are structured to
identify minimal knowledge in those content areas.
Task Analysis
The skills that the
EMT will minimally be able to perform are broken down into an
abbreviated task
analysis format for the instructor and student. The instructor may
modify the format as
needed for practice and testing purposes.
Topic Format
The topics have been
re-named from the previous versions of MDCIS Education
Program
Requirements. The topic titles are identical to those used by the
Basic
National Standard
Curriculum and should align more closely with chapter titles in
current text.
Text
The choice of text
and/or handout material is left to the discretion of the program
sponsor and I-C.
Content material has
been referenced to:
Emergency Medical
Technician Basic: National Standard Curriculum
Cardiopulmonary
Resuscitation: American Heart Association
Basic Trauma Life
Support - Brady
Pediatric Emergency
Management Curriculum-MDPH/EMS-C Project
TA-4
EMERGENCY MEDICAL
TECHNICIAN EDUCATION PROGRAM
CONTENT AREAS
TOPIC RECOMMENDED
COURSE HOURS
MODULE I
PREPARATORY (26 hours)
Introduction to
Emergency Medical Care 1 hour
The Well-Being of
the EMT-Basic 5 hours
Medical / Legal and
Ethical Issues 2 hours
The Human Body 10
hours
Baseline Vitals and
SAMPLE History 4 hours
Lifting and Moving
Patients 4 hours
MODULE 2 AIRWAY
(16 hours)
Airway. Oxygenation,
Ventilation 12 hours
EDTLA 4 hours
MODULE 3 PATIENT
ASSESSMENT (19 hours)
Scene Size-up 1 hour
Initial Assessment 2
hours
Focused History and
Physical Exam: Medical 4 hours
Focused History and
Physical Exam: Trauma 5 hours
Detailed Physical
Exam 2 hours
On-Going Assessment
1 hour
Communications 1
hour
Documentation 1 hour
Special
Considerations (Geriatrics) 2 hours
MODULE 4 MEDICAL
(43 hours)
General Pharmacology
4 hours
Respiratory
Emergencies 6 hours
Cardiovascular
Emergencies 16 hours
Diabetic Emergencies
2 hours
Allergic Reactions 1
hour
Poisoning/Overdose
Emergencies 3 hours
Environmental
Emergencies 2 hours
Behavioral
Emergencies 3 hours
Obstetrics 4 hours
Abdominal Illness 1
hour
CNS Illness 1 hour
MODULE 5 TRAUMA
(38 hours)
Bleeding and Shock
(PASG
and IV Maintenance)
12 hours
Soft Tissue Injuries
10 hours
Musculoskeletal Care
8 hours
Injuries to the Head
and Spine 8 hours
MODULE 6 INFANTS
& CHILDREN 8 hours
TA-5
MODULE 7
OPERATIONS (12 hours)
Ambulance Operations
2 hours
Gaining Access 5
hours
Overview Topics (
Triage, Disaster, HazMat) 5 hours
Recommended
Classroom Hours 162
Total Required
Clinical Hours 32
Total Recommended
Course Hours 194
TA-6
MODULE 1
PREPARATORY
Introduction to
Emergency Medical Care
Familiarizes the EMT
candidate with the introductory aspects of emergency medical
care. Topics covered
include the Emergency Medical Services system, roles and
responsibilities of
the EMT, quality improvement, and medical direction.
Well-Being of the
EMT (Stress Management, Communicable Disease)
Covers the emotional
aspects of emergency care, stress management, introduction to
Critical Incident
Stress Debriefing (CISD), scene safety, body substance isolation
(BSI),
personal protection
equipment (PPE), and safety precautions that can be taken prior to
performing the role
of an EMT.
Medical/Legal and
Ethical Issues
Explores the scope
of practice, ethical responsibilities, DNR legislation, consent,
refusals,
abandonment, negligence, duty to act, confidentiality, and special
situations
such as organ donors
and crime scenes. Medical/legal and ethical issues are vital
elements of the
EMT's daily life.
The Human Body
(Anatomy and Physiology
Enhances the EMT's
knowledge of the human body. Medical terminology, body
systems, anatomy,
physiology and topographic anatomy will be covered in this session.
Baseline Vital
Signs and SAMPLE History
Teaches assessing
and recording of a patient's vital signs and a SAMPLE history.
Lifting and
Moving Patients (Patient Handling)
Provides students
with knowledge of body mechanics, lifting and carrying techniques,
principles of moving
patients, and an overview of equipment. Practical skills of lifting
and moving will also
be developed during this lesson.
