Administrative Support: Diana Asbury, CIM June 30, 2013 Diana Asbury; CIM Administrative Support, EMS Curriculum Alignment Administrative Support Gaston College Dallas, North Carolina Edward Page Chandler, RN, Paramedic, BS EMS Program Coordinator Forsyth Technical Community College Winston-Salem, North Carolina Greg Chapman, BS, RRT, CCEMT-P Director The Center for Prehospital Medicine Department of Emergency Medicine Carolinas Medical Center Charlotte, North Carolina Susan Crisp, BS, Med, EdD-Candidate Assistant Professor Western Carolina University Cullowhee, North Carolina Rick Criste, BHS, NRP EMS Department Fayetteville Technical Community College Fayetteville, Carolina Michael Ennis, NRP, AAS Coordinator: EMS & Fire Programs Stanly Community College Albemarle, North Carolina Tom Ferrell, MS, NRP EMS Program Director Sandhills Community College Pinehurst, North Carolina Ken Fields, BS, NRP Clinical Coordinator/EMS Faculty Sandhills Community College Pinehurst, North Carolina Sara Houston, BSc, NRP EMS Program Director Durham Technical Community College Durham, North Carolina William B. Lineback, BS, EMT-P Department Head, EMS Wake Technical Community College Raleigh, North Carolina Eric Mayhew, BS, NRP, CICP, CEI-II AEMT Curriculum Alignment EMS Curriculum Coordinator EMS Program Coordinator/AHA Training Center Coordinator Carteret Community College
Discuss the importance of research as it pertains to EMS Discuss the methods of determining treatments based on evidence-based decision making. Emphasize the importance of documentation that leads to data collection Understand and discuss the research principles to interpret literature and advocate practice. Activities/Resources: Use of auditory, visual, and kinesthetic aids to facilitate the student learning environment for the topic of instruction. Research group project, evidence based scenarios, Q & A sessions Assessments: Scenario based training pertinent to topic of instruction, quiz, and exam (didactic and skills). Workforce Safety and Wellness Summary: Integrates comprehensive knowledge of the of the paramedic, which is intended to improve the health of EMS personnel, patients, and the community. TARGET SKILLS: Standard safety precautions Personal protective equipment Stress management Dealing with and dying Prevention of work - related injuries Lifting and moving patients Disease transmission Wellness principles Provider safety and well-being Key Terminology: Well-being Physical Mental Emotional Spiritual Stress Stressor Fight or flight syndrome Acute stress reactions Delayed stress reactions Cumulative stress reactions Defense Mechanisms Denial Regression Projection Displacement Anxiety Blind Panic Depression Overreaction Conversion Hysteria Burnout Grieving Process Stage 1 – Denial Stage 2 – Anger 3 – Bargaining Stage 4 – Depression Stage 5 – Acceptance Posttraumatic Stress Disorder (PTSD) Critical Incident Critical Incident Stress Management (CISM) Infectious Disease Communicable Disease Infection Transmission Direct Contact Bloodborne pathogens Indirect contact Airborne transmission Universal precautions Standard precautions Infection control
Discuss interviewing considerations used by paramedics in cross-cultural communications. Serve as a model for an effective communication process. Advocate the importance of external factors of communication. Promote proper responses to patient communication. Advocate development of proper patient rapport. Value strategies to obtain patient information. Exhibit professional behaviors in communication with patient form different cultures. Activities/Resources: Use of auditory, visual, and kinesthetic aids to facilitate the student learning environment for the topic of instruction. Discussion about body language and interpersonal communication. Assessments: Scenario based training pertinent to topic of instruction, quiz, and exam (didactic and skills). Medical/Legal and Ethics Summary: Integrates comprehensive knowledge of medical/legal and ethical issues, which is intended to improve the health of EMS personnel, patients, and the community. TARGET SKILLS: Consent and refusal of care to include: Consent/refusal of care Confidentiality Advanced directives Tort and criminal actions Evidence preservation Statutory responsibilities Mandatory reporting Ethical principles/moral obligations End-of-life issues Health care regulation Patient rights/advocacy Ethical tests and decision making Key Terminology: Ethics Morality Liability Civil Suit Plaintiff Defendant Tort Damages Punitive Damages Criminal Prosecution Assault Battery Imprisonment Defamation Libel Slander Due Process Medical Practice Act Scope of Practice HIPAA EMTALA Consent Informed Consent Expressed Consent Implied Consent Involuntary Consent Decision-making Capacity In loco parentis Emancipated minors
Key Terminology: Anatomy Physiology Homeostasis Topographic anatomy Anatomic position Coronal plane Transverse (axial) plane Sagittal (lateral) plane Midsagittal plane (Midline) section Longitudinal section Superior Inferior Lateral Medial Proximal Distal Superficial Deep Anterior Ventral Posterior Dorsal Palmar Plantar Apex Range of motion Flexion Extension Abduction Adduction Hyperflexion Hyperextension Supination Pronation Internal rotation External rotation Bilateral Unilateral Quadrants Prone Supine Trendelenburg Position Shock position\ Torso Fowler Position Matter Elements Atoms Protons Neutrons Electrons Atomic Number Atomic weight Isotope Radioisotopes Molecule Ions Ionic bond Cations Anions Covalent bonds Hydrogen bonds Compounds Synthesis reaction Decomposition reaction Exchange reaction Reversible reaction Enzymes Electrolytes Acids Bases pH Acidosis Alkalosis Organic chemicals Inorganic chemicals Carbohydrates Monosaccharides Disaccharides Oligosaccharides Polysaccharides Lipids Triglycerides Phospholipid Steroid Protein Peptides Polypeptides Nucleic Sex cells Somatic cells Cell membrane Semipermeable Cytoplasm Cytosol Organelles Nucleus Chromosomes Diffusion Solutes Concentration gradient Osmosis Osmotic pressure Crenation Lysis Hypertonic Hypotonic Isotonic Facilitated diffusion Active transport meiosis Mitosis Cytokinesis Differentiation Stem cells Adenosine triphosphate (ATP) Aerobic metabolism Anaerobic metabolism Lactic acid Epithelial tissues Connective tissues Muscle tissues Nervous tissues Basement membrane Avascular Simple squamous epithelium Simple cuboidal epithelium Simple columnar epithelium Pseudostratified columnar epithelium
Stratified squamous epithelium Stratified cuboidal epithelium Stratified columnar epithelium Transitional epithelium Glandular epithelium Exocrine glands Matrix Fibroblast Mast Macrophages Dense connective tissue Loose connective tissue Adipose tissue Areolar tissue Reticular connective tissue Cartilage Hyaline cartilage Elastic cartilage Fibrocartilage Bone Osteocytes Skeletal muscle tissue Smooth muscle tissue Cardiac muscle tissue Neurons Neuroglial cells Epithelial membranes Serous membranes Mucous membranes Cutaneous membranes Synovial membranes Tendons Ligaments Epiphyses Periosteum Endosteum Medullary cavity Bone marrow Compact bone Cancellous bone Trabeculae (articulation) Symphysis Fibrous Cartilaginous joint Synovial joint Joint capsule Synovial fluid Osteoblasts Ossification Endochondiral ossification Intramembranous ossification Osteoclast Axial skeleton Appendicular skeleton Thoracic cage Thorax Skull Auditory ossicles Cranium Cranial vault Foramen magnum Sutures Fontanelles Mastoid process Crista Cribiform plate Foramina Olfactory bulb Nasal cavity Maxillae Zygoma Orbits Nasal septum Paranasal sinuses Mandible Temporomandibular joint (TMJ) Hyoid bone Adam’s Thyroid cartilage Cricoid cartilage Cricothyroid membrane Fascia Sternocleidomastoid muscle Sternum Vertebral column Vertebrae Cervical spine Thoracic spine Lumbar spine Sacrum Coccyx Atlas Atlanto-occipital joint Axis Manubrium Xiphoid process Pulmonary artery Shoulder girdle Scapula Clavicle Acromion process Glenoid fossa Humerous Radius Ulna Metacarpals Phalanges Carpometacarpal joint Saddle joint Ilium Ischium Pubis Sacroiliac joints symphysis Acetabulum Femur Femoral head Greater trochanter Lesser trochanter Patella Medial malleolus Fibula Lateral malleolus Talus Calcaneus Metatarsals Musculoskeletal system Involuntary muscle Voluntary muscle neurons Neurotransmitters
Neuromuscular junction Motor end plate Motor unit Troponin Tropomyosin Sliding filament model Nerve impulse Action potentials Depolarization Polarized Repolarization Acetylcholine Muscle impulse Acetylcholinesterase Creatine phosphate Hemoglobin Myoglobin Oxygen debt Origin Insertion Respiratory system Nasopharynx Oropharynx Pharynx Larynx Esophagus Trachea Epiglottis Mainstem bronchi Hilum Secondary bronchi Bronchioles Alveolar ducts Alveoli Surfactant Alveolocapillary membrane Lungs Pleura Visceral pleura Parietal pleura Pleural Diaphragm Respiration Ventilation Hypoxic drive Buffer Buffer system Dorsal respiratory group (DRG) Ventral respiratory (VRG) Pneumotaxic (pontine) center Apneustic center Hering-Breuer reflex Tidal volume Inspiratory reserve volume Expiratory reserve volume Residual volume capacity Dead space Minute volume Labored breathing Agonal gasps Circulatory system Systemic circulation Pulmonary circulation Heart Myocardium Mediastinum Pericardium Epicardium Endocardium Purkinje fibers Ineratrial septum Interventricular septum Atrium Ventricle Coronary sinus Pulmonary veins Fossa ovalis Foramen ovale Atrioventricular valves Tricuspid valve Mitral valve Cusps Papillary muscle Chordae tendineae Semilunar valves Pulmonic valves Aortic Superior vena cava Inferior vena cava Aorta Bruit Electrical conduction system Sinoatrial (SA) node Atrioventricular (AV) node Bindle of HIS Chronotropic effect Dromotropic effect Inotropic effect Baroreceptors Chemoreceptors rate Contractility Alpha effects Beta effects Catecholamines Cardiac Systole Diastole Pulse pressure Afterload Stroke volume (SV) Cardiac output Ejection fraction Preload Arteries Veins Arterioles Capillaries Tunica intima Tunica Tunica adventitia Coronary arteries Left anterior descending (LAD) artery Circumflex coronary arteries Ascending aorta Aortic arch Carotid artery Descending aorta Carotid bifurcation Subclavian artery Brachial artery Femoral arteries Popliteal artery Dorsalis pedis artery Posterior tibial artery
