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21st Century Instructional Guide for Career Technical Education Medical Assistant Clinical Procedures Health Science Education Cluster Medical Office Assistant Concentration Title: Medical Assistant Clinical Procedures (0733) Standard Number: HSE.S. MCP.1 Essential Questions: Objective Number: HSE.O.MCP.1.1 Emergency Medial Care Students will perform basic emergency care. Is there an impact on patient care when medial assistants have a solid understanding of the knowledge and skills necessary to assist patients in office emergencies? Objective: Learning Plan & Notes to Instructor: examine the general principles of first aid. general principles recognize emergency exists check scene for safety, number of victims, and bystanders available to assist check victim for consciousness and follow CPR guidelines based on findings/primary survey perform secondary survey avoid unnecessary movement obtain consent or use implied consent avoid food and fluids protect from cold or chilling protect confidentiality call EMS as soon as possible or according to established guidelines Related instructional concepts: Good Samaritan Laws abandonment triage Provide clinical scenarios which require students to 1 HSE.O.MCP.1.2 articulate signs and symptoms and describe treatment for shock. HSE.O.MCP.1.3 prioritize the methods used for the control of bleeding. HSE.O.MCP.1.4 assess types of wounds and describe treatment for each. recognize signs and symptoms and respond appropriately. signs/symptoms of shock cyanosis diaphoresis rapid, weak pulse rapid, shallow respirations low blood pressure generalized weakness confusion anxiety/restlessness thirst nausea/vomiting blurred vision loss of consciousness treatment of shock positioning keep warm/avoid chilling avoid food and drink monitor ABCs activate EMS based on established guidelines Provide clinical scenarios which require students to recognize signs and symptoms and respond appropriately. methods to control bleeding direct pressure elevation pressure dressing pressure point Provide clinical scenarios which require students to recognize signs and symptoms and respond appropriately. types of wounds abrasion laceration 2 HSE.O.MCP.1.5 assess first aid measures for sudden illness and injury including, fainting, stroke, seizures, insulin shock and diabetic coma. incision puncture avulsion amputation treatment of wounds control bleeding prevent infection activate EMS based on established guidelines Provide clinical scenarios which require students to recognize signs and symptoms and respond appropriately. signs/symptoms of fainting dizziness extreme pallor diaphoresis coldness of skin nausea numbness and tingling of hands and feet treatment of fainting positioning loosen tight clothing activate EMS based on established guidelines signs/symptoms of stroke numbness, tingling sensation, loss of sensory perception, paralysis (limited to one side of body) slurred speech/no speech facial drooping difficulty swallowing nausea and/or vomiting eye pupils unequal in size mental confusion loss of consciousness treatment of stroke 3 monitor respirations avoid food/fluids reassure victim activate EMS based on established guidelines *optimal 3 hour treatment window signs/symptoms of seizures rigidity of body muscles followed by jerking movements face and lips may develop bluish color possible loss of bowel and bladder control loss of consciousness treatment of seizures prevent self-injury do not place anything between victim’s teeth do not force or restrain muscle movements monitor ABCs activate EMS based on established guidelines signs/symptoms of insulin shock muscle weakness mental confusion restlessness or anxiety diaphoresis pale moist skin hunger pangs rapid, irregular heartbeat loss of consciousness treatment of insulin shock if conscious and alert, give sweetened drink or place a cube or teaspoon of sugar in the victim’s mouth avoid hard candy monitor responsiveness and ABCs activate EMS based on established guidelines signs/symptoms of diabetic coma 4 HSE.O.MCP.1.6 confusion weakness or dizziness nausea and/or vomiting rapid deep respirations dry/flushed skin sweet or fruity odor to breath loss of consciousness treatment of diabetic coma activate EMS based on established guidelines neumonic statements: Warm and dry, think high. Cold and clammy, give candy. Provide clinical scenarios which require students to recognize signs and symptoms and respond appropriately. distinguish signs and symptoms and signs/symptoms of fractures describe treatment for bone and joint injuries, deformity including fractures, dislocations, sprains, and limited or loss of motion strains. pain/tenderness at site swelling discoloration protrusion of bone through the skin crepitation abnormal movements within a part of the body treatment of fractures maintain respirations treat for shock immobilize the injury splint/sling RICE activate EMS based on established guidelines * make no attempt to reduce the fracture signs/symptoms of dislocations deformity limited or abnormal movement 5 swelling discoloration pain/tenderness a shortening or lengthening of the affected arm or leg treatment of bone and joint injuries maintain respirations treat for shock immobilize the injury splint/sling RICE activate EMS based on established guidelines *make no attempt to reduce the dislocation signs/symptoms of sprains swelling pain discoloration impaired motion treatment of sprains RICE activate EMS based on established guidelines signs/symptoms of strains sudden pain swelling bruising treatment of strains RICE recommend a bedrest with a backboard under the mattress for a strained back after swelling decreases, apply warm, wet heat obtain medical help for severe strains and all back injuries Provide clinical scenarios which require students to recognize signs and symptoms and respond 6 HSE.O.MCP.1.7 HSE.O.MCP.1.8 See American Heart