Mass Casualty Incidents Due to Terrorism or Disaster – all material at this level represents the same depth and breadth as the EMR level. National EMS Core Content Categories PREPARATORY AND OPERATIONS EMS Systems The Roles and Responsibilities of the EMS Providers The of the EMS Provider Illness and Injury Prevention Medical / Legal Issues Ethics General Principles of Pathophysiology Pharmacology Venous Access and Medication Administration Therapeutic Communications Life Span Development Ambulance Operations Medical Incident Command Rescue Awareness and Operations Hazardous Materials Incidents Crime Scene Awareness Communications Documentation Airway Management and Ventilation History Taking Techniques of Physical Examination Patient Assessment TRAUMA Trauma Systems Mechanism of Injury Hemorrhage and Soft Tissue Trauma Burns Head and Facial Trauma Spinal Trauma Thoracic Trauma Abdominal Trauma Musculoskeletal Trauma MEDICAL Pulmonary 33.1 Acute/adult respiratory distress syndrome 33.2 Obstructive airway diseases 33.2.1 Asthma 33.2.2 Chronic bronchitis 33.2.3 Emphysema 33.3 Pneumonia 33.4 Pulmonary edema 33.5 Pulmonary thromboembolism 33.6 Neoplasms of the lung 33.7 respiratory infection 33.8 Spontaneous pneumothorax 33.9 Hyperventilation syndrome Cardiology Neurology Endocrinology Allergies and Anaphylaxis Gastroenterology Renal/Urology Toxicology Hematology Environmental Conditions Infectious and Communicable Diseases Behavioral and Psychiatric Disorders Gynecology Obstetrics Neonatology Pediatrics Geriatrics Abuse and Assault Patients with Special Challenges Acute Interventions for the Chronic Care Patient
being National EMS Education Standards (Alaska EMT-1 Lessons to National Core Content) Core Content Lesson (old AK EMT 2002) Module EMT Core Content Est. Hours 1 1-1 Preparatory Use simple knowledge of the EMS system, of the first responders. Safety/well-being of the EMT, medical/legal issues at the scene of an emergency while awaiting a higher level of care. 2 1-1 EMS Systems Simple depth, foundational breadth: • EMS systems • History of EMS • Roles/ responsibilities/ professionalism of EMS personnel • Quality improvement • Patient safety 11 Public Health Have an awareness of local public health resources and the role EMS personnel play in public health emergencies. Knowledge of the principles of illness and injury prevention in emergency care. 2 1-1 Research Simple simple breadth • Evidence-based decision making; impact of research on EMS care • Data collection 3 1-2 1-6 Workforce Safety & Wellness (Welling-Being of the EMT) • Standard safety precautions • Personal protective equipment • Stress management - Dealing with death and dying • Prevention of work related injuries • Lifting and moving patients • Disease transmission • Wellness principles 18 1-3 Documentation Simple depth, simple breadth Recording patient findings • Principles of medical documentation and report writing 17 3-7 EMS System Communication • EMS communication system Call for Resources • Transfer care of the patient • Interact within the team structure • Communication with other health care professionals • Team communication and dynamics Principles of communicating with patients in a manner that achieves a positive relationship
10 3-2 Therapeutic Communication (Interviewing techniques) 1-4Interviewing techniques • Adjusting communication strategies for age, stage of development, patients with special needs, differing cultures • Interviewing techniques • Verbal defusing strategies • Family presence issues 5 1-3 and Ethics Fundamental depth, foundational breadth • 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 6 1-4 Anatomy and Physiology Simple knowledge of the anatomy and function of the airway, heart, vessels, blood, lungs, skin, muscles, and bones 6 1-4 Pathophysiology Uses fundamental knowledge of the pathophysiology of shock respiration compromise, body response to life threats and perfusion to patient assessment and management. 1-4 Life Span Development Applies fundamental knowledge of life span development (age), related differences to patient assessment and management. 8 4-1 Pharmacology Uses simple knowledge of the medications, or administer to a peer in an emergency. Applies fundamental knowledge of the medications that the EMT may assist/administer to a patient during an emergency. 8 4-1 Principles of Pharmacology Simple simple breadth • Medication safety • Kinds of medications used during an emergency 9 4-1 Medication Administration Simple depth, simple breadth how to • Self-administer medication • Peer-administer medication Fundamental depth, foundational breadth Within the scope of practice of the EMT how to • Assist/administer medications to a patient 9 3-4 Emergency Medications Within the scope of practice of the EMT • Names • Effects - Actions • Indications • Contraindications • Complications • Routes of administration • Side effects • Interactions • Dosages for the medications administered