MODULE 2 AIRWAY
Airway,
Oxygenation, Ventilation
Teaches airway
anatomy and physiology, how to maintain an open airway, pulmonary
resuscitation,
variations for infants and children, and patients with laryngectomies.
The
use of airways,
suction equipment, oxygen equipment and delivery systems, and
resuscitation
devices will be discussed in this lesson. Use of the ETDLA (Combitube?
)
will also be
covered.
MODULE 3 PATIENT
ASSESSMENT
TA-7
Scene Size-Up
Enhances the EMT's
ability to evaluate a scene for potential hazards, determine by the
number of patients
if additional help is necessary, and evaluate mechanism of injury or
nature of illness.
This lesson draws on the knowledge of Module 1.
Initial
Assessment
Provides the
knowledge and skills to properly perform the initial assessment. In
this
session, the student
will learn about forming a general impression, determining
responsiveness,
assessment of the airway, breathing and circulation. Students will
also
discuss how to
determine priorities of patient care.
Focused History
and Physical Exam - Trauma Patients
Describes and
demonstrates the method of assessing patients' traumatic injuries. A
rapid approach to
the trauma patient will be the focus of this lesson.
Focused History
and Physical Exam - Medical Patients
Describes and
demonstrates the method of assessing patients with medical complaints
or signs and
symptoms. This lesson will also serve as an introduction to the care
of the
medical patient.
Detailed Physical
Exam
Teaches the
knowledge and skills required to continue the assessment and treatment
of the patient.
On-Going
Assessment
Stresses the
importance of trending, recording changes in the patient's condition,
and
reassessment of
interventions to assure appropriate care.
Communications
Discusses the
components of a communication system, radio communications,
communication with
medical direction, verbal communication, interpersonal
communication, and
quality improvement.
Documentation
Assists the EMT in
understanding the components of the written report, special
considerations
regarding patient refusal, the legal implications of the report, and
special reporting
situations. Reports are an important aspect of prehospital care. This
skill will be
integrated into all student practices.
Special Patient
Considerations
This topic reviews
situations of providing emergency care to geriatric patients and other
patients who may
need modified communications and special handling.
MODULE 4
MEDICAL/BEHAVIORAL EMERGENCIES AND
OBSTETRICS/GYNECOLOGY
TA-8
General
Pharmacology
Provides the student
with a basic knowledge of pharmacology, providing a foundation
for the
administration of medications given by the EMT and those used to
assist a
patient with
self-administration.
Respiratory
Emergencies (Chest Injury)
This chapter reviews
components of the lesson on respiratory anatomy and physiology.
It will also provide
instruction on assessment of respiratory difficulty and emergency
medical care of
respiratory problems, and the administration of prescribed inhalers.
Cardiovascular
Emergencies (AED, CPR)
Review of the
cardiovascular system, an introduction to the signs and symptoms of
cardiovascular
disease, administration of a patient's prescribed nitroglycerin, and
use
of the automated
external defibrillator are covered.
Diabetes/Altered
Mental Status
Review of the signs
and symptoms of altered level of consciousness, the emergency
medical care of a
patient with signs and symptoms of altered mental status and a
history of diabetes,
and the administration of oral glucose are covered.
Allergies
Teaches the student
to recognize the signs and symptoms of an allergic reaction, and
to assist the
patient with a prescribed epinephrine auto-injector.
Poisoning/Overdose
Teaches the student
to recognize the signs and symptoms of poisoning and overdose.
Information on the
administration of activated charcoal is also included in this section.
Environmental
Emergencies
Covers recognizing
the signs and symptoms of heat and cold exposure, as well as the
emergency medical
care of these conditions. Information on aquatic emergencies and
bites and stings
will also be included in this lesson.
Behavioral
Emergencies
Develops the
student's awareness of behavioral emergencies and the management of
the disturbed
patient. Restraining the combative patient will also be taught in this
lesson.
Obstetrics/Gynecology
A review of the
anatomical and physiological changes that occur during pregnancy,
management of normal
and abnormal deliveries, signs and symptoms of common
gynecological
emergencies, and neonatal resuscitation are covered.
Abdominal Illness
Briefly reviews
conditions related to abdominal complaints and the emergency care of
the "acute abdomen".
Central Nervous
System Illness
Covers the
assessment, related pathophysiology and provision of emergency medical
care for stroke and
seizure disorders.