Association/American Red demonstrate dressing, bandaging, and Cross performance guidelines. splinting techniques distinguish signs and symptoms and signs/symptoms of eye injuries describe treatment for injuries involving the redness eyes, head, nose, ears, chest, abdomen, and burning sensation genital organs. pain tearing presence of foreign object treatment of eye injuries foreign objects such as dust, dirt, or small particles o prevent victim from rubbing eye o draw upper lid down over lower lid to stimulate formation of tears o if particle not removed, grasp upper lid and have victim look down and tilt head toward injured side o use water/sterile solution to gently flush eye or use corner of sterile gauze to remove object o if particle is not removed by these actions or is embedded, make no attempt to remove it o apply sterile dry dressing o obtain medical assistance, preferably an eye specialist o activate EMS based on established guidelines signs/symptoms of head injuries clear or blood-tinged fluid draining from the nose or ears headache nausea/vomiting visual disturbances pupils unequal in size 7 muscle paralysis speech disturbances convulsions loss of consciousness treatment of head injuries keep victim lying flat treat for shock if no evidence of neck or spinal injuries, raise victim’s head slightly and support head, neck, and shoulders with a small pillow watch for signs of respiratory distress and provide rescue breathing as necessary make no attempt to stop the flow of fluid do not give liquids activate EMS based on established guidelines signs/symptoms of nose injuries bleeding from nostrils nose fracture treatment of nose injuries keep victim quiet if possible, place victim in sitting position with head tilted slightly forward apply pressure by pressing nostril(s) toward the midline if bleeding does not stop, insert small piece of gauze in the nostril while applying pressure on the outer surface of the nostril apply cold compress to bridge of nose apply pressure on the upper lip just beneath the nose if bleeding does not stop or fracture of the nose is suspected, seek medical attention activate EMS based on established guidelines injuries to the ear torn or detached tissue 8 ruptured or perforated eardrum clear or blood-tinged fluid draining from the ear treatment of wounds to the ear resulting in torn or detached flesh apply sterile dressing with light pressure to control bleeding save any torn tissue, using sterile water or sterile saline solution to keep tissue cool and moist (use cool, clean water if sterile not available) send tissue to medical facility with victim keep victim lying flat, raising head if no neck or spinal injury is suspected activate EMS based on established guidelines treatment of wounds to the ear resulting in ruptured or perforated eardrum place sterile gauze loosely in the outer ear canal do not allow victim to hit side of head in an attempt to restore hearing do not put any liquids into the ear activate EMS based on established guideline *recognize clear or blood-tinged fluid draining from the ear may be a sign of skull or brain injury (see treatment of head injuries) types of injuries to the chest sucking chest wound penetrating chest wounds crushing chest injuries signs/symptoms of sucking chest wounds deep open chest wound air flows in and out with breathing usual vacuum between pleura and lungs destroyed 9 lung on injured side collapses treatment of sucking chest wounds place nonporous, airtight dressing over wound (aluminum foil, plastic wrap) and tape in place maintain open airway and give artificial respirations as needed place victim on injured side and elevate head and chest slightly activate EMS based on established guidelines signs/symptoms of penetrating chest wounds object protruding from chest treatment of penetrating chest wounds do not attempt to remove the object immobilize object by placing dressing around it and taping in place place victim in comfortable position monitor respirations and give rescue breathing as needed activate EMS based on established guidelines signs/symptoms of crushing chest injuries usually caused by vehicular accident or heavy object striking chest ruptured ribs and damage to the lungs and/or heart can occur bleeding, bruising of the chest difficulty breathing, noisy respirations treatment of crushing chest injuries place victim in comfortable position elevate head and shoulders if no neck or spinal injury is suspected signs/symptoms of abdominal injuries severe abdominal pain or tenderness protruding organs open wounds nausea and vomiting 10 HSE.O.MCP.1.9 distinguish signs and symptoms and abdominal rigidity shock treatment of abdominal injuries position victim flat on back place small pillow under knees elevate head and shoulders remove clothing from around wound apply large, sterile dressing moistened with sterile water or normal saline solution to cover the area (use warm tap water if sterile solution not available) do not attempt to reposition protruding organs avoid food and fluids activate EMS based on established guidelines signs/symptoms of genital injuries resulting from falls, blows, explosions or burns severe pain bleeding shock treatment of genital injuries control severe bleeding with sterile or clean dressing, applying direct pressure to the area treat for shock do not remove any penetrating or protruding object save torn tissue moistened with sterile water or sterile normal saline solution send torn tissue to medical facility apply cold (ice pack) to decrease bleeding and relieve pain activate EMS based on established guidelines Provide clinical scenarios which require students to recognize signs and symptoms and respond appropriately. signs/symptoms of heat cramps 11 describe treatment for temperature related injuries, including heat and cold exposure, and burns. muscle pains and spasms excessive sweating treatment of heat cramps rest liquids firm pressure to cramped