Jugular veins Venous sinuses Subclavian veins Basilica vein Cephalic vein Axillary vein Hepatic portal system Hepatic veins Saphenous vein Femoral vein Plasma Albumins Globulins Fibrinogen Hematopoiesis Red blood cells Erythropoiesis Bilirubin Antigens Antibodies White blood cells Diapedesis Granulocytes Agranulocytles Neutrophils Eosinophils Basophils Histamine Heparin Lymphocytes Monocytes Platelets Hemostasis Tromboplastin Prothrombin Thrombin Fibrin Tissue Plasminogen activator (t-PA) Plasmin Pulse Blood pressure Sphygmomanometer Systemic vascular resistance (SVR) Perfusion Interstitial space Hydrostatic pressure Oncotic pressure Lymphatic system Lymph Lymph vessels nodes Thoracic duct Thymus Spleen Innate (nonspecific) defense Adaptive (specific) defense Immunity Interferons Complement Mononuclear phagocytic system Hapten T-lymphocytes B-lymphocytes Celluar immune response Plasma cells Humoral immune response Allergen Nervous system Central nervous system (CNS) Peripheral nervous system (PNS) Somatic nervous system Autonomic nervous system (ANS) Axons Dendrites Neuroglia Astrocytes Ependymal cells Microglial Oligodendrocytes Schwann cells Nodes of Ranvier matter Synapse Presynaptic terminal Synaptic cleft Postsynaptic terminal Synaptic vesicles Cerebrum Corpus callosum Cerebellum Brainstem Midbrain Pons Medulla oblongata Reticular activating system Spinal cord Reflex arc Meninges Dura mater Arachnoid Pia mater Cerebrospinal fluid (CSF) Subarachnoid space Choroid plexus Sympathetic nervous system Parasympathetic nervous system Sensory nerves Motor nerves Cranial nerves Oculomotor nerves nerve Spinal nerves Dermatones Nerve plexus Posterior column pathway pathways Sensory receptors Perception Adaptation After-image General senses Referred pain Phantom pain Encapsulated nerve endings Free nerve endings Neuropathy receptors Primary taste sensations Olfactory cells Globe
Renin-angiotensin system Intracellular fluid (ICF) Extracellular fluid (ECF) Intravascular fluid (plasma) Interstitial fluid Fluid balance Genital system Gametes Sperm Oocytes Haploid cell Homologous chromosome Zygote Diploid Autosomes Sex chromosomes Alleles Genotype Phenotype Prostate gland Seminal vesicles Scrotum Seminiferous tubules Speratogenic cells Interstitial cells Spermatogenesis Spermatogonia Epididymides Vasa deferential Ejaculatory duct Bulbourethral glands Cowper glands Semen Glans penis Erection Orgasm Emission Ejaculation Gonadotropins Androgens Testosterone Puberty Primordial follicles Oogenesis Primary follicles Ovulation Uterine Uterus Cervix Endometrium Myometrium Perimetrium Vagina Vulva Labia majora Labia minora Clitoris Vestibule Vestibular gland Menarche Corpus luteum Metabolism Basal metabolic rate Kilocalories Nutrients Calorie Vitamins Minerals Trace elements Cellular metabolism Anabolism Catabolism Substrate Oxidation Glycolysis Thermoregulation Objectives: DOT Objectives EMS Education Standards Be able to integrate the physiological, psychological, and sociological changes throughout human development with assessment and communication strategies for patients of all ages. Compare the physiological and psychosocial characteristics of an infant with those of an early adult. Compare the physiological and psychosocial characteristics of a toddler with those of an early adult. Compare the physiological and psychosocial characteristics of a preschool with those of an early adult. Compare the physiological and psychosocial characteristics of a school-aged child with those of an early adult. Integrates a complex depth and comprehensive breadth of knowledge of the anatomy and physiology of all human systems.
Pathophysiology Summary: Integrates comprehensive knowledge of pathophysiology of major human systems. TARGET SKILLS: Recognize the interrelations among structure and function at the tissue and organ system to include: Discussing the etiology, pathogenesis, local, and systemic effects of cell injury. Applying the concepts of inflammation and healing, immune responses, and electrolyte imbalances, genetics, and age to common disorders in major body systems. Discussing the concept of stress, the body’s response to stress, and the relationship stress has to the disease process. Defining and discussing hypoperfusion, the of shock, and Multiple Organ Dysfunction Syndrome (MODS). Key Terminology: Acid Acidosis Adipose tissue Adrenergic receptors Alcoholic ketoacidosis Alkalosis Allergen Anions Antidiuretic hormone (ADH) Apoptosis Asthma Atopic Atrophy Autocrine hormes Autosomal dominant Axons Baroreceptors Base Bradypnea Buffers Cations Cell signaling Chemoreceptors Connective tissue Dendrites Detones Dissociates Dysplasia Endocrine hormones Endothelial cells Epithelium Exocrine hormones Feedback inhibition Free radicals Gram-negative Gram-positive Hemochromatosis Hemolytic anemia Hemophilia Homeostasis Hormones Hypercalcemia Hypercholesterolemia Hyperkalemia Hypermagnesemia Hypernatremia Hyperphosphatemia Hyperplasia Hypertonic solution Hypertrophy Hypocalcemia Hypokalemia Hypomagnesemia Hyponatremia Hypophosphatemia Hypotonic solution Incidence Inflammatory response Ions Isotonic solution Ketoacidosis Lactic acidosis Leukocytles Ligands Metabolic acidosis Metabolic alkalosis Metaplasia Mitochondria Mixed acidosis alkalosis Morbidity Mortality Necrosis Negative feedback Neurotransmitters Nucleus Oliguria Organelles Osmolarity Osmosis Paracrine hormones Pathophysiology Peripheral nerves pH Phagocytes Polyuria Prevalence Pyrogens
Evaluation Injury prevention Health promotion Disease Surveillance Objectives: DOT Objectives EMS Education Standards Define public health and explain the goal of the public health field List the major public health laws, regulations, and guidelines in place in the United States, and list the purpose of each Explain the paramedic’s role in promoting public health both in terms of illness and injury Define primary prevention and secondary prevention and give examples of each Explain why EMS providers are in a unique position to promote public health Discuss the integration of the principles of public health and epidemiology including public health emergencies, health promotion, and illness and injury prevention. Activities/Resources: Use of auditory, visual, and kinesthetic aids to facilitate the student learning environment for the of instruction. Assessments: Scenario based training pertinent to topic of instruction, quiz, and exam (didactic and skills). Pharmacology Principles of Pharmacology Summary: Integrates comprehensive knowledge of pharmacology to formulate a treatment plan intended to mitigate emergencies and improve the overall health of the patient. TARGET SKILLS: Medication safety Kinds of medications used during an emergency Medication legislation Naming Classifications Storage and security Autonomic pharmacology Metabolism and excretion Mechanism of action Medication response Relationships Medication interactions Toxicity Schedules Pharmacokinetics Phases of medication activity Key Terminology: Absolute refractory period Absorption Acetylcholinesterase Active metabolites Active transport Affinity Agonist medications Anaphylaxis Antagonist medications
Antibiotics Antifungals Antimicrobials Automaticity Bioavailability Biotransformation Chelating agents Cholinergic Competitive antagonists Competitive depolarizing Cross-tolerance Cumulative action Cytochrome P-450 system Dependence Depolarization Depressant Distribution Diuretic Dose-response Dosing Down-regulation Duration of effect Ectopic foci Efficacy Elimination Endogenous Exogenous Extravasation Facilitated diffusion Fasciculation Filtration First-order elimination Habituation Half-life Hematocrit Hemolysis Hydrophilic Idiosyncratic Inactive metabolites Interference Ions Lipophilic Medial lethal dose (LD50) Medication monograph Medication sensitivity Noncompetitive antagonists Nondepoloarizing Nonionic Onset Osmosis Osmotic Paradoxical Partial agonist Peak Pharmacodynamics Pharmacokinetics Pharmacology Pinocytosis Placebo effect Plasma protein binding Potency Receptor Relative refractory period Stevens-Johnson syndrome Stimulant Sympathomimetrics Tachyphylaxis Therapeutic index Threshold Tolerance Untoward effects Vaughan-Williams classification scheme Volume of distribution Zero-order elimination Objectives: DOT Objectives EMS Education Standards Integrate pathophysiological principles of pharmacology and the assessment findings to formulate a impression and implement a pharmacologic management plan. Describe historical trends in pharmacology. At the end of this unit, the paramedic student will be able to apply a process of clinical decision making to use the assessment findings to help form a field impression. Define the components, stages and sequences of the critical thinking process for paramedics. the fundamental elements of critical thinking for paramedics. Summarize the six R’s of putting it all together: Read the patient Read the scene React Reevaluate Revise the management plan Review performance Integrate pathophysiological principles of pharmacology and the assessment findings to formulate a field impression and implement a pharmacologic management plan. Describe historical trends in pharmacology. Apply a process of clinical decision making to use the assessment findings to help form a field impression. Define the components, stages and sequences of the critical thinking process for paramedics. Apply the fundamental elements of critical thinking for paramedics. Summarize the six Rs of putting it all together: Read the patient Read the scene React Reevaluate Revise the management plan Review performance