TA-9
MODULE 5 TRAUMA
Bleeding and
Shock (PASG, IV Maintenance)
Reviews the
cardiovascular system, describes the care of the patient with internal
and
external bleeding,
signs and symptoms of shock (hypoperfusion), and the emergency
medical care of
shock (hypoperfusion).
Soft Tissue
Injuries (Burns)
Continues with the
information taught in Bleeding and Shock, discussing the anatomy
of the skin and the
management of soft tissue injuries and the management of burns.
Techniques of
dressing and bandaging wounds will also be taught in this lesson.
Musculoskeletal
Care
Review of the
musculoskeletal system, recognition of signs and symptoms of a
painful,
swollen, deformed
extremity and splinting are taught in this section.
Injuries to the
Head and Spine
Review the anatomy
of the nervous system and the skeletal system. Injuries to the
spine and head,
including mechanism of injury, signs and symptoms of injury, and
assessment are
covered. Emergency medical care, including the use of cervical
immobilization
devices and short and long back boards will also be discussed and
demonstrated by the
instructor and students. Other topics include helmet removal and
infant and child
considerations.
MODULE 6 INFANTS
AND CHILDREN
Presents information
concerning the developmental and anatomical differences in
infants and
children. There is discussion of common medical and trauma situations,
along with
infants/children dependent on special technology. Dealing with an ill
or
injured infant or
child patient has always been a challenge for EMS providers.
MODULE 7
OPERATIONS
Ambulance
Operations
Presents an overview
of the knowledge needed to function in the prehospital
environment. Topics
covered include responding to a call, emergency vehicle
operations,
transferring patients, and the phases of an ambulance call.
Gaining Access
Provides the EMT
student with an overview of rescue operations. Topics covered
include roles and
responsibilities at a crash scene, equipment, gaining access, and
removing the
patient.
TA-10
Overview Topics
Provides the EMT
student with information on hazardous materials, incident
management systems,
mass casualty situations, and basic triage.
TA-11
EMERGENCY MEDICAL
TECHNICIAN REFRESHER PROGRAM
Completion of an
approved EMT refresher program may be necessary to satisfy
eligibility
requirements for National Registry certification. Refresher programs
must be
submitted for
approval by an approved Education Program Sponsor. (Interim
application 30 days
in advance.)
Completion of an
approved EMT refresher program will also provide an equal number
of Continuing
Education credits (24).
Course content must
follow the initial training objectives as outlined in this document.
Course Topics
Required Minimum Course Hours
Preparatory 1
Airway 2
Patient Assessment 3
Medical/Behavioral 4
Trauma 4
Obstetrics, Infants,
Children 2
Elective Topics
(Other topics from
EMT Curriculum) 8
Total Required
Course Hours 24
It is strongly
encouraged that CPR re-certification and AED refresher become
pre-requisites or
co-requisites of a refresher program. These topics are not included in
the above listed
topics/hours.
MODULE 1
Preparatory
TA-12
Introduction to
Emergency Care
(Roles,
Responsibilities)
At completion of
this lesson, the EMT student will be able to:
1. Define Emergency
Medical Services (EMS) systems. (Cognitive)
2. Differentiate the
roles and responsibilities of the EMT from other prehospital care
providers.
(Cognitive)
3. Describe the
roles and responsibilities related to personal safety. (Cognitive)
4. Discuss the roles
and responsibilities of the EMT towards the safety of the crew, the
patient and
bystanders. (Cognitive)
5. Explain who has
authority for management of the scene and management of the patient
according to
Michigan statute. (Cognitive)
6. Define quality
improvement and discuss the EMT's role in the process. (Cognitive)
7. Define medical
direction and discuss the EMT's role in the process. (Cognitive)
8. Assess areas of
personal attitude and conduct of the EMT. (Affective)
9. Characterize the
various methods used to access the EMS system in your community.
(Cognitive)
10. Explain these
terms: (Cognitive)
Certification
Licensure Reciprocity
Standing Orders
Protocols Medical Control Authority
MODULE 1
Preparatory
Well Being of the
EMT
(Stress Management, Communicable Disease)
At the completion of
this lesson, the EMT student will be able to:
Stress Management
1. Define these
terms: (Cognitive)
Acceptance Acute
Stress Reaction
Anger Bargaining
Coping Cumulative
Stress Reaction
Defense Mechanisms
Delayed Stress Reaction
Denial Depression
Humor Isolation
Rationalization
Repression
Stress Stressor
2. Explain the
body's response to stress in these identified states: (Cognitive)
Stage One: Alarm
Reaction
Stage Two:
Resistance
Stage Three:
Exhaustion
3. Identify and/or
describe these types of stress reactions: (Cognitive)
Acute Stress
Reaction
Delayed Stress
Reaction
Cumulative Stress
Reaction
4. Identify the
different causes of anxiety and stress. (Cognitive)
TA-13
5. Identify and/or
describe the defense mechanisms used to reduce anxiety and stress.