muscle signs/symptoms of heat exhaustion pale, clammy skin profuse perspiration fatigue weakness headache nausea/vomiting muscle cramps dizziness/fainting core temperature normal treatment of heat exhaustion move to cool area loosen or remove clothing apply cool, wet cloths standard shock position if alert, sips of cool water (4 oz. every 15 min.) monitor ABCs activate EMS based on established guidelines signs/symptoms of heat stroke elevated body temperature (temp over 105°F) red, hot and dry skin rapid pulse loss of consciousness convulsions treatment of heat stroke (temp 104°F or above, hyperthermia) activate EMS immediately place in tub of cool water or sponge with cool water 12 ice/cold packs to wrists, ankles, axilla, and groin observe for signs and symptoms of shock signs/symptoms of cold exposure (temp 95°F or below, hypothermia) shivering numbness weakness or drowsiness glassy stare low body temperature poor coordination confusion, impaired judgment loss of consciousness treatment of cold exposure monitor ABCs remove any wet clothing and dry the person redress in warm clothing and warm them by wrapping in blankets if alert, give warm liquids to drink that do not contain alcohol or caffeine DO NOT warm the victim too quickly, such as by immersing him or her in warm water; rapid warming may cause dangerous heart rhythms activate EMS based on established guidelines signs/symptoms of frostbite lack of feeling in the affected area skin that appears waxy, cold to the touch or discolored (flushed, white, yellow or blue) treatment of frostbite get the victim out of the cold DO NOT attempt to rewarm the frostbitten area if there is a chance that it might refreeze or if you are close to a medical facility warm gently by soaking the affected area in warm water (100 – 105 degrees) until normal 13 color returns and the area feels warm handle the area gently, avoid rubbing affected areas avoid opening or breaking blisters do not allow victim to walk or stand apply loose dry, sterile dressings to the affected area if the fingers or toes are frostbitten, place dry, sterile gauze between them to keep them separated observe for signs and symptoms of shock activate EMS based on established guidelines signs/symptoms of types of burns first degree (superficial burn) o involves only top layer of skin o skin reddened, dry o mild swelling o pain or discomfort o usually heals within a week with no scarring second degree (partial thickness burn) o involves the top layers of the skin o skin red, usually painful o swelling o skin appears wet or mottled o blisters forming that may open and weeping clear fluid o usually heals in 3-4 weeks and may scar third degree (full thickness burn) o may destroy all layers of skin and some of the underlying structures (i.e. fat, muscle, bones, and nerves) o area involved has brown, white or black or charred appearance o extreme pain or relatively painless 14 HSE.O.MCP.1.10 distinguish signs and symptoms and describe treatment for poisoning, stings, bites, and allergic reactions. o life threatening due to fluid loss and shock treatment of burns first and second degree o cool water immersion o relieve pain o observe for shock o prevent infection o activate EMS based on established guidelines third degree o activate EMS immediately o cool water immersion based on severity of burn and percentage of body burned (Rule of Nines) o dry, sterile dressing o observe for shock o prevent infection o activate EMS based on established guidelines Provide clinical scenarios which require students to recognize signs and symptoms of temperature related emergencies and provide appropriate responses. signs/symptoms of ingestion poisoning abdominal pain and cramping nausea or vomiting diarrhea burns, odor, or stains around and in mouth drowsiness or unconsciousness poison containers nearby treatment of ingestion poisoning call Poison Control Center determine critical information o age and size of the victim o what was swallowed 15 o how much was swallowed (i.e. “a taste”, half a bottle, a dozen tablets) o when it was swallowed activate EMS based on established guidelines signs/symptoms of inhalation poisoning symptoms come and go symptoms worsen or improve in certain places or at certain times of the day people around the victim have similar symptoms pets seem ill signs/symptoms of carbon monoxide poisoning headache ringing in the ears (tinnitus) chest pain (angina) muscle weakness nausea and vomiting dizziness and visual changes (blurred or double vision) unconsciousness respiratory and cardiac arrest treatment of carbon monoxide poisoning remove victim from toxic environment and move into fresh air immediately call EMS, which will be able to give 100% oxygen, improving oxygenation and disassociating the linkage between the carbon monoxide and hemoglobin monoxide and hemoglobin monitor ABCs place unresponsive victim on one side seek medical attention (all victims need blood test to determine the level of carbon monoxide in their system) injection and contact poisoning 16 treatment for insect stings remove stinger by scraping (do not pinch) wash site with soap and water cover site and keep clean apply cold pack to reduce pain and swelling watch for signs of allergic reaction treatment for tick bites with gloved hand, grasp tick with fine-tipped, pointed, non-etched, non-rasped tweezers as close to the skin as possible and pull slowly do not try to burn tick off do not apply petroleum jelly or nail polish to the tick place the tick in a sealable container for analysis wash the bite area with soap and warm water apply antiseptic or triple antibiotic ointment if rash, flu-like symptoms, or joint pain appear, seek medical attention if neck of tick cannot be removed or if its mouth parts remain embedded, seek medical attention treatment for scorpion stings and spider bites wash the wound apply cold pack to the site activate EMS based on established guidelines if available, give