19 2-1 Airway Management, Respiration and Artificial Ventilation Applies knowledge (fundamental depth, foundational breadth) of general anatomy and physiology to patient assessment and management in order to assure a patent airway, adequate mechanical ventilation, and respiration of patients of all ages. 19 2-1 Airway Management Fundamental foundational breadth Within the scope of practice of the EMT • Airway anatomy • Airway assessment • Techniques of assuring a patent airway 6 19 20 21 22 33 43 2-1 Respiration Fundamental depth, simple breadth • Anatomy of the respiratory system • Physiology and pathophysiology of respiration - Pulmonary ventilation - Oxygenation - Respiration - External - Internal - Cellular • Assessment and management of adequate and inadequate respiration • Supplemental oxygen therapy 19 33 2-2 Artificial Ventilation Fundamental depth, foundational breadth - Assessment and management of adequate and inadequate ventilation • Artificial ventilation • Minute ventilation • Alveolar ventilation • Effect of artificial ventilation on cardiac output 14 15 16 20 21 22 24 3-1 Assessment Use scene information and simple patient assessment findings to identify and manage immediate life threats and injuries. Applies scene information and patient assessment findings (scene size up, primary and secondary assessment, patient history, and reassessment) to guide emergency management, 3 13 14 15 16 24 3-1 Scene Size-Up Complex depth, comprehensive breadth • Scene safety • Scene management • Multiple patient situations - Impact of the environment on patient care - Addressing hazards - Violence - Need for additional or specialized resources - Standard precautions 11 20 21 22 24 3-3 Primary Assessment • Primary assessment for all patient situations - Level of consciousness - ABCs - Identifying life threats - Assessment of vital functions • interventions needed to preserve life
6 7 21 22 25 31 38 39 3-4 3-5 Abdominal and Gastrointestinal Disorders Fundamental depth, foundational breadth Anatomy, physiology, pathophysiology, assessment, presentations and management of shock associated with abdominal emergencies • Acute and chronic gastrointestinal hemorrhage Simple depth, simple breadth • Peritonitis • Ulcerative diseases 6 7 20 22 45 4-7 Immunology Fundamental depth, foundational breadth Anatomy, physiology, pathophysiology, assessment, and management of hypersensitivity disorders and/or emergencies - Anaphylactic reactions 3 6 7 12 20 Infectious Diseases Simple simple breadth Assessment and management of • A patient who may have an infectious disease • How to decontaminate the ambulance and equipment after treating a patient 6 7 36 4-4 Endocrine Disorders Fundamental depth, foundational breadth - Anatomy, physiology, pathophysiology, and awareness of Diabetic emergencies cause altered mental status assessment and management of Acute diabetic emergencies 3 5 10 44 49 51 4-8 Psychiatric (Behavioral Emergency) Simple depth, simple breadth Recognition of Behaviors that pose a risk to the EMT, patient or others • Basic principles of the mental health system Fundamental depth, foundational breadth Assessment and management of - Acute psychosis • Suicidal/risk • Agitated delirium 6 7 20 21 22 34 52 4-3 Cardiovascular Anatomy, physiology, pathophysiology, assessment, signs, symptoms and management • Chest pain • Cardiac arrest • Acute coronary syndrome - Angina pectoris - Myocardial infarction • Aortic aneurysm/dissection • Thromboembolism Simple simple breadth • Heart failure • Hypertensive emergencies 6 7 8 20 40 4-6 Toxicology Fundamental foundational breadth Anatomy, physiology, pathophysiology, assessment, a Recognition and management of - Carbon monoxide poisoning - Nerve agent poisoning • How and when to contact a poison control center • Inhaled poisons • Ingested poisons • Injected poisons • Absorbed poisons • Alcohol intoxication and withdrawal