(Cognitive)
6. Recognize the
signs and symptoms of critical incident stress. (Cognitive)
7. Identify and
describe the stages of the grief process. (Cognitive)
8. State the steps
in the EMT's approach to the dying patient and their family.
(Cognitive)
9. Discuss the
possible reactions that a family member may exhibit when confronted
with
death and dying.
(Cognitive)
Communicable
Diseases
1. Define the
following terms: (Cognitive)
Communicable
Contamination Contagious
Personal Protective
Device Personal Protective Equipment
Body Substance
Isolation Universal precautions Transmission
Host Carrier Source
of infection
Infection Pathogen
Reservoir
Exposure Virulence
Incubation period
C.D.C. OSHA Patient
confidentiality
HIV AIDS Meningitis
Tuberculosis MERSA
VRS
HEPA Period of
communicability Percutaneous injury
2. Describe the
possible sources of disease. (Cognitive)
3. Recall the
factors for transmission of a disease to occur. (Cognitive)
4. Explain direct
and indirect contact. (Cognitive)
5. Explain
transmission via respiratory droplets. (Cognitive)
6. Explain vehicle
transmission. (Cognitive)
7. Explain airborne
transmission. (Cognitive)
8. Explain vector
transmission. (Cognitive)
9. Describe the
greatest hazard for transmission to occur. (Cognitive)
10. Recall the
factors which increase the risk of infection. (Cognitive)
11. List additional
actions, other than PPE's, to prevent infectious exposure.
(Cognitive)
12. List the
different types of PPE and how/when they are used: (Cognitive)
gloves mask HEPA
mask
gowns eye wear
disposable equipment
13. Recognize the
importance of universal precautions, or BSI.(Affective)
14. Define
hepatitis. (Cognitive)
15. Recall the
causes of hepatitis. (Cognitive)
16. Recognize and
define jaundice. (Cognitive)
17. List the
different forms of hepatitis. (Cognitive)
18. List the
different routes of transmission for each form of hepatitis.
(Cognitive)
19. Describe the
most appropriate PPD for each form of hepatitis. (Cognitive)
20. Describe the
importance of vaccinations. (Cognitive)
21. Define herpes
and list the different forms. (Cognitive)
22. Define and
recognize herpetic whitlow. (Cognitive)
23. Recall how the
herpes virus is transmitted. (Cognitive)
TA-14
24. Define
meningitis. (Cognitive)
25. Explain how
meningitis is transmitted. (Cognitive)
26. Recall which
airborne transmitted diseases are highly dangerous. (Cognitive)
27. Recall how HIV
is carried and transmitted. (Cognitive)
28. Describe which
routes of HIV contamination cause high or low probability of exposure.
(Cognitive)
29. List behaviors
or practices which increase the risk for infection with HIV.
(Cognitive)
30. Differentiate
between AIDS and HIV. (Cognitive)
31. Recall the
complications from AIDS. (Cognitive)
32. Discuss
procedures to follow when potential HIV exposure has occurred to EMS
personnel.
(Cognitive)
33. Discuss current
diagnostic procedures following HIV exposure. (Cognitive)
34. Explain and
recognize the signs and symptoms of tuberculosis. (Cognitive)
35. Explain how TB
is transmitted and when exposure is most likely to occur. (Cognitive)
36. Explain why
disposable items must be discarded after each use. (Cognitive)
37. Explain why
contaminated equipment must be handled using universal precautions.
(Cognitive)
38. Define and list
regulated waste. (Cognitive)
39. Determine the
need for a biohazard bag. (Cognitive)
40. Describe how to
properly dispose of contaminated waste. (Cognitive)
41. Describe how to
properly dispose of waste that contains body fluids. (Cognitive)
42. Recall how
equipment or surface contaminated with blood or body fluids must be
cleaned.