Activities/Resources: Use of auditory, visual, and kinesthetic aids to facilitate the student learning environment for the of instruction. Assessments: Scenario based training pertinent to topic of instruction, quiz, and exam (didactic and skills). Medication Administration Summary: Integrates comprehensive knowledge of medication administration to mitigate emergencies and improve the overall health of the patient. TARGET SKILLS: Within the scope of practice of the Paramedic, how to: Self-administer medication Peer-administer medication Assist/administer medication to a patient. Routes of administration Key Terminology: Access port Acidosis Active transport Administration set Alkalosis Anion Antecubital Anticoagulant Antidiuretic hormone (ADH) Antiseptics Aseptic technique Ataxia Aural Bivalent blood tubing Bolus Bone Injection Gun (BIG) Buccal Butterfly catheter Cannulation Carpopedal spasms Catheter shear Cation Celsius scale Colloid solutions Concentration Concentration gradient Crystalloid solutions D5W Dehydration Depolarization Desired dose Diaphysis Diffusion Diluent Disinfectants Drip chamber Drug reconstitution Electrolytes Enternal medications epiphyseal plate epiphyses external jugular (EJ) vein Extracellular fluid (ECF) EZ-10 Fahrenheit scale Fascia FASTI Flash chamber Gastric tubes gtt Hemostasis Hematoma Homeostasis Humerus placement Hypercalcemia Hyperkalemia Hypertonic solution Hypocalcemia Hypokalemia Hypotonic solution Implanted vascular access devices (VADs) Infiltration Interstitial Intracellular fluid (ICF) Intradermal Intramuscular (IM) Intranasal Intraosseous Intraosseous (IO) infusion Intraosseous (IO) space Intravascular Intravenous Intravenous (IV) therapy Ionic concentration Ions
Be able to describe all drugs a Paramedic can administer using the state formulary. Demonstrate the administration of emergency medications with the state formulary Describe and integrate emergency medications within the scope of practice of the paramedic, to include: Names Actions Indications Contraindications Complications Routes of administration Side effects Interactions Dosages for medications administered Activities/Resources: Use of auditory, visual, and kinesthetic aids to facilitate the student learning environment for the topic of instruction. Assessments: Scenario training pertinent to topic of instruction, quiz, and exam (didactic and skills). Airway Management, Respiration and Artificial Ventilation Airway Management Summary: Integrates complex knowledge of anatomy, physiology, and pathophysiology into the assessment to develop and implement a treatment plan with the goal of assuring a patent airway, adequate mechanical ventilation, and respiration for patients of all ages. TARGET SKILLS: Within the scope of practice of the paramedic: Airway anatomy Airway assessment Techniques of assuring a patent airway Key Terminology: Patent Upper airway Pharynx Nasoopharynx Turbinates septum Paranasal sinuses Cerebrospinal rhinorrhea Cerebrospinal otorrhea Oropharynx Aspiration Hyoid bone Palate Palatoglossal arch Palatopharyngeal arch Palatine tonsils Adenoid Larynx Thyroid cartilage Cricoid cartilage Cricothyroid membrane Glottis Vocal cords Epiglottis Thyroepiglottic ligament Glossoepiglottic ligament Hypoepiglottic ligament Vallecula Arytenoid cartilages Piriform fossae Laryngospasm Trachea Bronchi Carina Goblet cells Hilum Visceral pleura Parietal pleura Bronchioles Alveoli Surfactant
Addressing hazards Violence Need for additional or specialized resources Standard precautions Multiple patient situations Key Terminology: Field impression Scene size-up Mechanism of injury (MOI) Nature of illness (NOI) Active shooter Clandestine drug laboratories Concealment Contact and Cover Physical evidence Primary exit Secondary exit Situational awareness Tactical paramedics Testimonial evidence Tunnel vision Objectives: DOT Objectives EMS Education Standards Integrate the principles of general incident management and multiple casualty incident (MCI) management techniques in order to function effectively at major incidents. Describe the (simple triage and rapid treatment) method of initial triage. Understand, demonstrate, and discuss scene and patient assessment findings with knowledge of epidemiology and pathophysiology to form a field impression. Develop a list of differential diagnoses through clinical reasoning to modify the assessment and formulate a treatment plan to include scene safety and scene management. Activities/Resources: Use of auditory, visual, and kinesthetic aids to facilitate the student learning environment for the topic of instruction. Assessments: Scenario based training pertinent to topic of instruction, quiz, and exam (didactic and skills). Primary Assessment Summary: Integrate scene and patient assessment findings with knowledge of epidemiology and pathophysiology to form a field impression. This includes performing a primary assessment, developing a list of differential diagnoses through clinical reasoning to modify the assessment and formulate a treatment plan. TARGET SKILLS: Primary assessment for all patient situations including: Level of consciousness ABCs Identifying life threats Assessment of vital functions Initial general impression
Secondary Assessment Summary: Integrate scene and patient assessment findings with knowledge of epidemiology and pathophysiology to form a field impression. This includes developing a list of differential diagnoses through clinical reasoning to modify the assessment and formulate a treatment plan. TARGET SKILLS: Performing a rapid full body scan including: Focused assessment of pain Assessment of vital signs Techniques of physical examination including: Respiratory system Presence of breath sounds Cardiovascular system Neurological system Musculoskeletal system All anatomical regions Assessment of lung sounds Techniques of physical examination for all Body systems Anatomical regions Key Terminology: Inspection Palpation Percussion Auscultation Secondary assessment Pulse Blood pressure Systolic pressure Diastolic pressure Pulse oximetry Sphygmomanometer Ophthalmoscope Otoscope Full-body exam Focused assessment Alert and oriented (AxO) Glasgow coma (GCS) Epidermis Dermis Fibroblasts Turgor Diaphoresis Vasodilation Pallor Vasoconstriction Cyanosis Mottling Ecchymosis Tenting Diplopia Visual acuity Battle sign Cerumen Bronchovesicular sounds Vesicular sounds Adventitious breath sounds Wheezing Rhonchi Aspiration Stridor Pleural friction rubs Bronchophony Whispered pectoriloquy Egophony Splitting Korotkoff sounds Bruit Murmur Jugular venous distention (JVD) Lifts Heaves Thrills Orthostatic vital signs Ascites Guarding Hernia Pathologic fracture Physiologic fracture Scoliosis Reflexes Primitive reflexes Proprioception Dermatomes Delirium Dementia
Abdominal and Gastrointestinal Disorders Summary: Integrates assessment findings with principles of epidemiology and pathophysiology to formulate a field impression and implement a comprehensive treatment/disposition plan for a patient with an abdominal and/or gastrointestinal complaint. TARGET SKILLS: Anatomy, presentation, and management of shock associated with abdominal emergencies and gastrointestinal bleeding Anatomy, physiology, epidemiology, pathophysiology, psychosocial impact, presentations, prognosis, assessment, and management of: Acute and chronic gastrointestinal hemorrhage Peritonitis Ulcerative diseases Liver disorders Irritable bowel syndrome Inflammatory disorders Pancreatitis Bowel obstruction Hernias Infectious disorders Gall bladder and biliary disorders Rectal abscess Rectal foreign body obstruction Mesenteric ischemia Key Terminology: Digestion Acute abdomen Diarrhea Peristalsis Portal vein Cardiac sphincter Chime Soft stool Umbilical Epigastric Feculent Striate Protuberant Scaphoid Borborygmi Hyperperistalsis Tympanic Visceral pain Parietal pain Somatic pain Referred pain Rebound tenderness Murphy sign Orthostatic vital signs Dehydration Esophagogastric varices Gastritis Portal Hypertension Pruritis Hematemesis Melena Endoscopy Mallory-Weiss syndrome Peptic ulcer disease (PUD) Gastroesophageal reflux disease (GERD) Anal fissures Hematochezia Hepatitis Peritonitis Biliary tract disorders Choleangitis Cholelithiasis Cholecystitis Acalculus cholecystitis Appendicitis Diverticulitis Diverticulum Fistula Pancreatitis Uncreative colitis Irritable syndrome (IBS) Steatorrhea disease Acute gastroenteritis Rectal abscess Cirrhosis Urticarial Acholic stools Icteric
Collagen vascular diseases Systemic lupus erythematous Scleroderma Immune system Cellular immunity Humoral immunity Injection Absorption Inhalation Ingestin Primary response Sensitivity Basophils cells Mast cells Chemical mediators Immunity Secondary response Acquired immunity Natural immunity Histamine Pruritus Urticarial Objectives: DOT Objectives EMS Education Standards Define allergic reaction. Define anaphylaxis. Define allergens. Describe the common methods of entry of substances into the body. List common antigens most frequently associated with anaphylaxis. Describe physical manifestations in anaphylaxis. Recognize the signs and symptoms related to anaphylaxis. Differentiate among the various treatment and pharmacological interventions used in the management of anaphylaxis. Integrate the pathophysiological principles of the patient with anaphylaxis. Correlate abnormal findings in assessment with the clinical significance in the patient with anaphylaxis. Develop a treatment plan based on field impression in the patient with allergic reaction and anaphylaxis. Understand, demonstrate, and discuss the assessment findings with principles of anatomy, physiology, epidemiology, pathophysiology psychosocial impact, presentations, prognosis and management of a patient with common or immune system disorders and/or emergencies to include: Hypersensitivity Allergic and anaphylactic reactions Anaphylactoid reactions Collagen vascular disease Transplant related problems. Differentiate and formulate age related variations as it pertains to the management of a patient with common or major immune system disorders and/or emergencies. Discuss considerations of patient with neurological disorders as it pertains to: Communication and documentation Transport decisions Patient education Prevention of further common or major immune system disorders and/or emergencies. Activities/Resources: Use of auditory, visual, and kinesthetic aids to facilitate the student learning environment for the topic of instruction. Assessments: Scenario training pertinent to topic of instruction, quiz, and exam (didactic and skills). Infectious Diseases Summary: Integrates assessment findings with principles of epidemiology and pathophysiology to formulate a field impression and implement a comprehensive treatment/disposition plan for a patient with an infectious disorder complaint.
