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Paramedics
PREFACE
I. Application
for Education Program Approval
The Michigan
Department of Consumer & Industry Services (CIS) prior to
initiation of a
course must formally approve education programs. Each
education program
must have a sponsor, as defined in the administrative
rules and on-site
program approval process.
General Provisions
Each education
program course shall:
A. Utilize clearly
stated behavioral objectives and performance
criteria for the
didactic, practical, affective, and clinical activities.
B. Provide clinical
training in a hospital and advanced life support
agency and other
facilities as defined in clinical objective. Each
clinical site shall
be capable of meeting the clinical educational
objectives developed
by the Instructor-Coordinator.
Students who
complete an unapproved program course will not be eligible
for licensure.
Course Requirements
The EMS I-C is
responsible to provide each student with, or make
available for
his/her review and study, the following information:
A. A copy of the CIS
course approval
B. DOT/NHTSA
Paramedic objectives
C. A copy of the
current EMS legislation; Public Act 179 of 1990,
Public Act 375 of
2001, and administrative rules
D. The requirements,
which must be achieved to successfully
complete the course,
shall be in writing, and provided to each
student.
The education
program sponsor is responsible for notifying the Regional
Coordinator of any
modifications to its program schedule on the Interim
Course Application.
As Regional Coordinators conduct periodic on-site
visits to evaluate
courses, any changes to an approved education program
must be reported.
II. Program
Admission Prerequisites
The minimum
requirements for admission to a Paramedic course are
successful
completion of an Emergency Medical Technician (EMT)
course. However,
individuals wishing to participate in the Paramedic
examination for
licensure must provide proof of current or past Michigan
licensure at the EMT
level or EMT-Specialist or past Michigan licensure
at the EMT level and
currently NREMT at the EMT or EMT-I level.
Education program
sponsors are expected to establish written admission
policies and have
them available for prospective students, as stated in the
initial program
approval application.
All eligible
candidates for licensure must be at least 18 years of age, at the
time of application
to CIS.
III. Program
Staff
Emergency Medical
Services Instructor-Coordinator (EMS I-C)
The I-C for the
program must be licensed by CIS and possess dual
licensure as a
Paramedic. The I-C is the liaison between the class,
instructional staff,
program sponsor, physician director, and CIS or its
designee, in
approval and providing any supportive documentation
required by the
department.
Physician Director
Each education
program must have a physician director (PD), who
possesses current
licensure in accordance with department rules.
Responsibilities of
the PD include provision of medical expertise and
assurance that
current standards of emergency care are being presented in
each course. Further
responsibilities are outlined in the administrative
rules.
Instructors
Course instructors
are to be selected by the I-C and PD. Each instructor
shall possess
expertise and background in the topic area(s), which he/she
addresses.
Instructors are to be provided with the appropriate lesson
outline and
objectives in advance of the presentation, and are to be
thoroughly versed on
the content and limitations of the topic they are
present. The
Instructor-Coordinator and program sponsor are responsible
to assure all
program requirements are met.
IV. Licensure
Examination
Students who
successfully complete an approved course are eligible to
participate in the
examination for licensure, provided that they are in
compliance with the
current statue and administrative rules.
Following course
completion, the I-C must submit to the department and
the state designated
exam contractors a list of the names of the students
who successfully
completed the course. This information must be
submitted on the
Notification of Students Completing an Education
Program Course form
(J-122). This form must be signed by the I-C. The
licensure exam being
used by Michigan is the National Registry’s
Paramedic
Examination. A student must apply to take the licensure
examination and then
may apply for licensure after receiving test results
from the National
Registry.
V. Course Length
and Organization
This is a
competency-based program that includes didactic presentations,
practical
demonstrations, skills practice, and clinical and field internship
experience. The
sequence that lessons are presented is left to the
discretion of the
I-C. It is expected, however, that Unit One (Preparatory)
will be presented
first, and that hours will follow recommendations from
DOT National
Standard Curriculum EMT-Paramedic as a minimum.
VI. Lesson
Objective Format
The information
included, in conjunction with the full curriculum from
DOT/NHTSA National
Standard Curriculum EMT-Paramedic, is required
in order to meet the
established educational objectives for a Paramedic
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.
Note: The
enclosed material is a supplement to the DOT/NHTSA
National Standard
Curriculum EMT-Paramedic full curriculum and
should not be
used without the full curriculum and a current/updated
Paramedic
textbook reflecting the National Standard Curriculum.
Text
The choice of text
and/or handout material is left to the discretion of the
program sponsor and
I-C, however, it should be a current and an updated
version to reflect
the national standard curriculum.
To allow flexibility
in choosing a preferred text, program objectives were
developed to ensure
consistent minimum education standards, in
conjunction with the
educational objectives for the EMT-Paramedic, and
are to serve as the
foundation for course development.
Task Analysis
The skills that the
Paramedic 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.
The skills are identified in this manner instead of a
psychomotor
objective format. Enclosed are the National Registry of
Emergency Medical
Technicians’ Task sheets to be used for testing
purposes.
PARAMEDIC
OBJECTIVES OUTLINE
TABLE OF CONTENT
UNIT PAGE
I. Preparatory
A. EMS Systems/Roles
and Responsibilities
B. Well-being of the
Paramedic
C. Illness and
Injury Prevention
D. Medical/Legal
Issues
E. Ethics
F. General
Principles of Pathophysiology
G. Pharmacology
H. Medication
Administration
I. Therapeutic
Communications
J. Lifespan
Development
II. Airway
A. Airway Management
and Ventilation
III. Patient
Assessment
A. History Taking
B. Techniques of
Physical Examination
C. Patient
Assessment
D. Clinical Decision
Making
E. Communications
F. Documentation
IV. Trauma
A. Trauma Systems
and Mechanism of Injury
B. Hemorrhage and
Shock
C. Soft Tissue
Trauma
D. Burns
E. Head and Facial
Trauma
F. Spinal Trauma
G. Thoracic Trauma
H. Abdominal Trauma
I. Musculoskeletal
Trauma
V. Medical
A. Pulmonary
B. Cardiology
C. Neurology
D. Endocrinology
E. Allergies and
Anaphylaxis
F. Gastroenterology
G. Urology
H. Toxicology
I. Hematology
J. Environmental
Conditions
K. Infectious and
Communicable Diseases
L. Behavioral and
Psychiatric Disorders
M. Gynecology
N. Obstetrics
VI. Special
Conditions
A. Neonatology
B. Pediatrics
C. Geriatrics
D. Abuse and Assault
E. Patients with
Special Challenges
F. Acute
Interventions for the Chronic Care Patient
VII. Assessment
Based Management
A. Assessment Based
Management
VIII. Operations
A. Ambulance
Operations
B. Medical Incident
Command
C. Rescue Awareness
and Operations
D. Hazardous
Materials Incidents
E. Crime Scene
Awareness
IX. Lifelong
Learning
X. Continuing
Education
XI. Clinical
Rotations
A. Psychomotor
Skills
B. Ages
C. Pathologies
D. Complaints
E. Team Leader
Skills
Note:
Time for
comprehensive final student evaluation in not included, as this is a
competency-based
curriculum. It is mandatory to evaluate student performance
throughout the
course, including comprehensive final didactic and practical
examinations.
PARAMEDIC:
National Standard Curriculum
A Competency
Based Program of Study
Competencies:
· Mathematics:
should have high school level, pre-algebra or algebra
· Reading: should
have 12+ reading level
· Writing: should
have a ninth grade or equivalent level at minimum, if less than
satisfactory results
in spelling, grammar, vocabulary, and syntax then skill levels
should be raised
Recommendation:
Programs assess applicant’s basic skills prior to entry into training
and
encourage
remediation before pursuing a paramedic certification.
Required: EMT-Basic
certification
Pre- or
Co-requisites: Human anatomy and physiology
PREPARATORY –
At
the completion of this module, the paramedic students will
understand the roles
and responsibilities of a Paramedic within an EMS system, apply the
basic concepts of
development, pathophysiology and pharmacology to assessment and
management of
emergency patients, be able to properly administer medications, and
communicate
effectively with patients.
EMS systems/Role and
Responsibilities – At the completion of this unit, the
paramedic student
will understand his or her roles and responsibilities
within an EMS
system, and how these roles and responsibilities differ
from other levels of
providers.
1.1 Define the
following terms: Cognitive/knowledge
EMS Systems
Licensure
Certification
Registration
Profession
Professionalism
Health care
professional
Ethics
Peer review
Medical direction
Protocols
1.2 Describe key
historical events that influenced the development of
national Emergency
Medical Services (EMS) systems.