victim antivenom treatment for snake bites (if bitten by a pit viper, such as a rattle snake, copperhead or cotton mouth) activate EMS based on established guidelines wash wound keep injured area still and below the level of the heart treatment for snake bites (if bitten by an elapid snake, such as a coral snake) 17 activate EMS based on established guidelines wash wound apply elastic roller bandage keep injured area still and below the level of the heart for any snake bite, DO NOT apply ice cut the wound apply suction apply a tourniquet use electric shock treatment for animal bites control bleeding first if the wound is bleeding seriously do not clean serious wounds; the wound will be cleaned at a medical facility activate EMS based on established guidelines wash minor wounds with soap and water control bleeding apply a triple antibiotic ointment and a dressing watch for signs of infection treatment for marine life stings (jellyfish) soak the area in vinegar treatment for marine life stings (stingray) immobilize the area soak the area in non-scalding hot water until pain goes away clean and bandage the wound treatment for exposure to poisonous plants remove exposed clothing and wash the exposed area thoroughly with soap and water, as soon as possible after contact with poisonous plants such as poison ivy, poison sumac, and poison oak 18 wash clothing exposed to plant oils; wash your hands thoroughly after handling exposed clothing put a paste of baking soda and water of the area several times a day if a rash or weeping sore has already begun to develop see a healthcare provider if the condition gets worse allergic reactions in all poisoning victims, observe for sign and symptoms of anaphylactic shock and treat for shock if necessary *anaphylaxis is a medical emergency, activate EMS immediately and monitor ABCs *information obtained from American Red Cross First Aid/CPR/AED, 2006 and Diversified Health Occupations, 6th ed. Provide clinical scenarios which require students to recognize signs and symptoms and respond appropriately. See American Heart Association or American Red Cross course certification requirements. HSE.O.MCP.1.11 obtain certification in First Aid. Standard Number: HSE.S.MCP.2 Essential Question: Objective Number: HSE.O.MCP.2.1 CPR and First Aid for Obstructed Airway Students will identify the need for and perform cardiopulmonary resuscitation and first aid for an obstructed airway. Is CPR done incorrectly better than no CPR at all? Objective: Learning Plan & Notes to Instructor: analyze the risk factors for cardiovascular disease. risk factors age gender race family history diabetes 19 HSE.O.MCP.2.2 HSE.O.McP.2.3 HSE.O.MCP.2.4 HSE.O.MCP.2.5 smoking hypertension cholesterol obesity determine the signs and symptoms of a heart signs/symptoms of a heart attack attack. chest pain shortness of breath cyanosis weakness anxiety nausea/vomiting diaphoresis denial loss of consciousness *three groups who do not have classic symptoms diabetics elderly women treatment of heart attack activate EMS immediately have person stop activity and rest comfortably monitor ABCs offer an aspirin if medically appropriate and local protocols allow *optimal 90 minute treatment window Provide clinical scenarios which require students to recognize signs and symptoms and respond appropriately. See America Heart Association/American Red Cross demonstrate CPR for the infant, child, and performance guidelines. one-rescuer adult. See America Heart Association/American Red Cross demonstrate the correct use of the AED. performance guidelines. determine signs and symptoms of an signs/symptoms of FBAO (foreign body airway obstructed airway. obstruction) universal distress signal (except toddlers) 20 HSE.O.MCP.2.6 HSE.O.MCP.2.7 HSE.O.MCP.2.8 Standard Number: HSE.S.MCP.3 Essential Questions: Objective Number: HSE.O.MCP.3.1 HSE.O.MCP.3.2 HSE.O.MCP.3.3 HSE.O.MCP.3.4 inability to talk, cough, or breathe high-pitched whistling sound on inspiration cyanosis loss of consciousness Provide clinical scenarios which require students to recognize signs and symptoms and respond appropriately. demonstrate universal distress signal recognize and demonstrate universal distress signal for obstructed airway. See America Heart Association/American Red Cross demonstrate procedures to relieve airway performance guidelines. obstruction in an infant, child and adult. See America Heart Association/American Red Cross obtain certification for adult, child, and infant performance guidelines. CPR and choking. Physical Examination Students will perform basic physical examinations. In the documentation of patient complaints is it acceptable to quote the patient verbatim? Objective: Learning Plan & Notes to Instructor: determine the medical assistant’s role in the physical exam process. MA role prepare exam room assist patient assist MD subjective & objective observation subjective & objective recording medical history form physical form Related discussion could include who completes the form. Could also give handouts of examples of these forms methods of examination inspection palpation percussion compare subjective and objective observation and recordings. differentiate between medical history and physical exam forms. recognize methods of examination. 