TARGET SKILLS: Anatomy, physiology, epidemiology, pathophysiology, psychosocial impact, reporting requirements, prognosis, and management of: A patient who may have an infectious disease How to decontaminate the ambulance and equipment treating a patient A patient who may be infected with a bloodborne pathogen HIV – related disease Hepatitis B Antibiotic resistant infections Current infectious diseases prevalent in the community Hepatitis Pneumonia Meningococcal meningitis Tuberculosis Tetanus diseases Sexually transmitted disease Gastroenteritis Fungal infections Rabies Scabies and lice Lyme disease Mountain Spotted Fever Antibiotic resistant infections Key Terminology: Communicable disease Infectious disease Endemic Epidemic Pandemic Bacteria Viruses Fungi Parasites Contact transmission Bloodborne pathogens Fomites Droplet transmission Airborne transmission Vector Other potential infectious materials (OPIM) Needleless systems Designated infection control officer (DICO) Source individual Standard precautions Vaccines Vaccinations Immunization Contaminated Carriers Virulence Host resistance Incubation period Communicable period Vesicles Infection Meningitis Meningococcal meningitis Tuberculosis (TB) Tuberculin skin test Pneumonia Respiratory syncytial virus (RSV) Mononucleosis Influenza Sexually transmitted diseases (STDs) Gonorrhea Syphilis Chancre Chlamydia Scabies Lice Viral hepatitis Serum hepatitis Jaundice Icterus Human immunodeficiency virus (HIV) Seropositive Acquired immunodeficiency syndrome (AIDS) Opportunistic infections Infectious hepatitis Zoonotic West Nile (WNV) Lyme disease Hantavirus Rabies Tetanus Staphylococcus aureus Colonized Nosocomial infection Measles Rubella Mumps Chickenpox Pertussis Severe acute respiratory syndrome (SARS) Avian (bird) flu Objectives: DOT Objectives EMS Education Standards
Consistently demonstrate the use of body substance isolation. Demonstrate the ability to comply with body substance isolation guidelines. Activities/Resources: Use of auditory, visual, and kinesthetic aids to facilitate the student learning environment for the topic of instruction. Assessments: Scenario training pertinent to topic of instruction, quiz, and exam (didactic and skills). Endocrine Disorders Summary: Integrates assessment findings with principles of epidemiology and pathophysiology to formulate a field impression and implement a comprehensive treatment/disposition plan for a patient with an endocrine disorder complaint. TARGET SKILLS: Awareness that diabetic emergencies may altered mental status. Anatomy, physiology, epidemiology, psychosocial impact, presentations, prognosis, pathophysiology, assessment, and management of: Acute diabetic emergencies Diabetes Adrenal disease Pituitary and thyroid disorders Key Terminology: Glands Hormones Homeostasis Exocrine glands Endocrine glands Target tissues Agonists Antagonists Antidiuretic hormone (ADH) Hypothalamus Pineal Pituitary gland Thyroid Thyroxine Iodine Calcitonim Thymus gland Lymphocytes Killer T cells Helper T cells Suppressor T cells Lymphokines Parathyroid hormone (PTH) Adrenal glands Adrenal cortex Adrenal medulla Catecholamines Adrenocorticotropic hormone (ACTH) Cortisol Aldosterone Norepinephrine Epinephrine Pancreas Islets of Langerhans Glucagon Insulin Somatostatin Gonads Testes Androgens Testosterone Ovaries Estrogen Progesterone Luteinizing hormone (LH) Diabetes mellitus Necrosis Lipolysis Dyslipidemia Microangiopathy Ischemia Type I diabetes Type 2 diabetes Insulin resistance Gestational diabetes Hypoglycemia Hyperglycemia Diabetic ketoacidosis (DKA)
Hyperosmolar nonketotic come (HONK) Nhyperosmolar hyperglycemic nonketotic come (HHNC) Primary adrenal insufficiency Secondary adrenal insufficiency Corticosteroids Addisonian crisis Cushing syndrome Pheochromocytoma Congenital adrenal hyperplasia (CAH) Thyroid-stimulating hormone (ISH) Graves disease Goiter Exophthalmos Pretibial myxedema Hashimoto disease Myxedema coma Thyrotoxicosis Thyroid storm Panhypopituitarism Inborn error of metabolism (IEM) Objectives: DOT Objectives EMS Education Standards Integrate pathophysiological principles and assessment findings to formulate a impression and implement a treatment plan for the patient with an endocrine problem. Describe the incidence, morbidity, and mortality of endocrinologic emergencies. Identify the risk factors most predisposing to endocrinologic disease. Discuss the anatomy and physiology of organs and structures related to endocrinologic diseases. Review the pathophysiology of endocrinologic emergencies. Discuss the pathophysiology of thyrotoxicosis. Recognize signs and symptoms of the patient with thyrotoxicosis. Describe the management of thyrotoxicosis. Discuss the management of the patient with thyrotoxicosis. Discuss the pathophysiology of myxedema. Recognize signs and symptoms of the patient with myxedema. Describe the management of myxedema. Discuss the management of the patient with myxedema. Discuss the pathophysiology of Cushing's syndrome. Recognize signs and symptoms of the patient with Cushing's syndrome. Describe the management of Cushing's syndrome. Discuss the management of the patient with Cushing’s syndrome. Discuss the pathophysiology of adrenal Insufficiency. Understand, demonstrate, and discuss the assessment findings with principles of anatomy, physiology, epidemiology, pathophysiology psychosocial impact, presentations, prognosis and management of a patient with endocrine disorders to include: Acute diabetic emergencies Diabetes Renal disease Pituitary and thyroid disorders Differentiate and formulate age related variations as it pertains to the management of endocrine disorders. Discuss considerations of patient with endocrine disorders as it pertains to: Communication and documentation Transport decisions Patient education Prevention.