(Cognitive)
43. Demonstrate
appropriate use of PPE in various simulated patient
scenarios.(Psychomotor)
TA-15
Module I
Preparatory
Medical Legal and
Ethical Issues
At the completion of
this lesson, the EMT student will be able to:
1. Define the terms
and discuss implications of: (Cognitive)
Abandonment False
Imprisonment Libel
Implied consent
Expressed consent Civil Law
Actual consent
Informed consent Assault
Administrative Law
Law of consent Battery
Malpractice
Negligence Liability
Breech of duty
Causation/Proximate cause Tort
Damages Duty to act
Living wills
Standard of Care
Scope of Practice DNR
Defendant Plaintiff
Slander
Res Ipsa Loquitur
Respondeat Superior Patient confidentiality
Good Samaritan Law
Emancipated Minor
2. State the
specific statutes and regulations in Michigan regarding the EMS
system.
(Cognitive)
3. List the levels
of EMS licensure in Michigan. (Cognitive)
4. List the
requirements for licensure of EMS personnel in the state of Michigan.
(Cognitive)
5. Describe the
differences in training necessary for each level of EMS licensure in
Michigan.
(Cognitive)
6. List the
requirements for maintaining an EMT license. (Cognitive)
7. Explain the
benefits and responsibilities of continuing education. (Cognitive)
8. Discuss the EMT's
obligations to the emergency patient. (Cognitive)
9. Discuss the
methods of obtaining consent. (Cognitive)
10. Explain
utilizing the consent of minors in providing care. (Cognitive)
11. List the
requirements and discuss the implications of securing written refusal
of patient
treatment and/or
transportation. (Cognitive)
12. Explain patient
confidentiality. (Cognitive)
13. Describe some of
the special patient situations which may result in special reports or
paper work.
(Cognitive)
14. List the aspects
of the Standard of Care. (Cognitive)
15. Explain
negligence and how it relates to the standard of care using the four
elements
needed to prove
negligence. (Cognitive)
16. Discuss the
importance of Do Not Resuscitate [DNR] (advance directives)
legislation
and local or state
provisions regarding EMS application. (Cognitive)
17. Discuss the
considerations of the EMT in issues of organ retrieval. (Cognitive)
18. Describe the
actions that an EMT should take to assist in the preservation of a
crime
scene. (Cognitive)
19. State the
conditions that require an EMT to notify local law enforcement
officials.
(Cognitive)
20. Discuss the
handling of patient's possessions during transportation of the
patient.
(Cognitive)
MODULE 1
Preparatory
TA-16
The Human Body
At the completion of
this lesson, the EMT student will be able to:
Introduction to A
& P
1. Define the
following: (Cognitive)
Abduction Adduction
Prone Supine
Anterior Posterior
Superior Inferior
External Internal
Visceral Parietal
Deep Superficial
Lateral Medial
Median Midline
Horizontal Vertical
Midclavicular
Midaxillary Frontal Sagittal
Anatomical position
Bilateral Distal Proximal
Extension Flexion
Homeostasis Metabolism
Cell Tissue Aerobic
Anaerobic
Semi-fowlers
Trendelenburg Fowlers position Recumbent
2. Define the
following medical prefixes & suffixes: (Cognitive)
Prefixes:
a an angio arthro
anti bi brady cardio
cephalo chole circum
contra
cerebro cyst cyt
dermato
dys endo entero epi
erythro extra gastro
hem(ato)
hemi hepato hystero
hyper
hypo in intra inter
leuko mal meningo
myo
nephro ortho osteo
oto
para peri phlebo
pneumo
poly post pre pulmo
pyo quad retro rhino
sclero super supra
tachy uro vaso
Suffixes:
algia asthenia
esthesia ectomy
emia genic graph(y)
itis
megaly oma osis
ostomy
otomy paresis pathy
plegia
pnea rrhea scopy
uria
3. Identify the body
cavities. (Cognitive)
4. Locate the
boundaries of all body cavities. (Cognitive)
5. Recognize the
organs contained in each specific body cavity. (Cognitive)
6. Describe the
characteristics of living matter. (Cognitive)
7. Discuss the
relationship of cells, tissues, organs and body systems. (Cognitive)
8. Explain the needs
of organisms. (Cognitive)
TA-17
9. Describe the
components of cells. (Cognitive)
10. Explain the
functions of cells. (Cognitive)
11. Explain anerobic
and aerobic metabolism. (Cognitive)
12. Describe the end
products of metabolism. (Cognitive)
13. Describe the
general types of tissues in the body. (Cognitive)
| 