21 HSE.O.MCP.3.5 demonstrate screening procedures including the measurement and recording of vital signs, height and weight, vision and hearing screening and chief complaints. auscultation Related discussion could include how these methods are used & when. Could also show a percussion hammer and stethoscope. screening procedures chief complaint height & weight o demonstrate procedure for measuring adult hgt/wgt o demonstrate procedure for measuring infant hgt/wgt o explain use of growth charts o demonstrate procedure for plotting hgt/wgt o students then should practice and then return demonstration temperature demonstrate procedure for oral, rectal, axillary temp using an electronic/digital thermometer demonstrate procedure for tympanic temp demonstrate charting procedure students should then practice and then return demonstration Related discussion could also include the s/s of fever and the appropriate care. pulse demonstrate the measurement of a radial pulse demonstrate the measurement of an apical pulse demonstrate charting students then are to practice & then do a return demonstration 22 blood pressure demonstrate the measurement of a b/p students then are to practice & then check off Related discussion would be how to augment the sounds of b/p. vision screening demonstrate the assessment of distance visual acuity using a Snellen chart students are then to practice & then do a return demonstration HSE.O.MCP.3.6 differentiate the eight positions used for physical examinations. HSE.O.MCP.3.7 relate the purpose of draping. HSE.O.MCP.3.8 demonstrate the correct draping procedure for each type of position used for physical examinations. determine the components and sequence of a routine physical examination including eye and ear procedures. HSE.O.MCP.3.9 positions for physical examinations sitting horizontal recumbent dorsal recumbent lithotomy Sims’ knee-chest semi-Fowler’s high Fowler’s draping Related discussion could include cloth vs paper. This is best done when demonstrating positioning. routine physical exam components sequence eye procedures demonstrate irrigation demonstrate instillation students then practice and do a return demonstration of each procedure 23 ear procedures demonstrate irrigation demonstrate instillation students then practice and do a return demonstration of each procedure GYN exam position instruments pediatrics positions instruments (include growth charts) Related discussion could be well baby visits compared to sick child visits. assist with physical examinations record finding on appropriate forms Performed during the clinical internship. HSE.O.MCP.3.10 choose the procedures, instruments used, and positions for various special examinations, to include GYN and pediatrics. HSE.O.MCP.3.11 assist with physical examinations and record findings on appropriate physical examination forms. Basic Pharmacology Students will identify principles of basic pharmacology. Standard Number: HSE.S.MCP.4 Essential Question: Objective Number: HSE.O.MCP.4.1 HSE.O.MCP.4.2 What might happen if the MA did not know information about commonly prescribed drugs? Objective: Learning Plan & Notes to Instructor: examine absorption, excretion, side effect, local and systemic effect, and contraindication as related to pharmacology. pharmacology terms absorption excretion side effect local effect systemic effect contraindication main sources of drug information PDR drug package insert Nurses Drug Handbook Internet compare main sources of drug information. 24 HSE.O.MCP.4.3 differentiate the three types of drug names and give an example for each. HSE.O.MCP.4.4 examine the Federal Food, Drug, and Cosmetic Act and the Controlled Substance Act of 1970. HSE.O.MCP.4.5 examine the law in terms of administering, prescribing, and dispensing drugs. HSE.O.MCP.4.6 distinguish common drug classifications and list examples. United States Pharmacopeia/National Formulary drug names & examples chemical name generic (official) name Brand (Trade) name Federal Food, Drug, and Cosmetic Act brief history purposes as relates to drugs Controlled Substance Act of 1970 purpose DEA enforces the Act laws of pharmacology administering drugs prescribing drugs dispensing drugs common drug classifications & examples analgesic anesthetic (local) antacid antibiotic anticoagulant anticonvulsant antidepressant antidiarrheal antiemetic antihistamine antihypertensive anti-inflammatory antipyretic antitussive bronchodilator decongestant diuretic 25 HSE.O.MCP.4.7 compare the five levels of controlled substances and discuss the legal issues associated with each. HSE.O.MCP.4.8 compare routes of drug administration and drug forms. immunization levels of controlled substances Schedule I Schedule II Schedule III Schedule IV Schedule V Discuss medical acceptance/use, abuse and addiction potential, examples, and legal issues with each Schedule. routes of drug administration buccal inhalation intradermal intramuscular intravenous ophthalmic oral otic rectal subcutaneous sublingual topical transdermal urethral vaginal Discuss who may administer drug by these routes. Also discuss the special precautions for each. drug forms solid o tablet o capsule o caplet o spansule o enteric-coated tablet 26 HSE.O.MCP.4.9 relate the methods of inventory, storage, dispensation, and disposal of medication. HSE.O.MCP.4.10 classify emergency drugs and supplies. o scored tablet o time-released tablet o sublingual tablet o chewable tablet o troche/lozenge o gelcap Show samples for a “show & tell.” Also discuss special precautions for each one. Semi-solid o suppository o transdermal patch o ointments o creams o Discuss special precautions for each Liquid o suspension o emulsion o tincture o lotion o elixir o syrup o aerosol Discuss special precautions for each. methods to handle medication inventory storage dispensation disposal emergency drug classification antihistamine oxygen epinephrin emergency supplies crash cart supplies on the cart 27 HSE.O.MCP.4.11 HSE.O.MCP.4.12 HSE.O.MCP.4.13 HSE.O.MCP.4.14 examine commonly abused drugs and describe their physical and emotional effects. commonly abused drugs alcohol narcotics caffeine cocaine & crack amphetamines hallucinogens PCP cannabis (marijuana) paint & other substances that can be “sniffed” physical & emotional effects of each determine common abbreviations associated common abbreviations with pharmacology. every hour, etc every day, etc sublingual ID, SC, IM tsp, tbsp, oz before & after tab, cap bid, tid, qid ac & pc OD, OS, OU characterize the physician’s medication order physician’s medication order and discuss the information on a