Hydrogen Flouride Hydrogen Sulfide Hypertensive Emergencies Hypnotics Hypotension ICE Idiosyncratic Reactions Ingestion Inhalation Injection Intentional Poisoning/OD Ipecac Jimson Weed Lortab Lysergic Acid Diethylamide (LSD) Meperidine Mescaline Medication Overdose Metals Methamphetamine Malignant Hyperthermia Marijuana and Cannabis Methadone Methylene Blue Mistletoe Morphine Mushrooms Narcan Nausea Nerve Agent (Sarin, Soman) Occupational Exposure Opiates Organophosphate Other Oxides of Nitrogen Oxycontin Peyote Phencyclidine (PCP) Physostigmine Pine Oil Products Pinpoint Pupils Pralidoxime Chloride (2-PAM) Propoxyphene Psychiatric Medications Psychosis/Seizures Pyrethrums (Raid) Respiratory Arrest Respiratory Depression Respiratory Support Salicylates Sedation Sedatives Seizure Solu-Medrol Solvents Toxidrome Warfarins Licit Illicit Poison Drug Toxicologic emergencies Toxidrome Drug abuse Habituation Physical dependence Psychological dependence Tolerance Withdrawal syndrome Drug addiction Antagonist Potentiation Synergism Alcoholism Delirium tremens (DTs0 Cocaine Amphetamines Methamphetamine Rhabdomyolysis Marijuana Hallucinogen Spice Sedative-hypnotic Barbiturates Benzodiazepines Narcotic Opiate Opioid Organophosphates Caustics Hydrocarbons Tricyclic antidepressants (TCAs) Monoamine oxidase inhibitors (MAOIs) Selective serotonin reuptake inhibitors Serotonin syndrome Lithium Salicylates Theophylline POISONOUS PLANTS: Dieffenbachia Caladium Lantana Foxglove Castor bean Objectives: DOT Objectives EMS Education Standards Integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with a toxic exposure. Describe the incidence, morbidity, and mortality of emergencies. Understand, demonstrate, and discuss the assessment findings with principles of anatomy, physiology, electrophysiology, epidemiology, pathophysiology psychosocial impact, presentations, prognosis and
Aplastic crisis Hemolytic crisis Sickle cell crisis Vasoocclusive crisis Acute chest syndrome Splenic sequestration crisis Acute splenic sequestration syndrome Anemia Iron deficiency anemia Thalassemia Leukopenia Thrombocytopenia Petechiae Leukemia Lymphoid system Lymphoblasts Lymphomas Polycythemia Pruritus Disseminated intravascular coagulation (DIC) Hemophilia Melena Multiple myeloma Neoplastic cells Transfusion reactions Transfusion-related lung injury Objectives: DOT Objectives EMS Education Standards Integrate the pathophysiological principles of the hematopoietic system to formulate a field impression and implement a treatment plan. Explain the significance of the hematocrit with respect to red cell size and number. Explain the correlation of the RBC count, hematocrit, and hemoglobin values. Define anemia. Describe normal white blood cell (WBC) production, function, and destruction. Identify the characteristics of the inflammatory process. Identify the difference between cellular and humoral immunity. Identify alterations in immunologic response. Describe platelets with respect to normal function, life span and numbers. Describe the components of the hemostatic mechanism. Describe the function of coagulation factors, platelets and vessels necessary for normal coagulation. Describe the intrinsic and extrinsic clotting systems with respect to identification of factor deficiencies in each stage. Identify blood groups. Describe how acquired factor deficiencies may occur. Define fibrinolysis. Describe the pathology and clinical manifestations and prognosis associated with: Anemia Leukemia Lymphomas Polycythemia Understand, demonstrate, and discuss the assessment findings with principles of anatomy, physiology, electrophysiology, epidemiology, pathophysiology psychosocial impact, presentations, prognosis, and management of a patient with a hematological disease and/or emergency to include: Sickle cell disease Hematological conditions Blood transfusion complications Hemostatic disorders Lymphomas Red blood cell disorders White blood cell disorders Coagulopathies. Differentiate and formulate age related variations as it pertains to the management of hematological emergencies. Discuss considerations of patient with hematological emergencies as it pertains to: Communication Documentation Transport decisions Patient education Prevention
Summary: Integrates assessment findings with principles of epidemiology and pathophysiology to formulate a field impression and implement a comprehensive treatment/disposition plan for a patient with a gynecological complaint. TARGET SKILLS: Recognition and management of associated with vaginal bleeding. Anatomy, physiology, epidemiology, pathophysiology, psychosocial impact, presentations, prognosis, assessment findings, and management of: Sexual assault (to include appropriate emotional support) Vaginal bleeding Infections Pelvic Inflammatory Disease Ovarian Dysfunctional uterine bleeding Vaginal foreign body Key Terminology: Pudendum Mons pubis majora Labia minora Perineum Clitoris Prepuce Vestibule Vagina Bartholin glands Hymen Imperforate hymen Oocyte Fallopian tube Uterus Menstruation Menstrual Cervix Proliferative phase Secretory phase Menarche Menopause Premenstrual syndrome (PMS) Amenorrhea Gravida Para Dysmenorrhea Vaginal bleeding Dysfunctional uterine bleeding Hypermenorrhea Polymenorrhea Metrorrhagia Ectopic pregnancy Hemoperitoneum Endometritis Endometrium Endometriosis Pelvic inflammatory disease (PID) Contraceptive device Vaginitis Vaginal yeast infections Vulvovaginitis Gardnerella vaginitis Ovarian cyst Ovarian torsion Tubo-ovarian abscess Ruptured ovarian cyst Prolapsed uterus Toxic shock syndrome (TSS) Bacterial vaginosis Chancroid Chlamydia Cytomegalovirus (CMV) Genital herpes Gonorrhea Genital warts Syphilis Trichomoniasis Sexual assault Rape Objectives: DOT Objectives EMS Education Standards Describe the anatomy and physiology of the female reproductive system including the Understand, demonstrate, and discuss the assessment findings with principles of anatomy, physiology, electrophysiology, epidemiology, pathophysiology psychosocial impact,
Summary: Integrates assessment findings with principles of epidemiology and pathophysiology to formulate a field impression and implement a comprehensive treatment/disposition plan for a patient with a Disease of the Eyes, Ears, Nose and Throat complaint. TARGET SKILLS: Recognition and management of nose bleed. Knowledge of anatomy, physiology, epidemiology, pathophysiology, psychosocial impact, presentations, prognosis, and management of common or major diseases of the eyes, ears, nose, and throat including nose bleed. Key Terminology: Globe Oculomotor nerve Optic nerve Sclera Cornea Cataract Conjunctiva Iris Pupil Lens Retina Anterior chamber Aqueous humor Posterior chamger Vitreous humor Visual cortex Central vision Peripheral vision Lacrimal apparatus Nasolacrimal duct Diabetic retinopathy Dysconjugate gaze Adnexa Conjunctivitis Sympathetic eye movement Chalazion Hordeolum Glaucoma Hyphema Iritis Papilledema Retinal detachment Periorbital cellulitis Orbital cellulitis External ear Middle ear Inner ear Auricle External auditory canal Tympanic membrane Ossicles Cochlear duct Oval window Cochlea Organ of Corti Battle sign Cerumen Labyrinthitis Meniere disease Vertigo Tinnitus Otitis Nasal septum Turbinates Paranasal sinuses Epistaxis Cerebrospinal rhinorrhea Rhinitis Sinusitis Crown Cusps Pulp Dentin Alveoli Alveolar ridges Mastication Hypoglossal nerve Glossopharyngeal nerve Trigeminal nerve Dentalgia Dental abscess Oral candidiasis Ludwig angina Epiglottis Dysphagia Laryngitis Tracheitis Tonsillitis Pharyngitis Peritonsillar abscess Temporomandibular joint disorder Objectives: DOT Objectives EMS Education Standards Demonstrate the care of the patient exhibiting signs and symptoms of a nose bleed/epistaxis Understand, demonstrate, and discuss the assessment findings with principles of anatomy, physiology, epidemiology, pathophysiology psychosocial impact, presentations, prognosis, and management of a patient with common or major diseases of the
Law of conservation of energy Mechanical energy Mechanism of injury (MOI) Missile fragmentation Multisystem trauma Negative wave pulse Newton’s first law of motion Newton’s second law of motion Pathway expansion Penetrating trauma Permanent cavity Positive wave pulse Potential energy Pulmonary blast injuries Revised trauma score (RTS) Shearing Spelling Trauma Trauma score Tympanic membrane Velocity (V) Waddell Whiplash Objectives: DOT Objectives EMS Education Standards Integrate the principles of kinematics to enhance the patient assessment and predict the likelihood of injuries based on the patient’s mechanism of injury. List and describe the components of a comprehensive trauma system. Describe the role of and differences between levels of trauma centers. Describe the criteria and procedure for air medical transport. Define energy and as they relate to trauma. Define laws of motion and energy and understand the role that increased speed has on injuries. Describe each type of impact and its effect on unrestrained victims (e.g., down and under, up and over, compression, deceleration). Describe the pathophysiology of the head, thorax, and abdomen that result from the above forces. List specific injuries and their causes as related to interior and exterior vehicle damage. Describe the kinematics of penetrating injuries. List the motion and energy considerations of mechanisms other than motor vehicle crashes. Define the role of kinematics as an additional tool for patient assessment. Understand, discuss, and demonstrate assessment findings with principles of epidemiology and pathophysiology to formulate a field impression to implement a comprehensive treatment/disposition plan for an acutely injured patient to include: Identification and categorization of trauma patients, specifically the national trauma triage protocol Incidence/significance of trauma Trauma system of injury Trauma assessment Role of documentation in trauma Trauma scoring scales Trauma center designations Transfer of patients to the most appropriate hospital. Activities/Resources: Use of auditory, visual, and kinesthetic aids to facilitate the student learning environment for the topic of instruction. Assessments: Scenario based training pertinent to topic of instruction, quiz, and exam (didactic and skills).