6 7 8 10 21 22 33 37 43 49 52 4-2 Respiratory Anatomy, physiology, pathophysiology, assessment, and management of Fundamental depth, foundational breadth • Epiglottitis • Spontaneous pneumothorax • Pulmonary edema • Asthma • Chronic obstructive pulmonary disease • Environmental and industrial exposure • Toxic gas Simple depth, simple breadth • Pertussis • Cystic fibrosis • Pulmonary embolism • Pneumonia • Viral respiratory infections 6 7 10 20 22 41 6-1 Hematology Simple depth, simple breadth Anatomy, physiology, pathophysiology, assessment, and management of • Sickle cell crisis • Clotting disorders 6 7 20 21 22 39 3-4 Genitourinary Renal Simple depth, simple breadth Anatomy, physiology, pathophysiology, assessment, management • pressure assessment in hemodialysis patients • Complications related to - dialysis - Urinary catheter management (no insertion) • Kidney stones 6 7 10 20 21 22 43 45 4-9 Gynecology Simple depth, simple breadth Anatomy, physiology, assessment findings, recognition and management of shock associated with • Vaginal bleeding • Sexual assault (to include appropriate emotional support) Simple depth, simple breadth • Infections 6 7 20 21 22 48 49 50 52 3-4 Disorders Fundamental depth, foundational breadth Anatomy, physiology, pathophysiology, assessment and management of • Non-traumatic fractures 6 20 22 Diseases of the Eyes, Ears, Simple depth, simple breadth Recognition and management of • Nose bleed
7 21 14 24 26 32 5-1 Multi-System Trauma Fundamental depth, foundational breadth Pathophysiology, assessment, and management of • Multi-system trauma • Blast injuries 6 7 20 21 22 42 4-7 Environmental Emergencies Fundamental depth, foundational breadth Pathophysiology, assessment, recognition and management of • Submersion incidents • Temperature-related illness • Near drowning • Temperature-related illness • Bites and envenomations • Dysbarism - High-altitude - Diving injuries • Electrical injury • Radiation exposure * Alaska Cold Injuries Guidelines highlighted 11 22 47 48 49 51 52 6-1 Special Patient Populations Recognizes and manages life threats based on simple assessment findings for a patient with special needs while awaiting additional emergency response. Applies a fundamental knowledge of growth, development, and aging and assessment findings to provide basic emergency care and transportation for a patient with special needs. 6 7 20 21 22 46 4-9 Obstetrics Fundamental depth, foundational breadth Anatomy and physiology of normal pregnancy • Normal delivery • Vaginal bleeding in the pregnant patient • Pathophysiology of complications of pregnancy • Assessment of the pregnant patient Management of - Normal delivery - Abnormal delivery - Nuchal cord - Prolapsed cord - Breech delivery - Third trimester bleeding ~ Placenta previa ~ Abruptio placenta - Spontaneous abortion/miscarriage - Ectopic pregnancy - Preeclampsia/Eclampsia 6 7 22 47 6-1 Neonatal care Fundamental depth, foundational breadth Assessment and management • Newborn • Neonatal resuscitation 6 6-1 Pediatrics Fundamental depth, foundational breadth Age-related assessment findings, age-related, and developmental
7 10 11 20 21 22 48 stage related assessment and treatment modifications for pediatric specific major diseases and/or emergencies • Upper airway obstruction • Lower airway reactive disease • Respiratory distress/failure/arrest • Shock • Seizures • Sudden Infant Death Syndrome • Gastrointestinal disease 6 7 10 11 20 21 22 49 Geriatrics Fundamental depth, foundational breadth 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 • impact of age-related changes on assessment and care • Cardiovascular diseases • Respiratory diseases • Neurological diseases • Endocrine diseases • Alzheimer’s • Dementia 6 7 10 11 20 21 22 51 Patients with Special Challenges Simple depth, simple breadth - Healthcare implications of • Abusev / Neglect • Homelessness / Poverty • Bariatrics • Technology dependent • Hospice/ terminally ill • Tracheostomy care/dysfunction • Homecare • Sensory deficit/loss • Developmental disability • Sensory deficit/loss 2 12 7-1 EMS Operations Knowledge of operational roles and responsibilities to ensure safe patient, public, and personnel safety 2 3 14 7-1 Principles of Safely Operating a Ground Ambulance Simple foundational breadth • Risks and responsibilities of transport 2 13 7-3 Incident Management Fundamental foundational breadth Establish & work within the incident management system 2 13 23 7-3 Multiple Casualty Incidents Simple depth, simple breadth • Triage principles • Resource management 2 3 12 23 Air Medical Simple simple breadth • Safe air medical operations • Criteria for utilizing air medical response 2 12 7-2 Simple depth, simple breadth