prescription parts of the prescription label. who may write each section prescription label information found there how to read the directions determine the systems of measurement and systems of measurement accurately calculate drug dosages. metric apothecary household calculate drug dosages This can be done as a weekly test. This can also be done as part of the return 28 demonstration in the administration of injections. Standard Number: HSE.S.MCP.5 Essential Question: Objective Number: HSE.O.MCP.5.1 Medication Administration Students will identify the principles in the administration of medications. HSE.O.MCP.5.2 determine safety measures related to the administration of medications. HSE.O.MCP.5.3 examine the “Rights” of administration of medication. HSE.O.MCP.5.4 differentiate preferred routes of administration. Once a MA is proficient in administering injections, is there still a need to map out injection sites? Objective: Learning Plan & Notes to Instructor: examine the role and responsibility of the medical assistant associated with administration of medication. role & responsibility of MA administer within scope of practice follow the “rights” of drug administration familiar with the medication familiar with terminology, abbreviations, symbols, & signs used safety measures in the administration of medications prevention of needle sticks discard needles and syringes into biohazard containers wear appropriate PPE place patient in appropriate position check expiration date work in quiet, well lit area read label 3 times check condition of medication “Rights” of medication administration right patient right drug right dose right route right time right documentation routes of administration oral o patient position o contraindications for use 29 HSE.O.MCP.5.5 compare types of needles and syringes along with their use. HSE.O.MCP.5.6 select the appropriate site for administration of parenteral medication. intradermal o sites used o uses o contraindications of sites subcutaneous o tissue layer used o uses o sites used & landmarks o patient position o contraindications of sites o maximum volume for injection intramuscular o tissue layer used o uses o sites used & landmarks o patient position o contraindications of sites o maximum volume for injection rectal o uses o patient position o lubrication of suppository needles length & gauge parts of the needle uses of each size safety feature syringes sizes & use of each size parts of the syringe how to read each size of syringe parts of the needle & syringe that must remain sterile site for parenteral medication subcutaneous 30 HSE.O.MCP.5.7 demonstrate preparation of parenteral medication. HSE.O.MCP.5.8 demonstrate administration of medication by various routes. Standard Number: HSE.S.MCP.6 Essential Question: Objective Number: HSE.O.MCP.6.1 Clinical Externship Students will participate in clinical externship. o upper arms o upper thighs o upper medial back o abdominal external oblique Demonstrate the landmarks and location for each site. Intramuscular o Deltoid o Gluteus medius o Vastus lateralis o Z-track Demonstrate the landmarks and location for each site. demonstrate preparation of parenteral medication ampule vial cartridge Demonstrate the preparation from each, students practice, and then students do a return demonstration. administration of medication by various routes oral intradermal subcutaneous intramuscular Demonstrate each one, students practice, and then students do a return demonstration. What rules should govern the student during clinical internship? Objective: Learning Plan & Notes to Instructor: demonstrate a working knowledge of eligibility requirements 31 HSE.O.MCP.6.2 HSE.O.MCP.6.3 HSE.O.MCP.6.4 HSE.O.MCP.6.5 HSE.O.MCP.6.6 HSE.O.MCP.6.7 HSE.O.MCP.6.8 HSE.O.MCP.6.9 HSE.O.MCP.6.10 HSE.O.MCP.6.11 HSE.O.MCP.6.12 HSE.O.MCP.6.13 Standard Number: HSE.S.MCP.7 internship eligibility requirements. conform to professional standards for health care workers. comply with required health regulations such as proof of physical examination and immunization status. provide proof of personal health insurance. wear proper clinical attire. report to clinical site on time and ready to work. notify clinical site and instructor when absent. professional standards health regulations physical exam immunizations are current personal health insurance proper clinical attire report on time & ready to work absences reported to clinical site reported to instructor conform to policies regarding performance of performance skills skills and scope of responsibility/practice. performs skills within scope of practice for a MA performs only those skills that has successfully been done as a return demonstration correctly and safely perform entry-level entry-level procedures procedures under supervision of an instructor performs only those skill that have been or clinical site preceptor. successfully done as a return demonstration performs independently only those skills as approved by the preceptor request assistance or clarification as needed. assistance or clarification as needed organize and effectively manage time. organize & manage time accurately and efficiently complete documentation documentation required for clinical externship. participate in clinical internship evaluation evaluation process process. Information Technology Applications Students will: use information technology applications. demonstrate use as appropriate to healthcare applications. 