Bleeding Summary: Integrates assessment findings with principles of epidemiology and pathophysiology to formulate a field impression to implement a comprehensive treatment/disposition plan for an acutely injured Bleeding patient. TARGET SKILLS: Recognition, pathophysiology, assessment, and management of bleeding and fluid resuscitation. Key Terminology: Afterload Blood Cardiac output (CO) Compensated shock (classes I and II) Decompensated shick (class III) Ejection fraction (EF) Erythrocytes Hematemesis Hematochezia Hematocrit Hematuria Hemoglobin Hemophilia Hemoptysis Hemorrhage Hemorrhagic shock Hemostasis Hematoma Hypoperfusion Hypovolemic shock Irreversible (class IV) Leukocytes Melena Perfusion Plasma Platelets Preload Stroke volume (SV) Objectives: DOT Objectives EMS Education Standards List the structure and function of the circulatory system. Differentiate between arterial, venous, and capillary bleeding. State methods of emergency medical care of external bleeding. Establish the relationship between body substance isolation and bleeding. Establish the relationship between airway management and the trauma patient. Establish the relationship between mechanism of injury and internal bleeding. List the of internal bleeding. List the steps in the emergency medical care of the patient with signs and symptoms of internal bleeding. List signs and symptoms of shock (hypoperfusion). Understand, discuss, and demonstrate assessment findings with principles of epidemiology and pathophysiology to formulate a field impression to implement a comprehensive treatment/disposition plan for an acutely injured patient with bleeding to include: Classifications of shock Assessment consideration in shock Shock management strategies and considerations Bleeding considerations
Manubrium Mediastinum Myocardial contusion Myocardial rupture Needle decompression Neurovascular bundle Open pneumothorax Pericardial sac Pericardiocentesis Pericardium Pleura Pneumothorax Pulmonary contusion Pulsus paradoxus Scapula Sternum Subconjunctival hematcoma Subcutaneous Suprasternal notch Tension pneumothorax Thoracic inlet Thorax Traumatic aortic disruption Traumatic asphyxia Xiphoid process Objectives: DOT Objectives EMS Education Standards Describe the incidence, morbidity, and mortality of thoracic injuries in the trauma patient. Discuss the anatomy and physiology of the organs and structures related to thoracic injuries. Predict thoracic injuries based on mechanism of injury. Discuss the types of thoracic injuries. Discuss the pathophysiology of thoracic injuries. Discuss the assessment findings associated with thoracic injuries. Discuss the management of thoracic injuries. Identify the need for rapid intervention and transport of the patient with thoracic injuries. Discuss the epidemiology and pathophysiology of specific chest wall injuries, including: Rib fracture Flail segment Sternal fracture Discuss the assessment findings associated with chest wall injuries. Identify the need for rapid intervention and transport of the patient with chest wall injuries. Discuss the management of chest wall injuries. Discuss the pathophysiology of injury to the lung, including: Simple pneumothorax Open pneumothorax Tension pneumothorax Understand, discuss, and demonstrate assessment findings with principles of epidemiology and pathophysiology to formulate a field impression to implement a comprehensive treatment/disposition plan for an acutely injured patient with chest trauma to include: Incidence of trauma Traumatic aortic disruption Pulmonary contusions Blunt cardiac injury Hemothorax Pneumothorax Cardiac tamponade Rib fractures Flail chest Commotio cordis Tracheobronchial disruption Diaphragmatic rupture Traumatic asphyxia. Differentiate and formulate age related variations as it pertains to the management of the patient with trauma. Discuss considerations of patient with chest trauma as it pertains to: Communication Documentation Transport decisions Patient education Prevention
Discuss the assessment findings associated with traumatic asphyxia. Discuss the management of traumatic asphyxia. Differentiate between thoracic injuries based on the assessment and history. Value the implications of failing to initiate timely interventions to patients with thoracic trauma. Demonstrate a clinical assessment for a patient with suspected thoracic trauma. Demonstrate the following techniques of management for thoracic injuries: Needle decompression Fracture stabilization ECG monitoring Oxygenation and ventilation Activities/Resources: Use of auditory, visual, and kinesthetic aids to facilitate the student learning environment for the topic of instruction. Assessments: Scenario based training pertinent to topic of instruction, quiz, and exam (didactic and skills). Abdominal and Genitourinary Trauma Summary: Integrates assessment findings with principles of epidemiology and pathophysiology to formulate a field impression to implement a comprehensive treatment/disposition plan for an acutely injured Abdominal and Genitourinary Trauma patient. TARGET SKILLS: Recognition, pathophysiology, assessment, and management of: Blunt versus penetrating mechanisms Evisceration Impaled object Solid and hollow organ injuries Injuries to the external genitalia Vaginal bleeding due to trauma Sexual assault Vascular injury Retroperitoneal injuries Key Terminology: Blunt trauma Closed abdominal injury Duodenum evisceration Hematuria Hemoperitoneum Kehr sign Mesentery Open abdominal injury Penetrating trauma Peritoneal Peritoneum Peritonitis Periumbilical Pylorus Retroperitoneal space Somatic pain Visceral pain
Open fractures Closed fractures Dislocations Amputations/replantation Upper and lower extremity orthopedic trauma Sprains/strains Pelvic fractures Amputations/replantation Compartment syndrome Pediatric fractures Tendon laceration/transection/rupture (Achilles and patellar) Key Terminology: 6 Ps of musculoskeletal assessment Abduction Acetabulum Acromion Adduction Amputation Angulation Anterior tibial artery Appendicular skeleton Arthritis Articulations Atrophy Avascular necrosis Avulsion fracture skeleton Axilla Axillary artery Bowing fracture Boxer’s fracture Brachial artery Buckle fracture Buddy splinting Bursa Bursitis Calcaneus Carpal tunnel syndrome Carpals Cartilage Cartilaginous joints Cauda equine syndrome Clavicle Closed fracture Comminuted fracture Compartment syndrome Complete fracture Compound fracture Crepitus Crush syndrome Cubital tunnel syndrome Deep vein thrombosis (DVT) Depression fracture Devascularization Diaphysis Diastasis Digital arteries Dislocation Displaced fracture Distraction injury Dorsal Dorsiflex Endosteum Epiphysis Fascia Fasciitis Fatigue fractures Fatigue injuries Femoral artery Femoral shaft fractures Fibrous joints Fibula Flat bones Flexor tenosynovitis of the hand Fracture Gangrene Glenoid fossa Gout Greenstick fracture Hematopoiesis Humerus Hypertrophy Hyperuricemia Ilium Impacted fracture Incomplete fracture Indirect injury Intertrochanteric fractures Irregular Ischium Joint Joint capsule Lactic acid Lateral compression ligaments Linear fracture Long bones Luxation Malleolus Mallet finger March fractures Medullary canal Metacarpals Metaphysis Metatarsals Muscle fatigue Myalgia Myositis Neurovascular compromise Nondisplaced fracture Nursemaid’s elbow Oblique fracture olecranon Open-book pelvic fracture Open fracture Ossification centers Osteoarthritis (OA) Osteoporosis Overriding Paresthesias Paronychia Patella Pathologic fracture Pectoral girdle Pelvic girdle Periosteum Phalanges Physis
Plantar Plantar flexion Point tenderness Polyneuropathy Popliteal artery Posterior tibial artery Pronation Pubic symphysis Pubis Pulmonary embolism Radial artery Radius Range of motion (ROM) Recruitment Rhabdomyolysis Rheumatoid arthritis (RA) Round bones Sacroiliac joints Scaphoid Scapula Segmental fracture Septic arthritis bones Silver fork deformity Skeletal muscle Slipped capital femoral epiphysis (SCFE) Snuffbox Somatic motor neurons Spinal stenosis Spiral fracture Sprains Straddle fracture Strain Stress fracture Striated muscle Subclavian artery Subluxation Supination Supracondylar fractures Synovial joints Synovial membrane Talus Tarsals Tendinitis Tendons Thompson test Thromboembolic disease Torus fracture Transverse fracture Twisting injuries Ulna Ulnar artery Vertical volar Volkmann ischemic contracture Voluntary muscle Objectives: DOT Objectives EMS Education Standards Describe the function of the musculoskeletal system. Explain the anatomy and physiology of the musculoskeletal system. Describe the different types of musculoskeletal injuries including: Fractures Dislocations Amputations Sprains Strains. Describe the four mechanisms of injury. Differentiate between open and closed fractures. Explain how to assess the severity of an injury. Describe the treatment of a patient experiencing an orthopedic injury. Understand, discuss, and demonstrate assessment findings with principles of epidemiology and pathophysiology to formulate a field impression to implement a comprehensive treatment/disposition plan for an acutely injured patient with orthopedic trauma to include: Incidence Pediatric fractures Tendon lacerations/transection/rupture (achilles and patellar) Open fractures Closed fractures Dislocations Compartment syndrome and lower extremity orthopedic trauma Pelvic fractures Amputations/replantation. Differentiate and formulate age related variations as it pertains to the management of the patient with orthopedic trauma. Discuss considerations of patient with orthopedic trauma as it pertains to: Communication
Documentation Transport decisions Patient education Prevention Activities/Resources: Use of auditory, visual, and kinesthetic aids to facilitate the student learning environment for the topic of instruction. Assessments: Scenario based training pertinent to topic of instruction, quiz, and exam (didactic and skills). Soft Tissue Overview Summary: Integrates assessment findings with principles of epidemiology and pathophysiology to formulate a field impression to implement a comprehensive treatment/disposition plan for an acutely injured Soft Tissue Trauma patient. TARGET SKILLS: Recognition, pathophysiology, assessment, and management of wounds to include: Avulsions Bite wounds Laceration Puncture wounds Incisions Chemicals in the eye and on the skin Crush syndrome High-pressure injection Burns Electrical Chemical Thermal Radiation Key Terminology: Abrasion Adipose Amputation Avulsion Bandage Chemotactic factors Closed wound Collagen Compartment syndrome Contusion Crush injury Crush syndrome Deep fascia Degloving Degranulate Dermis Dressing Ecchymosis Elastin Epidermis Epithelialization Erythema Fasciotomy Gangrene Glomerular filtration Granulocytes Ground substance Hematoma High-pressure injection injuries Homeostasis Hyperkalemia Hyperphosphatemia Hypertrophic scar Incision Integument Keloid scar Laceration Lymphangitis Lymphocytes Macrophages Melanin Mucopolysaccharidegel Myoglobin Necrotizing fasciitis Neovascularization Open wound Pedicle Puncture wound Rabid Rhabdomyolysis Sebaceous gland Sebum Subcutaneous Tension lines Volkmann contracture
BURNS Acute radiation syndrome Adipose tissue Burn shock Circumferential Collagen Comedo Consensus formula Contact burn Cutaneous Dermis Desquamation Elastin Epidermis Escharotomy Flame burn burn Full-thickness burn Homeostasis Integument Joule’s law Lund and Browder chart Melanin Mucopolysaccharide gel Ohm’s law Partial-thickness burn Rule of nines Rule of palms Scald burn Sebaceous gland Steam burn Subcutaneous layer Superficial burn Supraglottic Thermal burn Thermoregulation Zone of coagulation Zone of hyperemia Zone of stasis Objectives: DOT Objectives EMS Education Standards Integrate pathophysiological principles and the assessment findings to formulate a field impression and implement the treatment plan for the patient with soft tissue trauma. Describe the layers of the skin, specifically: Epidermis and dermis (cutaneous) Superficial fascia (subcutaneous) Deep fascia Discuss the pathophysiology of wound healing including: Hemostasis Inflammation Epithelialization Neovascularization Collagen synthesis Differentiate between the following types of closed soft tissue injuries: Crush injuries Discuss the incidence, morbidity, and mortality of blast injuries. Predict injuries based on mechanism of injury including: Primary Secondary Tertiary Discuss the pathophysiology associated with blast injuries. Discuss the effects of an explosion within an enclosed space on a patient. Discuss the management of a patient with a injury. Understand, discuss, and demonstrate assessment findings with principles of epidemiology and pathophysiology to formulate a field impression to implement a comprehensive treatment/disposition plan for an acutely injured patient with soft tissue trauma to include: Incidence of soft tissue injury Anatomy and physiology of soft tissue injury Pathophysiology of wound healing Wounds Avulsions Bite wounds Lacerations Puncture wounds Lacerations Burns (electrical, chemical, thermal, radiation) High pressure injections wounds Crush syndrome. Differentiate and formulate age related variations as it pertains to the management of the patient with soft tissue trauma. Discuss considerations of patient with soft tissue trauma as it pertains to communication and documentation, transport decisions, patient education, and prevention.
