EMT-INTERMEDIATE TO
ADVANCED EMT
LYNETTE MCCULLOUGH, MCH, NRP
PROGRAM OVERVIEW
• Introductions
• Course Purpose
• National and State Curriculum/Scope of Practice and Licensure
Revisions
• Requirements for AEMT Licensure
• Course Requirements
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Attendance
Cognitive competency
Skills competency
Clinical requirements
CURRICULUM OUTLINE
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Module 1:
Module 2:
Module 3:
Module 4:
Module 5:
Module 6:
Module 7:
Pretest, Preparatory, Operations
Anatomy, Physiology, Pathophysiology
Pharmacology
Patient Assessment and Resuscitation
Medical, Trauma, and Special Patients
Integration and Practical Applications
Clinical Experience
PRETEST
90 MINUTES TO COMPLETE
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
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
COMPREHENSIVE HEALTHCARE
• Individualized Care
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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
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Law Enforcement
Fire Services
Emergency Management
EMS
Animal Control
Water Supply/Waste Management
EMS SYSTEM COMPONENTS
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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
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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
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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
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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
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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
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Hypothesis
Literature Review
Methodology
Findings
Discussion (includes identification of limitations)
Conclusions
Abstract
WORKFORCE SAFETY AND
WELLNESS
WELLNESS
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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
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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
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Emergency Moves
Urgent Moves
Non-urgent Moves
Moving equipment
STRESS
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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
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Scope of Practice
Standard of Care
Duty to Act
Good Samaritan
Breach of Duty (malfeasance, misfeasance, nonfeasance)
Abandonment
Proximate Cause
Negligence
MEDICOLEGAL ISSUES
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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
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Cultural diversity
Sexual harrassment
Substance abuse
Ethics and morality
OPERATIONS
OPERATIONS
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Vehicle operations
Air-medical operations
Extrication and Special Rescue Operations
Hazardous Materials Exposures
Multiple-Casualty Operations
Terrorism
SUMMARY
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EMS Systems
Public Health
Research
Workforce safety and wellness
Medicolegal
Operations