32 Essential Question: Objective Number: HSE.O.MCP.7.1 HSE.O.MCP.7.2 Standard Number: HSE.S.MCP.8 Essential Question: Objective Number: HSE.O.MCP.8.1 HSE.O.MCP.8.2 HSE.O.MCP.8.3 HSE.O.MCP.8.4 21st Century Skills Information and Communication Skills: Given that the majority of clinical procedures are “hands on” type of skills, is it really necessary for a MA to have computer skills? Objective: Learning Plan & Notes to Instructor: implement the use of software and hardware. implement software and hardware utilize the Internet as a resource/research utilize the internet as a resource tool tool. Career and Technical Student Organization Students will participate in the local chapter of the Career and Technical Student Organization (CTSO). How does participation in a Career and Technical Student Organization (CTSO) impact professional development and lifelong learning? Objective: Learning Plan & Notes to Instructor: participate in the local chapter of the appropriate Career and Technical Student Organization (CTSO). use parliamentary procedures in chapter meetings. demonstrate team membership/leadership and problem solving skills. participate in local, state, and national projects impacting healthcare and healthcare education. Learning Skills & Technology Tools 21C.O.912.1.LS1 See www.HOSA.org. See Robert’s Rules of Order. See HOSA Handbook. See HOSA Handbook. Teaching Strategies Culminating Activity Student recognizes information Utilizing scenario based needed for problem solving, problems, students apply can efficiently browse, search cognitive learning and and navigate online to access access information via relevant information, evaluates Internet to solving realinformation based on credibility, world problems related to social, economic, political clinical skills and and/or ethical issues, and emergency medical presents findings clearly and procedures. persuasively using a range of Students use Internet Evidence of Success Students will demonstrate mastery according to industry guidelines as established by American Red Cross and/or American Heart Association. 33 technology tools and media. 21C.O.912.1.LS2 21C.O.912.1.TT2 Thinking and Reasoning Skills: 21C.O.912.2.LS1 resources to access information on drugs presented within the curriculum. Student analyzes and interprets Students utilize electronic visuals and recognizes the responders within impact digital media influences classroom presentations (e.g. design, technique, and and recognize the scope rate of speed) have on of response through audiences. The student’s visual interpretation of digital products reflect a sophisticated media. Responders are understanding of subject, digital used in conjunction with media and design techniques. the virtual white board. Student routinely applies Student utilizes keyboarding skills, keyboard keyboarding skills to shortcut techniques, and document in a simulated mouse skills with facility, speed patient electronic medical and accuracy. record. Student engages in a critical thinking process that supports synthesis and conducts evaluation using complex criteria. Students engage in an analysis of client scenarios to process toward the best course of action in rendering emergency care and routine medical office care. Students can verbalize the significance of data as displayed through the use of electronic responders. Students demonstrate mastery in the use of keyboarding skills as evidenced by the use of all charting rules and lack of errors in the patient electronic medical record. Students demonstrate mastery in the ability to analyze and prioritize care in emergency situations and care within the medical office. Mastery is evidenced by 100% accuracy as presented by industry skill 34 21C.O.912.2.LS3 21C.O.912.2.TT4 Personal, and Workplace, Skills: 21C.O.912.3.LS1 21C.O.912.3.LS2 21C.O.912.3.LS3 Student engages in a problem solving process by formulating questions and applying complex strategies in order to independently solve problems. Student uses technology tools and multiple media sources to analyze a real-world problem, design and implement a process to assess the information, and chart and evaluate progress toward the solution. Through the use of virtual medical office software and Internet resources, the student engages in problem solving of realworld scenarios related to emergency and routine medical office care. Student remains composed and focused, even under stress, willingly aligns his/her personal goals to the goals of others when appropriate, approaches conflict from winwin perspective, and derives personal satisfaction from achieving group goals. Student independently considers multiple perspectives and can represent a problem in more than one way, quickly and calmly changes focus and goals as the situation requires, and actively seeks innovations (e.g. technology) that will enhance his/her work. Student demonstrates ownership of his/her learning by setting goals, monitoring Students participate in a clinical internship, working independently and collaboratively with other members of the healthcare team. Within the clinical setting, students engage in the problem-solving process and participate in group dynamics in order to meet the challenges of individual patient needs. Students use virtual medical office software forms to chart patient care. Students display ownership of their learning standards. Students successfully solve complex real-world healthcare scenarios and chart patient care through the use of virtual medical office. Patient care and the use of the simulated medical records are evaluated through the use of industry skill standards. Students successfully participate in the clinical internship as demonstrated by satisfactory clinical evaluations completed by the instructor and/or clinical preceptor. Satisfactory status is determined by individualized program rules and regulation. Students demonstrates 35 21C.O.912.3.LS4 21C.O.912.3.TT1 21C.O.912.3.TT4 and adjusting performance, extending learning, using what he/she has learned to adapt to new situations, and displaying perseverance and commitment to continued learning. Student demonstrates ethical behavior and works responsibly and collaboratively with others in the context of the school and the larger community, and he/she demonstrates civic responsibility through engagement in public discourse and participation in service learning. Student protects software, hardware