Temperature-related illness Bites and envenomations Dysbarism High-altitude Diving injuries Electrical injury Radiation exposure High altitude illness Key Terminology: Acute lung injury Acute mountain sickness (AMS) Afterdrop Altitude illnesses Arterial gas embolism (AGE) Ataxia Atmosphere absolute (ATA) Barotrauma metabolic rate (BMR) Boyle’s law Breath-hold diving Chilblains Classic heatstroke Cold dieresis Conduction Convection Core body temperature (CBT) Dalton’s law Decompression illness (DCI) Decompression sickness (DCS) Deep frostbite Drowning Envenomation Environmental emergencies Evaporation Exercise-associated hyponatremia Exertional heatstroke Feet of seawater (fsw) Frostbite Frostnip Gangrene Heat cramps Heat exhaustion Heat illness Heatstroke Heat syncope Henry’s law High-altitude cerebral edema (HACE) High-altitude pulmonary edema (HAPE_ Homeostasis Hyperthermia Hypothalamus Hypothermia Laryngospasm Loxoscelism Malignant hyperthermia Neuroleptic malignant syndrome (NMS) Nitrogen narcosis Odynophagia Orthostatic hypotension Partial pressure Pulmonary over pressurization syndrome (POPS) Radiation Saturation diving Self-contained underwater breathing apparatus Shallow water blackout Superficial frostbite Surface-tended diving Thermogenesis Thermolysis Thermoregulation Trench foot Wind chill factor Objectives: DOT Objectives EMS Education Standards Integrate pathophysiological principles and assessment findings to formulate a field impression and implement the treatment plan for the patient with an environmentally induced or exacerbated medical or traumatic condition. Describe the function of the Divers Alert Network (DAN) and how its members may Understand, discuss, and demonstrate assessment findings with principles of epidemiology and pathophysiology to formulate a field impression to implement a comprehensive treatment/disposition plan for an acutely injured patient with environmental emergencies to include: Incidence
Assessments: Scenario training pertinent to topic of instruction, quiz, and exam (didactic and skills). Neonatal Care Summary: Integrates assessment findings with principles of pathophysiology and knowledge of psychosocial needs to formulate a field impression and implement a comprehensive treatment/disposition plan for patients with a need for Neonatal Care. TARGET SKILLS: Assessment and management of: Newborn care Neonatal resuscitation Anatomy and physiology of neonatal circulation Assessment of the newborn Presentation and management of: Newborn Neonatal Resuscitation Key Terminology: Acrocyanosis Amniotic fluid Apgar score Apnea Asphyxia Atrial septal defect (ASD) Bradycardia Central cyanosis Choanal atresia Cleft lip Cleft palate Coarctation of the aorta (CoA) Congenital heart disease (CHD) Diaphragmatic hernia Erb palsy transition Foramen ovale Free-flow oxygen Generalized seizure Gestation Grunting Hypoglycemia Hypoplastic left heart syndrome (HLHS) Hypothermia Hypotonia Hypoxic ischemic encephalopathy Infantile hypertrophic pyloric stenosis (IHPS) Intercostal retractions Intestinal atresia Intestinal stenosis Intussusception Klumpke paralysis Macroglossia Malrotation Meconium Multifocal seizure Nasal flaring Neonate Newborn Oligohydramnios Patent ductus arteriosus (PDA) Pathogenic gastroesophageal reflux (GER) Persistent pulmonary hypertension Pierre Robin sequence Placenta previa Polycythemia Polyhydramnios Positive-pressure ventilation (PPV) Post-term Premature Preterm Primary Primigravida Prolapsed cord Pulmonary hypertension Pulmonary stenosis Retinopathy of prematurity Secondary apnea Seizure Small for gestation age Surfactant Term Tetralogy of Fallot (Tof F) Thermoregulation
TARGET SKILLS: Age-related assessment findings, age related anatomic and physiologic variations, and developmental stage related assessment and treatment modifications for pediatric-specific major or common diseases and/or emergencies to include: Upper airway obstruction Lower airway reactive disease Foreign body (upper and lower) airway obstructions Respiratory distress/failure/arrest Seizures Sudden infant syndrome Gastrointestinal disease Bacterial tracheitis Asthma Bronchiolitis Respiratory Syncytial Virus (RSV) Pneumonia Croup Epiglottitis Hyperglycemia Hypoglycemia Pertussis Cystic fibrosis Bronchopulmonary dysplasia Congenital heart diseases Hydrocephalus and ventricular shunts Key Terminology: Absence seizures Acrocyanosis Apparent life-threatening event (ALTE) Bacterial tracheitis Blow-by technique Bronchiolitis Bronchopulmonary dysplasia Central venous catheter abuse Child protective service (CPS) Complex febrile seizures Complex partial seizures Congenital adrenal hyperplasia (CAH) Congenital heart disease Croup Cystic fibrosis (CF) Dilated cardiomyopathy (DCM) Epiglottitis Gastrostomy tube Generalized seizures Grunting Hemophilia Hydrocephalus Hypertrophic cardiomyopathy (HCM) Hypopituitarism Inborn errors of metabolism (IEM) Intussusception Malrotation with volvulus Meckel diverticulum Meningitis Mottling Myocarditis Muchal rigidity Obtunded Ossification centers Panhypopituitarism Partial seizures Pediatric Assessment Triangle (PAT) Pertussis Petechial Pneumonia Purpuric Pyloric stenosis Respiratory arrest Respiratory distress Respiratory failure Respiratory syncytial virus (RSV) Retractions Sepsis Sickle cell disease (SCD) Simple febrile seizures Simple partial seizures Sniffing position Status epilepticus Subglottic space Sudden infant death syndrome (SIDS) Synchronized cardioversion Tenting Thrombocytopenia Thrombosis Tonic-clonic seizures Tripoding Vasoconstriction Ventilation-perfusion mismatch Ventricular shunt Von Willebrand disease Objectives: DOT Objectives EMS Education Standards
Integrate pathophysiological principles and assessment findings to formulate a impression and implement a treatment plan for the pediatric patient. Discuss the paramedic's role in the reduction of infant and childhood morbidity and mortality from illness and injury. Identify methods/ mechanisms that prevent injuries to infants and children. Describe Emergency Medical Services for Children (EMSC). Discuss how an integrated EMSC system can affect patient outcome. Outline differences in adult and childhood anatomy and physiology. Discuss age appropriate vascular access sites for infants and children. Discuss anatomical features of children that predispose or protect them from certain injuries. Determine when pain management and sedation are appropriate for infants and children. Define children with special health care needs. Define technology assisted children. Discuss appropriate receiving facilities for low and high risk infants and children. Describe the epidemiology, including the incidence, morbidity/mortality, risk factors and prevention strategies for neurological emergencies in infants and children. Describe the epidemiology, including the incidence, morbidity/mortality, risk factors and prevention strategies for trauma in infants and children. Describe the epidemiology, including the incidence, morbidity/mortality, risk factors and prevention strategies for children with special health care needs including technology-assisted children. Discuss the pathophysiology of children with special health care needs including children. Discuss the management/treatment plan for children with special health care including technology-assisted children. Recognize and appreciate the physical and emotional difficulties associated with separation of the parent/guardian of a special needs child Understand, demonstrate, and discuss assessment findings with principles of anatomy, physiology, epidemiology, pathophysiology, psychosocial impact, presentations, age related assessment and treatment modifications of the or common diseases and/or emergencies to include: Pediatric anatomical variations and assessments Growth and development Foreign body (upper and lower airway) obstruction Bacterial tracheitis Asthma Bronchiolitis (RSV) Pneumonia Croup Epiglottitis Respiratory distress/failure/arrest Seizures Sudden infant death syndrome Hyperglycemia Hypoglycemia Pertussis Shock GI disease Cystic fibrosis Bronchopulmonary dysplasia Congenital heart diseases Hydrocephalus and ventricular shunts Toxicologic exposures Abuse and neglect Discuss considerations of the pediatric patient as it pertains to communication and documentation, transport decisions, psychological support/communication strategies.