Cognitive/knowledge
1.3 Identify
national groups important to the development, education,
and implementation
of EMS. Cognitive/knowledge
1.4 Differentiate
among the four nationally recognized levels of EMS
training/education,
leading to licensure/certification/registration.
Cognitive/knowledge
1.5 Describe the
attributes of a paramedic as a health care professional.
Cognitive/knowledge
1.6 Describe the
recognized levels of EMS training/education, leading
to
licensure/certification in his/her state. Cognitive/knowledge
1.7 Explain
paramedic licensure/certification, recertification, and
reciprocity
requirements in his/her state. Cognitive/knowledge
1.8 Evaluate the
importance of maintaining one’s paramedic
license/certification. Cognitive/problem solving
1.9 Describe the
benefits of paramedic continuing education.
Cognitive/knowledge
1.41 Defend the
importance of continuing medical education and skills
retention.
Affective/problem solving
1.10 List current
state requirements for paramedic continuing education
in his/her state.
Cognitive/knowledge
1.11 Discuss the
role of national associations and of a national registry
agency.
Cognitive/knowledge
1.12 Discuss current
issues in his/her state impacting EMS.
Cognitive/knowledge
1.13 Discuss the
roles of various EMS standard setting agencies.
Cognitive/knowledge
1.14 Identify the
standards (components) of an EMS system as defined
by the National
Highway Traffic Safety Administration.
Cognitive/knowledge
1.15 Describe how
professionalism applies to the paramedic while on
and off duty.
Cognitive/knowledge
1.16 Describe
examples of professional behaviors in the following
areas: integrity,
empathy, self-motivation, appearance and personal
hygiene,
self-confidence, communications, time management,
teamwork and
diplomacy, respect, patient advocacy, and careful
delivery of service.
Cognitive/knowledge
1.46 Exhibit
professional behaviors in the following areas: integrity,
empathy,
self-motivation, appearance and personal hygiene, selfconfidence,
communications, time
management, teamwork and
diplomacy, respect,
patient advocacy, and careful delivery of
service.
Affective/application
1.17 Provide
examples of activities that constitute appropriate
professional
behavior for a paramedic. Cognitive/application
1.39 Serve as a role
model for others relative to professionalism in
EMS.
Affective/problem solving
1.43 Assess personal
attitudes and demeanor that may distract from
professionalism.
Affective/problem solving
1.18 Describe the
importance of quality EMS research to the future of
EMS.
Cognitive/problem solving
1.19 Identify the
benefits of paramedics teaching in their community.
Cognitive/knowledge
1.20 Describe what
is meant by “citizen involvement in the EMS
system.
Cognitive/knowledge
1.21 Analyze how the
paramedic can benefit the health care system by
supporting primary
care to patients in the out-of-hospital setting.
Cognitive/problem
solving
1.22 List the
primary and additional responsibilities of paramedics.
Cognitive/knowledge
1.23 Describe the
role of the EMS physician in providing medical
direction.
Cognitive/knowledge
1.24 Describe the
benefits of medical direction, both on-line and offline.
Cognitive/knowledge
1.25 Describe the
process for the development of local policies and
protocols.
Cognitive/application
1.26 Provide
examples of local protocols. Cognitive/knowledge
1.27 Discuss
prehospital and out-hospital care as an extension of the
physician.
Cognitive/knowledge
1.28 Describe the
relationship between a physician on the scene, and the
EMS physician
providing on-line medical direction.
Cognitive/knowledge
1.29 Describe the
components of continuous quality improvement.
Cognitive/knowledge
1.30 Analyze the
role of continuous quality improvement with respect
to continuing
medical education and research. Cognitive/problem
solving
1.31 Define the role
of the paramedic relative to the safety of the crew,
the patient, and
bystanders. Cognitive/knowledge
1.38 Assess personal
practices relative to the responsibility for personal
safety, the safety
of the crew, the patient, and bystanders.
Affective/problem
solving
1.32 Identify local
health care agencies and transportation resources for
patients with
special needs. Cognitive/knowledge
1.40 Value the need
to serve as the patient advocate inclusive of those
with special needs,
alternate life styles and cultural diversity.
Affective/problem
solving
1.33 Describe the
role of the paramedic in health education activities
related to illness
and injury prevention. Cognitive/knowledge
1.44 Value the role
that family dynamics plays in the total care of
patients.
Affective/problem solving
1.45 Advocate the
need for injury prevention, including abusive
situations.
Affective/knowledge
1.34 Describe the
importance and benefits of research.
Cognitive/application
1.35 Explain the EMS
provider’s role in data collection.
Cognitive/knowledge
1.42 Advocate the
need for supporting and participating in research
efforts aimed at
improving EMS systems. Affective/knowledge
1.36 Explain the
basic principles of research. Cognitive/knowledge
1.37 Describe a
process of evaluating and interpreting research.
Cognitive/problem
solving
The well-being of
the paramedic – At the completion of this unit, the
paramedic student
will understand and value the importance of personal
wellness in EMS and
serve as a healthy role model for peers.
2.1 Discuss the
concept of wellness and its benefits.
Cognitive/knowledge
2.2 Define the
components of wellness. Cognitive/knowledge
2.34 Advocate the
benefits of working toward the goal of total personal
wellness.
Affective/application
2.3 Describe to role
of the paramedic in promoting wellness.
Cognitive/knowledge
2.35 Serve as a role
model for other EMS providers in regard to a total
wellness lifestyle.
Affective/problem solving
2.36 Value the need
to assess his/her own lifestyle.
Affective/application
2.4 Discuss the
components of wellness associated with proper
nutrition.
Cognitive/knowledge
2.37 Challenge
his/herself to each wellness concept in his/her role as a
paramedic.
Affective/problem solving
2.5 List principles
of weight control. Cognitive knowledge
2.40 Improve
personal physical well-being through achieving and
maintaining proper
body weight, regular exercise and proper
nutrition.
Affective/problem solving
2.6 Discuss how
cardiovascular endurance, muscle strength, and
flexibility
contribute to physical fitness. Cognitive/application
2.7 Describe the
impact of shift work on circadian rhythms.
Cognitive/knowledge
2.8 Discuss how
periodic risk assessments and knowledge of warning
signs contribute to
cancer and cardiovascular disease prevention.
Cognitive/knowledge
2.9 Differentiate
proper from improper body mechanics for lifting and
moving patients in
emergency and non-emergency situations.
Cognitive/problem
solving
2.45 Demonstrate
safe methods for lifting and moving patients in
emergency and
non-emergency situations.
Psychomotor/application
2.10 Describe the
problems that a paramedic might encounter in a
hostile situation
and the techniques used to manage the situation.
Cognitive/knowledge
2.11 Given a
scenario involving arrival at the scene of a motor vehicle
collision, assess
the safety of the scene and propose ways to make
the scene safer.
Cognitive/problem solving
2.12 List factors
that contribute to safe vehicle operations.
Cognitive/knowledge
2.13 Describe the
considerations that should be given to:
Using escorts
Adverse
environmental conditions
Using lights and
siren
Proceeding through
intersections
Parking at an
emergency scene
2.14 Discuss the
concept of “due regard for the safety of all others”
while operating an
emergency vehicle. Cognitive/knowledge
2.15 Describe the
equipment available for self-protection when
confronted with a
variety of adverse situations.
Cognitive/knowledge
2.16 Describe the
benefits and methods of smoking cessation.
Cognitive/knowledge
2.38 Defend the need
to treat each patient as an individual, with respect
and dignity.
Affective/application
2.39 Assess his/her
own prejudices related to the various aspects of
cultural diversity.
Affective/problem solving
2.17 Describe the
three phases of the stress response.
Cognitive/knowledge
2.18 List factors
that trigger the stress response. Cognitive/knowledge
2.19 Differentiate
between normal/healthy and detrimental reactions to
anxiety and stress.
Cognitive/problem solving
2.20 Describe the
common physiological and psychological effects of
stress.
Cognitive/knowledge
2.21 Identify causes
of stress in EMS. Cognitive/knowledge
2.22 Describe
behavior that is a manifestation of stress in patients and
those close to them
and how these relate to paramedic stress.
Cognitive/knowledge
2.23 Identify and
describe the defense mechanisms and management
techniques commonly
used to deal with stress.
Cognitive/knowledge
2.41 Promote and
practice stress management techniques.
Affective/problem
solving
2.24 Describe the
components of critical incident stress management
(CISM).
Cognitive/knowledge
2.25 Provide
examples of situations in which CISM would likely be
beneficial to
paramedics. Cognitive/knowledge
2.26 Given a
scenario involving a stressful situation, formulate a
strategy to help
cope with the stress. Cognitive/problem solving
2.27 Describe the
stages of the grieving process (Kubler-Ross).
Cognitive/knowledge
2.28 Describe the
needs of the paramedic when dealing with death and
dying.
Cognitive/knowledge
2.42 Defend the need
to respect the emotional needs of dying patients
and their families.
Affective/problem solving
2.29 Describe the
unique challenges for paramedics in dealing with the
needs of children
and other special populations related to their
understanding or
experience of death and dying.
Cognitive/knowledge
2.30 Discuss the
importance of universal precautions and body
substance isolation
practices. Cognitive/knowledge
2.31 Describe the
steps to take for personal protection from airborne
and bloodborne
pathogens. Cognitive/knowledge
2.46 Demonstrate the
proper procedures to take for personal protection
from disease.
Psychomotor/application
2.32 Given a
scenario in which equipment and supplies have been
exposed to body
substances, plan for the proper cleaning,
disinfection, and
disposal of the items. Cognitive/problem solving
2.43 Advocate and
practice the use of personal safety precautions in all
scene situations.
Affective/problem solving
2.33 Explain what is
meant by an exposure and describe principles for
management.
Cognitive/knowledge
2.44 Advocate and
serve as a role model for other EMS providers
relative to body
substance isolation practices. Affective/problem
solving
Illness and injury
prevention – At the completion of this unit, the paramedic
student will be able
to integrate the implementation of primary injury
prevention
activities as an effective way to reduce death, disabilities and
health care costs.
3.1 Describe the
incidence, morbidity and mortality of unintentional
and alleged
unintentional events. Cognitive/knowledge
3.14 Demonstrate the
use of protective equipment appropriate to the
environment and
scene. Psychomotor/problem solving
3.2 Identify the
human, environmental, and socioeconomic impact of
unintentional and
alleged unintentional events.
Cognitive/knowledge
3.3 Identify health
hazards and potential crime areas within the
community.
Cognitive/knowledge
3.4 Identify local
municipal and community resources available for
physical,
socioeconomic crises. Cognitive/knowledge
3.10 Value and
defend tenets of prevention in terms of personal safety
and wellness.
Affective/problem solving
3.5 List the general
and specific environmental parameters that should
be inspected to
assess a patient’s need for preventative information
and direction.
Cognitive/knowledge
3.11 Value and
defend tenets of prevention for patients and
communities being
served. Affective/problem solving
3.6 Identify the
role of EMS in local municipal and community
prevention programs.
Cognitive/knowledge
3.12 Value and
contribution of effective documentation as one
justification for
funding of prevention programs.
Affective/problem
solving
3.7 Identify the
local prevention programs that promote safety for all
age populations.
Cognitive/application
3.13 Value personal
commitment to success of prevention programs.
Affective/problem
solving
3.8 Identify patient
situations where the paramedic can intervene in a
preventative manner.
Cognitive/knowledge
3.9 Document primary
and secondary injury prevention data.
Cognitive/knowledge.
Medical/Legal Issues
– At the completion of this unit, the paramedic student
will understand the
legal issues that impact decisions made in the out-ofhospital
environment.
4.1 Differentiate
between legal and ethical responsibilities.
Cognitive/application
4.2 Describe the
basic structure of the legal system in the United
States.
Cognitive/knowledge
4.3 Differentiate
between civil and criminal law as it pertains to the
paramedic.
Cognitive/knowledge
4.4 Identify and
explain the importance of laws pertinent to the
paramedic.
Cognitive/knowledge
4.5 Differentiate
between licensure and certification as they apply to
the paramedic.
Cognitive/knowledge
4.6 List the
specific problems or conditions encountered while
providing care that
a paramedic is required to report, and identify
in each instance to
whom the report is to be made.
Cognitive/knowledge
4.7 Define the
following terms: cognitive/knowledge
Abandonment
Advance directives
Assault
Battery
Breach of duty
Confidentiality
Consent (expressed,
implied, informed, involuntary)
Do not resuscitate
(DNR) orders
Duty to act
Emancipated minor
False imprisonment
Immunity
Liability
Libel
Minor
Negligence
Proximate cause
Scope of practice
Slander
Standard of care
Tort
4.8 Differentiate
between the scope of practice and the standard of care
for paramedic
practice. Cognitive/problem solving
4.9 Discuss the
concept of medical direction, including off-line
medical direction
and on-line medical direction, and its
relationship to the
standard of care of a paramedic.
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