and network resources from viruses, vandalism, and unauthorized use and employs proper techniques to access, use and shut down technology equipment. Student adheres to acceptable use policy and displays ethical behaviors related to acceptable use of information and communication technology (e.g., privacy, security, copyright, file-sharing, plagiarism); student predicts the possible cost and effects of unethical use of technology (e.g., consumer fraud, within the clinical internship by exhibiting behaviors expected of the professional medical assistant. satisfactory performance in the clinical setting as evidenced by clinical evaluations. The students model ethical practices as it relates to working independently, with peers, and with other members of the healthcare community. Throughout the clinical internship students model ethical practices as evidenced by a satisfactory performance on clinical evaluations. Students apply HIPAA regulations throughout course work and interaction with others. Students acknowledge responsibility in the use of software, hardware, and the Internet. Students adhere to the computer use policy applicable to the individual clinical agency and HIPAA rules and regulation governing patient privacy. 36 intrusion, spamming, virus setting, hacking) on culture and society; student identifies the methodologies that individuals and businesses can employ to protect the integrity of technology systems. 21C.O.9Student models ethical 12.3.TT5 behavior relating to security, privacy, computer etiquette, passwords and personal information and demonstrates an understanding of copyright by citing sources of copyrighted materials in papers, projects and multi-media presentations. Student advocates for legal and ethical behaviors among peers, family, and community regarding the use of technology and information. Learning Skills & Technology Tools Entrepreneurship Skills: B.01-B.11, .17-.28 D.01-D.07, .11, .016, .17.33 E.01-.03 Understands the personal traits/behaviors associated with successful entrepreneurial performance. Understand concepts, strategies, and systems needed to interact effectively with others. Understands concepts and procedures needed for basic computer operations. Teaching Strategies Culminating Activity Students will process leadership, personal management, communication, and interpersonal skills as they engage in collaborative work, decision-making processes during the clinical internship. Students engage in computer operations through the use of the Evidence of Success Student display appropriate leadership, communication, and interpersonal traits/behaviors in working independently and with the healthcare team. Students demonstrate mastery in the use of 37 electronic medical record. Culminating Assessment: basic computer operations as evidenced by the ability to work independently with the electronic medical record. Culminating Assessment Today you will be working in the triage area of the office. You will be given written patient scenarios. You will then do the height, weight, TPR, B/P, and vision screening on an adult patient. You will also be required to document your assessments. You will be graded according to the rubric in your textbook. You have been assigned to assist the physician as he performs various physical exams. You will be given different written patient scenarios. You will be expected to give the appropriate explanations to the patient as well as select the proper position and place the drape appropriately. You will be graded according to the rubric in your textbook. You have been assigned to a pediatric clinic for the day. You will be expected to measure height, weight, head circumference, chest circumference, plot those measurements on growth charts. You will also be expected to assist with the physical exam. You will be graded according to the rubric in you textbook. You have been assigned to assist in the medical specialties clinics. You will be given written scenarios. You will then be expected to perform ear irrigation, ear instillation, eye irrigation, and eye instillation. You will be graded according to the rubric in your text. Industry Accreditation/ Certification Your assignment is to give all the injections for the office today. You will be given written scenarios. You will be expected to accurately calculate the dosage and prepare the dosage from an ampule, vial, and carpujet. Then you will be expected to select the appropriate site and administer and ID, SC, and IM injection. You will be judged according to the rubric in your text. Industry Accreditation/Certification Obtain industry certification in CPR and First Aid Links and Other Resources Links and Other Related Websites: 38 Resources See websites as listed in current textbooks. Pathways to Success http://careertech.k12.wv.us/pathwaystosuccess/ U.S. Department of Labor in the 21st Century http://www.dol.gov/ Advanced Distributed Learning www.adlnet.org America's Career InfoNet www.acinet.org America's Job Bank www.ajb.org America's Service Locator www.servicelocator.org CareerOneStop www.careeronestop.org Employment & Training Administration www.doleta.gov The Job Accommodation Network (JAN) http://www.jan.wvu.edu Monthly Labor Review Online: Labor Force Archives http://www.bls.gov/opub/mlr/indexL.htm#Labor force Occupational Information Network www.doleta.gov/programs/onet Office of Disability Employment Policy www.dol.gov/odep 39 Career Voyages http://www.careervoyages.gov/index.cfm Workforce West Virginia https://www.workforcewv.org/ West Virginia Earn A Degree Graduate Early (EDGE) http://www.wvtechprep.wvnet.edu/edge.htm West Virginia Career and Technical Education http://careertech.k12.wv.us/ Contacts Contacts: HSE Teachers: See HSE Directory HSE Coordinators: Rebecca Davis [email protected] Cyndy Sundstrom [email protected] OCTI Assistant Executive Director and EOCTST Coordinator: Donna Burge-Tetrick OCTI Executive Director: Gene Coulson 40