Demonstrate the ability to provide reassurance, empathy and compassion for the parent/guardian. Demonstrate the use of a length-based resuscitation device for determining equipment sizes, drug doses and other pertinent information for a pediatric patient. Demonstrate proper placement of a gastric tube in infants and children. Demonstrate an appropriate technique for administration of intramuscular, inhalation, subcutaneous, rectal, endotracheal and oral medication for infants and children. Demonstrate an appropriate technique for insertion of an intraosseous line for infants and children. Demonstrate appropriate parent/ caregiver interviewing techniques for infant and child death situations. Activities/Resources: Use of auditory, visual, and kinesthetic aids to facilitate the student learning environment for the of instruction. Assessments: Scenario training pertinent to topic of instruction, quiz, and exam (didactic and skills). Geriatrics Summary: Integrates assessment findings with principles of pathophysiology and knowledge of psychosocial to formulate a field impression and implement a comprehensive treatment/disposition plan for patients with a need for geriatric care. TARGET SKILLS: Impact of age-related changes on assessment and care. Changes associated with aging, psychosocial aspects of aging, and age-related assessment and treatment modifications for the major or common geriatric diseases and/or emergencies to include: Cardiovascular diseases Respiratory diseases Neurological diseases Endocrine diseases Alzheimer’s Dementia Fluid resuscitation in the elderly Normal and abnormal changes associated with pharmacokinetic changes, psychosocial, and economic aspects of aging, polypharmacy, and age-related assessment and treatment modifications for the major or common geriatric diseases and/or emergencies to include: Cardiovascular diseases Respiratory diseases
EMS Operations Principles of Safely Operating a Ground Ambulance Summary: Knowledge of operational roles and responsibilities to ensure safe patient, public, and personnel safety. TARGET SKILLS: and responsibilities of emergency response and transport. Key Terminology: Air ambulances Belt noise Blind spots Brake fade Cleaning Cushion of safety Decontaminate Disinfection DOT KKK 1822 Drift Due regard Heavy-duty ambulance High-level disinfection Hydroplaning Landing zone Medevac Peak loads Posting Spotter Steering play Sterring pull Sterilization Strategic deployment Type I ambulance Type II ambulance Type III ambulance Wheel bounce Wheel wobble Objectives: DOT Objectives EMS Education Standards Discuss the medical and non-medical equipment needed to respond to a call. List the phases of an ambulance call. Describe the general provisions of state laws relating to the operation of the ambulance and privileges in any or all of the following categories: Speed Warning lights Sirens Right-of-way Parking Turning List contributing factors to unsafe driving conditions. Describe the considerations that should be given to: Request for escorts. Following an escort vehicle. Intersections. Understand, demonstrate, and discuss the knowledge of operations roles and responsibilities to ensure safe patient, public, and personnel safety to include risk and responsibilities of the emergency response and transport.
Finance Freelancing Hospital surge capacity Incident action plan Incident commander (IC) Incident command system (ICS) Joint information center (JIC) Jump START triage Liaison officer (LNO) logistics Medial incident command Morgue supervisor Multiple-casualty incident (MCI) Mutual aid response National Incident Management System (NIMS) Open incident Operations Planning Primary triage Public information officer (PIO) Rehabilitation supervisor Rescue supervisor Safety officer Secondary triage Single command system Span of control Staging supervisor START triage Termination of command Transfer of command Transportation supervisor Treatment supervisor Triage Triage supervisor Unified command system Objectives: DOT Objectives EMS Education Standards Describe concepts of the national incident management system and its components. Describe the ICS structure and the role of EMS response within it. Describe how ICS provides safety to patients, providers, and bystanders at an incident Describe the Role of the Paramedic in establishing command under ICS. Understand, demonstrate, and discuss the knowledge of operations and responsibilities to ensure safe patient, public, and personnel safety to include establishing and working within the incident management system. Activities/Resources: Use of auditory, visual, and kinesthetic aids to facilitate the student learning environment for the topic of instruction. Assessments: Scenario based training pertinent to topic of instruction, quiz, and exam (didactic and skills). Multiple Casualty Incidents Summary: Knowledge of operational roles and responsibilities to ensure safe patient, public, and personnel safety. TARGET SKILLS: Triage principles to include: Performing Re-triage Destination decisions Post Traumatic and cumulative stress Resource management
State the steps that should be taken to protect the patient during extrication. Evaluate various methods of gaining access to the patient. Activities/Resources: Use of auditory, visual, and kinesthetic aids to facilitate the student learning environment for the topic of instruction. Assessments: Scenario training pertinent to topic of instruction, quiz, and exam (didactic and skills). Hazardous Materials Awareness Summary: Knowledge of operational roles and responsibilities to ensure safe patient, public, and personnel safety. TARGET SKILLS: Risks and responsibilities of operating in a cold zone at a hazardous material incident or other special incident. Key Terminology: Absorption Asphyxiant Authority having jurisdiction (AHJ) Bill of lading CAMEO Carbon monoxide Carboy Cargo tank Chemical asphyxiants CHEMTREC (Chemical Transportation Emergency Center) Container Corrosives Cyanide Cylinders Decontamination corridor Dilution Disposal Dose effect Drums Dry bulk cargo tanks Emergency decontamination Evacuation Flammable range Flash point Hazardous material HAZWOPER (HAZardous Waste Operations and Emergency Response) Ignition temperature Immediately dangerous to life and health (IDLH) Intermodal tanks Labels Lethal concentration (LC) Lethal dose (LD) Level A ensemble Level B ensemble Level C ensemble D ensemble effect Lower flammable limit (LFL) Mass decontamination Material safety data sheets (MSDS) MC-306/DOT 406 flammable liquid tanker MC-307/DOT 407 chemical hauler MC-312/DOT 412 corrosive tanker MC-331 pressure cargo tanker MC-338 cryogenic tanker Medical monitoring Neutralization Nonbulk storage vessels Permissible exposure limit (PEL) Placards Primary contamination Secondary containment
TARGET SKILLS: Risks and responsibilities of operating on the scene of a natural or man-made disaster (this section subject to ongoing collective and cooperative review and input from all stakeholders including the Department of Transportation, Department of Homeland Security, and the Department of Health and Human Services) Key Terminology: Alpha Ammonium nitrate Anthrax Apocalyptic violence Asymmetric warfare Bacteria Beta Botulinum Buboes Bubonic plague Chlorine (CL) Communicability Contact hazard Contagious Covert Cross-examination Cyanide Decay Dirty bomb Disease vector Dissemination Domestic terrorism DuoDote Elevated G agents Gamma (x-rays) Guerilla warfare Imminent Incubation International terrorism Ionizing radiation LD50 Lewisite (L) Lymphatic system Lymph nodes MARK 1 Miosis Mutagen National Terrorism Advisory system (NTAS) Nerve agents Neurotoxins Neutron radiation terrorism Off-gassing Organophosphates Persistency Phosgene Phosgene (CX) Pneumonic plague Points of distribution (PODs) Radioactive material Radiologic dispersal device (RDD) of exposure Sarin (GB) Secondary device Smallpox (GD) Special atomic demolition munitions (SADMs) State-directed terrorism State-sponsored terrorism Suicide bombers Sulfur mustard (H) Syndromic surveillance (GA) Terrorism V (VX) hazard Vesticants Viral hemorrhagic fevers (VHFs) Viruses Volatility Weapon of mass destruction (WMD) Weaponizaton 6-feet rule report(AAR) All-hazards approach Ashfall Casualty collection points Cold stress Continuity of operations plan (COOP) Critical infrastructure Directed area Disaster Disaster management Dust suffocation Emergency operations center (EOC) Epidemic Forward surgical team Incident command system (ICS) Lister bags Mutual aid agreements (MAAs)overtopping Pandemic Point of distribution (POD) Pyroclastic explosions Radio operators Seasonal affective disorder (SAD) Space junk Tg lines Thermals Unified command system Water buffalo trailers Objectives: