Download BSAD C070 - Cerro Coso Community College

BSAD C070 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE BSAD C070 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: BSAD C070 2. COURSE TITLE: Business Mathematics 3. SHORT BANWEB TITLE: Business Mathematics 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This course provides practice with a wide range of mathematical procedures used in various business applications. Students perform calculations both manually and using a calculator to solve problems in accounting, retail, finance, and taxation. Learners will require access to a printing calculator with features including: round off/up key, decimal selector for 0 through 6 plus float memory keys and 10-12 digit keyboard. Advisory: Level 3 Math. 12. GRADING METHOD S = Standard Letter Grade Default: P = Pass/No Pass;A = Audit Optional: 13. TOTAL UNITS: 3 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 3 Lab 0 Min Hours 54 0 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: Yes 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSAD%20C070.htm[4/8/2013 1:25:37 PM] BSAD C070 IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Perform basic ten-key touch operations using an electronic calculator 2. Calculate discounts, markups, percents and prorate 3. Perform banking, depreciation, and payroll calculations 4. Calculate and explain mortgage types, installment payments and amortization 5. Calculate cost of inventory using different methods 6. Define corporate investment, shares of stock, shareholders, dividends, and stock exchange 7. Explain and calculate simple, compound, true interest, 8. Identify and Convert between International System of Measurement Units (SI) and units of the U.S. Customary System (USCS) 23. REQUISITES Advisory: Advisory 5 Mathematics - 3 Levels Prior to Transfer 24. DETAILED TOPICAL OUTLINE: Lecture: A. Using a Calculator for basic Mathematics review (A) a. Keypad and calculator introduction b. Addition, subtraction, multiplication and division of whole numbers c. Using fractions d. Using decimals B. Banking Applications (A, C) a. The check register b. Bank statements c. Bank reconciliation C. Retail Applications (A, B) a. Percents b. Trade discounts c. Markups D. Payroll Applications (A, C) a. Calculating gross pay b. Payroll deductions and taxes c. Employer responsibilities E. Simple Interest (A, G) a. Calculations and maturity value b. Payments before the due date c. Promissory notes d. Discounting notes F. Compound Interest (A, D) a. Calculating manually and with a table b. The effective rate (APY) G. Installment Buying (A, D, G) a. Finance charges b. Calculating APR c. Revolving charge accounts H. Mortgages (A, D) a. Types of mortgages b. Amortization c. Calculating monthly payment I. Depreciation (A, C) a. Straight-line method b. Units of production method c. Sum-of-the-years-digits method d. Declining balance method J. Costing Inventory (A, E) a. Specific identification b. Weighted average c. LIFO d. FIFO file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSAD%20C070.htm[4/8/2013 1:25:37 PM] BSAD C070 K. Stocks and Bonds (A, F) a. Investment in stocks b. Investment in bonds c. Yields on investments d. Selling price of stocks L. Measurement (A, H) a. International System of Units (SI) b. Decimal System c. U. S. Customary System (USCS) d. Conversion Tables 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; 2. Lecture; 3. Other Methods: Hands-on application of methods 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Reading B. Workbook Assignments 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to A. Chapter Tests (A- H) B. Mid-term and Final Assessments (A- H) C. Workbook and Practice Assignments (A- H) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Polinsky, M. . (2003) Solving Business Problems Using an Electronic Calculator , 6th, Glencoe McGraw-Hill Manuals Periodicals Software Other 29. METHOD OF DELIVERY: 30. MINIMUM QUALIFICATIONS: Business (Masters Required);Mathematics (Masters Required);Office Technologies; 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision Curriculum Committee Approval 02/26/2010 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval CSU Approval Status IGETC Approval IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSAD%20C070.htm[4/8/2013 1:25:37 PM] BSAD C070 Course ID (CB00) CCC000301531 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) C = Not Transferable Course Units of Credit Maximum High (CB06): 3 Course Units of Credit Minimum Low (CB07): 3 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): XXXXXXXX = Not qualified for SEQ code (qual for CAN only); Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSAD%20C070.htm[4/8/2013 1:25:37 PM] BSAD C072 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE BSAD C072 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: BSAD C072 2. COURSE TITLE: Introduction to Accounting 3. SHORT BANWEB TITLE: Introduction to Accounting 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This course covers basic accounting concepts and procedures required to complete an accounting cycle. Account types, (assets, liabilities, equity, revenue, expenses) as well as procedures for bank reconciliation, petty cash, and payroll are introduced. Learners complete business transactions from day-to-day recordkeeping to closing entries and preparation of year end documents balance sheet, income statement, and statement of owner''s equity for a sample merchandising business. Advisory: BSAD C070, Reading Level 1, Writing Level 2. 12. GRADING METHOD S = Standard Letter Grade Default: A = Audit;CR;A = Audit;P = Pass/No Pass;Pass/NoPass Optional: 13. TOTAL UNITS: 3 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 2 Lab 1 Min Hours 36 54 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSAD%20C072.htm[4/8/2013 1:25:37 PM] BSAD C072 IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Explain, identify and record, increases and decreases in General Ledger accounts. 2. Accurately prepare documents in the “Accounting Cycle”. 3. Accurately process source documents. 4. Prepare and record information. 5. Analyze and accurately record closing transactions. 23. REQUISITES Advisory: Advisory 5 Reading - 1 Level Prior to Transfer Advisory 5 Writing - 2 Levels Prior to Transfer BSAD C070 24. DETAILED TOPICAL OUTLINE: Lecture: Topic Subtopic A Accounting Concepts and Procedures A 1 Definition of Accounting 2 The difference between bookkeeping and accounting 3 Accounting equation 4 Assets, Liabilities, and Equity 5 The Balance Sheet 6 Revenue, expenses, and withdrawals 7 Expanded accounting equation 8 Preparing financial statements 9 The Income Statement 10 The Balance Sheet 11 The Statement of Owner’s Equity B C Content SLO Debits and Credits 1 The T Account 2 Balancing an account 3 Recording business transactions 4 Transaction analysis The Accounting Cycle 1 Analyzing and record to the journal 2 Posting to the ledger 3 Preparing the Trial Balance 4 Common errors A, B A, B, C file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSAD%20C072.htm[4/8/2013 1:25:37 PM] BSAD C072 D E F G H 5 Preparing a worksheet 6 Adjusted trial balance 7 Income Statement 8 Preparing financial statements 9 Journalizing and posting adjusting entries 10 Journalizing and posting closing entries 11 The post closing trial balance 1 Banking Procedures and Control of Cash 2 Checking accounts 3 Bank reconciliation process 4 Petty cash establishment 5 Reconciling and replenishing of petty cash Payroll Concepts and Procedures 1 Employee Federal and State withholding tax 2 Social Security tax 3 Workers Compensation Insurance 4 Payroll process 5 Recording and paying the payroll 6 Individual earnings record Employer’s Tax Responsibilities A, B, C, D 1 Employer’s payroll tax expense 2 Employer’s Quarterly Federal tax return 3 FICA tax obligations 4 W2, W3, form 940 EZ Special Journals, Sales and Cash Receipts 1 Gross sales 2 Sales returns and allowances 3 Sales journal and accounts receivable subsidiary ledger 4 Credit memorandum 5 Cash receipts journal 6 Journalizing, posting, and recording 7 Schedule of accounts receivable Special Journals, Purchases and Cash Payments 1 Purchases 2 Purchase returns and allowances 3 Purchases journal and accounts payable subsidiary ledger 4 Debit memorandum 5 Cash payments journal A, B, C, D A, B, C, D, E A, B, C, D A, B, C, D file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSAD%20C072.htm[4/8/2013 1:25:37 PM] BSAD C072 6 Journalizing, posting, and recording 7 Schedule of accounts payable Worksheets 1 Adjustments for merchandise Inventory 2 Completing a worksheet Completing the Accounting Cycle for a Merchandise Company 1 Preparing financial statements 2 Income Statement 3 Balance Sheet 4 Statement of Owner’s Equity 5 Journalizing and posting adjusting and closing entries 6 Preparing the Post-Closing Trial Balance Lab: Students work on hands-on written accounting projects from the text. I J A, B, C, D, E A, B, C, D, E 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; 2. Lecture; 3. Other Methods: A. Lectures on chapter learning outcomes and the accounting cycle PowerPoint presentation of chapter learning outcomes Demonstration of transaction processing, posting, completion of worksheet, adjustments, and preparation of financial documents. Web based study tools in CengageNow 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to Text readings, open book theory tests, practical chapter problems, and CengageNow submission of chapter work. (A-E) 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to A. Written chapter accounting problems demonstrating mastery of chapter learning outcomes (A-E) B. Chapter pre-test and post test (A-E) C. Chapter Theory quiz(A-E) D. Open Book Mid term theory exam demonstrating understanding of theoretical concepts (A-E) E. Mid-term and final project case problems demonstrating ability to journalize daily transactions, post to the General Ledger, complete a worksheet, journalize adjusting and closing entries, and prepare financial documents to complete the accounting cycle for a merchandising business. (A-E) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Heinz, J. & Parry, R. P.. (2008) College Accounting Chapers 1-15 , 19th, Mason: Thomson Southwestern Manuals Periodicals Software Other CengageNow course access code and Working papers for text listed above. 29. METHOD OF DELIVERY: Online (purely online no face-to-face contact) ;iTV – Interactive video = Face to face course with significant required activities in a distance modality ;Online with some required face-to-face meetings (“Hybrid”); 30. MINIMUM QUALIFICATIONS: 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision Curriculum Committee Approval Board of Trustees State Approval UC Approval UC Approval Status file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSAD%20C072.htm[4/8/2013 1:25:37 PM] BSAD C072 CSU Approval CSU Approval Status IGETC Approval IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000377618 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) C = Not Transferable Course Units of Credit Maximum High (CB06): 3 Course Units of Credit Minimum Low (CB07): 3 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): XXXXXXXX = Not qualified for SEQ code (qual for CAN only); Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSAD%20C072.htm[4/8/2013 1:25:37 PM] BSAD C145 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE BSAD C145 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: BSAD C145 2. COURSE TITLE: Business Communication 3. SHORT BANWEB TITLE: Bus. Communication 4. COURSE AUTHOR: O'Connor, Karen L. 5. COURSE SEATS: 6. COURSE TERMS: 70 = Fall; 30 = Spring; 50 = Summer 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC Course Revision 9. START TERM: 30 = Spring, 2013 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This course presents the principles and techniques of effective written and oral business communication. Students discuss, critique, and practice business-writing strategies to produce messages, letters, reports, and presentations, while developing critical thinking skills. Business communication in a global environment is also emphasized. 12. GRADING METHOD S = Standard Letter Grade Default: A = Audit;P = Pass/No Pass Optional: 13. TOTAL UNITS: 3 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 3 Lab 0 Activity Min Hours 54 0 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Management (AS Degree Program) Management (AS Degree Program) Management- (Certificate of Achievement) Management- (Certificate of Achievement) Small Business Management/Entrepreneurship (AS Degree Program) Small Business Management/Entrepreneurship (AS Degree Program) Small Business Management/Entrepreneurship- (Certificate of Achievement) Small Business Management/Entrepreneurship- (Certificate of Achievement) file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSAD%20C145.htm[4/8/2013 1:25:38 PM] BSAD C145 Elective: 21. GENERAL EDUCATION APPLICABILITY Local: IGETC: CSU: UC Transfer Course: CSU Transfer Course: California State Polytechnic University, Pomona = California State University, Fresno = California State University, Northridge = 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Explain and apply the principles, techniques, and strategies of effective business communication and how to apply those principles at work, in teams, and in a multi-cultural business environment. 2. Prepare business communication including letters, reports, presentations, and other messages that are clear, concise, courteous, complete and grammatically correct. 3. Critique oral communication skills to determine effective techniques. 4. Plan and produce visual aids using presentation software. 5. Identify appropriate strategies for resume writing including use of electronic media. 6. Practice effective business communication techniques in independent and group projects. 23. REQUISITES Advisory: Advisory Students need to be able to identify central points, both explicit and implied, of the textbook readings. Reading - 1 Level Prior to Transfer Advisory Students need to be able to write predominantly clear and error-free sentences and paragraphs. Students need to be able to construct organized mid-size compositions (at least five pages) with clear organization, keywords, thesis, and topic sentences. Writing - 1 Level Prior to Transfer CSCI C121 24. DETAILED TOPICAL OUTLINE: Lecture: A. Building Career Success with Business Communication B. The communication process, a. Listening, b. Non-verbal communication, c. Workplace Diversity, C. The Writing Process a. Creating Business Messages, b. The Basics of Business Writing, D. Writing for Business Messages and Oral Presentations, a. Analyzing Purpose and Audience, b. Anticipating the Audience, c. Adapting to the Audience, d. Improving Writing Techniques, e. Researching to Collect Information, f. Organizing to Show Relationships, E. Writing Effective Sentences, a. Improving Writing Techniques, file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSAD%20C145.htm[4/8/2013 1:25:38 PM] BSAD C145 b. Paragraph Coherence, c. Composing Drafts, F. Revising and Proofreading Business Messages, a. The Process of Revision, b. Concise Wording, c. The Process of Proofreading, d. Edit and Revise Documents, G. Corresponding At Work , a. E-Mail and Memorandums, b. Applying the Writing Process to Produce Effective E-mail Messages and Memos, c. Analyzing the Structure of E-Mail Messages and Memos, d. Using E-Mail Smartly and Safely, e. Writing Information and Procedure E-Mail Messages and Memos, f. Writing Request and Reply e-Mail Messages and Memos, H. Direct Letters and Goodwill Messages, a. Writing Effective Goodwill Messages, b. Direct Requests for Information and Action, c. Direct Claims, I. Replies to Information Requests, a. Adjustment Letters, b. Letters of Recommendation, J. Writing Winning Goodwill Messages, K. Persuasive Messages, a. Persuasive Requests, b. Sales Letters, L. Negative Messages, a. Strategies for Delivering Bad News, b. Techniques for Delivering Bad News Sensitively, c. Refusing Routine Requests and Claims, d. Breaking Bad News to Customers, e. Breaking Bad News to Employees, f. Ethics and Indirect Strategy, g. Reporting Workplace Data M. Informal Reports, a. Understanding Report Basics, b. Guidelines for Developing Informal Reports, c. Six Kinds of Formal Reports (information, progress, justification, recommendation, feasibility, minutes, and summaries, N. Proposals and Formal Reports, a. Understanding Business Proposals, b. Informal Proposals, file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSAD%20C145.htm[4/8/2013 1:25:38 PM] BSAD C145 c. Formal Proposals, d. Preparing to Write Formal Reports, e. Researching Secondary Data, f. Organizing and Outlining Data, g. Illustrating Data, h. Presenting the Final Report, O. Developing Speaking And Technology Skills a. Communicating in Person, In Meetings, By Telephone, and Digitally, b. Face-to-Face Workplace Communication, c. Planning and Participating in Productive Business and Professional Meetings, d. Improving Telephone, Cell Phone, and Voice Mail Skills, e. Other Digital Communication Tools in the Workplace, P. Making Effective and Professional Oral Presentations, a. Getting Ready for an Oral Presentation, b. Organizing Content for a Powerful Impact, c. Building Audience Rapport, d. Planning Visual Aids, e. Designing Multimedia Presentations, f. Polishing Delivery, g. Adapting to International and Cross Cultural Audiences, Q. Communicating For Employment, a. The Job Search, Resumes, and Cover Letters, b. Preparing for Employment, c. The Persuasive Resume, d. Optimizing Your Resume for Today’s Technologies, e. Applying Final Touches, f. The Persuasive Cover Letter, R. Employment Interviewing and Follow-Up Messages, a. Types of Employment Interviews, b. Before the Interview, c. The Day of Your Interview, d. Closing the Interview, e. Other Employment Letters and Documents, S. Grammar Mechanics Review And Reinforcement Workshops, a. Nouns, Possessive Nouns, Pronouns, b. Verbs and Verb Tense, c. Verb Agreement (Subject/ Verb), Verb Mood (Indicative/Imperative/Subjunctive), Voice (Active/Passive), d. Adjectives and Adverbs, e. Prepositions and Conjunctions, f. Commas and Semi-colons, file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSAD%20C145.htm[4/8/2013 1:25:38 PM] BSAD C145 g. Other Punctuation, h. Capitalization, i. Number style, 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Discussion; 2. Group Work; 3. In-class writing; 4. Instruction through examination or quizzing; 5. Lecture; 6. Library; 7. Written work; 8. Other Methods: Textbook and electronic readings Videos 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Homework and Reading Assignments: Students will complete textbook reading assignments and practice skills in homework. This includes grammar mechanics workshops in addition to chapter topics. B. Communication: Students will write a variety of business communication messages, including memos, letters, email, proposals, informal reports, proposals, and formal reports, all of professional quality. C. Research: Students will conduct research into their report assignment area, evaluate and interpret information, accurately present this information through quotation, paraphrase, and/or summarizing, and properly cite sources used. D. Visual Elements: In order to improve clarity, students will demonstrate effective use of visual elements such as charts, graphs, and pictures. E. Final reports: Students will complete 1) a professional quality formal report of at least 6 pages, including appropriate front and back matter, organized content, effective visuals, and proper citation of sources used. 2) Resume, cover letter, and follow up messages. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to A. Weekly Assignments: Weekly writing and chapter assignments will reinforce concepts and skills from lecture material. B. Discussion: Students will participate in discussions to critique and explore issues of communication. C. Write and revise business messages to be clear, correct, concise, courteous, complete, and free grammatical errors. D. Reports: Students will research and develop content for writing business reports. 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Guffey, M. . (2013) Essentials of Business Communication, 9th, Natorp Boulevard Thomson SouthWestern Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online with some required face-to-face meetings (â€œHybridâ€);Online (purely online no face-to-face contact) ;iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality ;Face to face; 30. MINIMUM QUALIFICATIONS: Business (Masters Required);Office Technologies; 31. APPROVALS: Origination Date 09/22/2012 Last Outline Revision 11/30/2007 Curriculum Committee Approval Board of Trustees 11/16/2012 12/20/2012 State Approval UC Approval CSU Approval UC Approval Status 50 = Summer 2000 IGETC Approval CSU Approval Status Approved IGETC Approval Status file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSAD%20C145.htm[4/8/2013 1:25:38 PM] BSAD C145 CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification There are no substantial changes to this course. Course Element Changes Course Change Justification There are no substantial changes to this course. Course ID (CB00) CCC000245878 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 3 Course Units of Credit Minimum Low (CB07): 3 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Not part of Coop Work Exp; Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): CAN-Code Seq (CB15): Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSAD%20C145.htm[4/8/2013 1:25:38 PM] BSOT C100 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE BSOT C100 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: BSOT C100 2. COURSE TITLE: Introduction to Business Office Technology 3. SHORT BANWEB TITLE: Intro to BSOT 4. COURSE AUTHOR: O'Connor, Karen L. 5. COURSE SEATS: 6. COURSE TERMS: 70 = Fall; 30 = Spring; 50 = Summer 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC New Course 9. START TERM: 70 = Fall, 2012 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This course provides the learner with a survey of skills and topics covered in the Business Office Technology Program certificates and degree. Business English, an orientation to industry standard office software, entry level office procedures, and office ethics are covered. Potential completers of the Business Office Technology certificates and degree are introduced to skills and topics relevant to success as an office clerk, administrative assistant, or office manager. 12. GRADING METHOD Default: S = Standard Letter Grade Optional: 13. TOTAL UNITS: 3 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 3 Lab 0 Min Hours 54 0 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C100.htm[4/8/2013 1:25:38 PM] BSOT C100 IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Describe the skills, knowledge, attitudes, and traits employers expect in an entry level office clerk or administrative assistant as presented in the Business Office Technology certificates and degree. 2. Demonstrate appropriate use of reference resources and problem solving skills for effective completion of office tasks requiring preparation of documents. 3. Apply essential business English conventions, including punctuation, parts of speech, and grammar skills, to effective written office communication. 23. REQUISITES Advisory: Advisory Students need to be able to read and annotate text and office resource books for more complete understanding. Reading - 1 Level Prior to Transfer and Advisory Students will need to be able to write compositions of at least 500 words with clear organization, thesis, topic sentences, keywords, transitions, and sufficient, logical supporting details. Students will also identify and correct major errors in grammar and practice proofreading, revision, and editing techniques for better focus, structure, and style. Writing - 2 Levels Prior to Transfer and CSCI C070 24. DETAILED TOPICAL OUTLINE: Lecture: Business English Grammar and Usage Punctuation Capitalization Number Formats Hyphenating and Dividing Words Abbreviations and Symbols Words Often Confused and Misused Elements of Writing Style Spelling, Proofreading, and Editing Address Format and Forms of Address The Workplace Entering the Workplace The Administrative Professional Managing and Organizing Yourself The Workplace Environment Working Ethically The Workplace Team Developing Customer Focus Survey of Business Office Technology Topics Keyboarding Word Processing Spreadsheets Database Presentation Software Email Software Business Mathematics and calculator usage Accounting Business Communication Office Personnel Seminar Office Skills Pre-tests and Assessment Business English Keyboarding Speed and Accuracy Word Processing with Word Spreadsheets with Excel Database with Access Work related office experience file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C100.htm[4/8/2013 1:25:38 PM] BSOT C100 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Case Study; 2. Computational Work; 3. Demonstration; 4. Discussion; 5. Group Work; 6. In-class writing; 7. Instruction through examination or quizzing; 8. Lecture; 9. Problem Solving; 10. Skills Development and Performance; 11. Written work; 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to Weekly Textbook chapter readings relevent to homework assignments: Examples include chapters 1-10 from the Handbook for Office Professionals. Writing exercises related to business English: Example, choose the correct word for a sentence from a selection of often misused words or re-writing a sentence for a better communication of meaning. Weekly Textbook chapter readings relevent to homework assignments: Examples include chapters one through six of "The Administrative Professional", Entering the Workforce, Becoming a Professional, Managing and Organizing Yourself, Working Ethically, Understanding the Workplace Team, Developing Customer Focus. Examples of homework include: Start a collection of local and/or online help-wanted ads for administrative professionals by copying into a Word document. Students solve case studies related to workplace skills in the areas of communication, developing relationships, or using technology and then write and proofread a report describing their repsonse to a situation. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to Homework assignments requiring short written reports of 150-250 words: Students may be asked to write a short essay describing their values. ex. What are the sources of your values? Describe at least one ethical decision that you have made at work, at school, or in your personal life by aplying your values. Participation in weekly discussion forums: Students may be asked to report in a discussion forum on a topic of interest related to the weekly content. ex. What does respecting your employer's resources mean? Projects or short answers related to chapter work: Describe the qualities of effective teams presented in this chapter. Weekly quizzes related to business English concepts: Punctuation, parts of speech, grammar. Exam: Business English final theory Project: Completion of pre-tests for self-assessment report of preparedness for study A reasonable evaluation schedule may include: 10% Participation 30% Chapter Homework Assignments related to Aministrative Professional 30% Chapter Homework assignments related to The Handbook for Office Professionals, including 15 % Business English final theory assessment 15% Final Project 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Fulton-Calkins, P.. (2011) The Administrative Professional , 14, South-Western, Cengage Learning Clark, J., Clark, L.. (2009) A Handbook for Office Professionals How 12 , 12, South-Western Cengage Learning Manuals Periodicals Software Microsoft. Microsoft Office Suite , 2010 ed. -- Students should have access to at least the student version of the Microsoft Office suite including Word, Excel, Access, Powerpoint, and Outlook in Microsoft Office 2007 or higher. MS Office 2010 is preferred. Other 29. METHOD OF DELIVERY: Online (purely online no face-to-face contact) ;Online with some required face-to-face meetings (â€œHybridâ €);iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality ;Online course with on ground testing;Face to face; 30. MINIMUM QUALIFICATIONS: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C100.htm[4/8/2013 1:25:38 PM] BSOT C100 31. APPROVALS: Origination Date 09/22/2011 Last Outline Revision Curriculum Committee Approval 01/12/2012 Board of Trustees 03/19/2012 State Approval UC Approval 11/18/2011 UC Approval Status CSU Approval 70 = Fall 2012 IGETC Approval CSU Approval Status Approved IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Students entering the the Business Office Technology certificates and degree need a focussed entry point. Students taking this course at the outset of their path of study toward the Business Office Technology major will be better prepared to succeed with the rest of the program because they will be exposed to the kinds of skills and aptitudes that are appropriate for success in this field. This course will allow Office Personnel Seminar to become a true capstone. Course Element Changes Course Change Justification Course ID (CB00) CCC000530073 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) C - Credit - Not Degree Applicable; Course Transfer Status (CB05) C = Not Transferable Course Units of Credit Maximum High (CB06): 3 Course Units of Credit Minimum Low (CB07): 3 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): D = Possible Occupational; Cooperative Education Course Status (CB10): Not part of Coop Work Exp; Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): CAN-Code Seq (CB15): Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C100.htm[4/8/2013 1:25:38 PM] BSOT C127 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE BSOT C127 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: BSOT C127 2. COURSE TITLE: MS PowerPoint 3. SHORT BANWEB TITLE: MS PowerPoint 4. COURSE AUTHOR: O'Connor, Karen L. 5. COURSE SEATS: 6. COURSE TERMS: 70 = Fall; 30 = Spring; 50 = Summer 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC Course Revision 9. START TERM: 70 = Fall, 2011 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This is a hands-on microcomputer course designed to provide basic understanding of Microsoft PowerPoint. Topics to be covered include planning, creating, editing, viewing, and printing. This course prepares the student to take the core level Microsoft PowerPoint Office Users Specialist certification exam. 12. GRADING METHOD S = Standard Letter Grade Default: A = Audit;P = Pass/No Pass Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C127.htm[4/8/2013 1:25:38 PM] BSOT C127 IGETC: CSU: UC Transfer Course: University of California, Los Angeles = USC Viterbi School of Engineering: ITP 050x Microsoft PowerPoint (1.0 unit) CSU Transfer Course: California State Polytechnic University, Pomona = CIS 101 Introduction to Personal Computing, (Includes Word, PowerPoint) California State University, Chico = BSIS 101 Windows, Word Processing, and Presentation Software California State University, East Bay = IS 52L Computer Concepts Lab 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Use the basic features of Microsoft PowerPoint including slide show creation, editing, and a variety of formatting tools. 2. Use other basic features including table creation, graphic insertion, printing and file management. 3. Determine and apply appropriate problem solving techniques using Help and reference material off and online for successful creation of powerpoints using Microsoft Office. 23. REQUISITES Advisory: CSCI C121 and CSCI C070 or CSCI C101 24. DETAILED TOPICAL OUTLINE: Lecture: A. Creating a Presentation 1. Delete slides 2. Create a specified type of slide 3. Create a presentation from a template or a wizard 4. Navigate among different views (slide, outline, sorter, and tri-pane) 5. Create a new presentation from existing slides 6. Copy a slide from one presentation into another 7. Insert headers and footers 8. Create a blank presentation 9. Create a presentation using the AutoContent Wizard 10. Send a presentation via e-mail B. Modifying a Presentation 1. Change the order of slides using Slide Sorter view 2. Find and replace text 3. Change the layout for one or more slides 4. Modify the Slide Master 5. Modify slide sequence in the outline pane 6. Apply a design template C. Working with Text 1. Check spelling 2. Change and replace text fonts (individual slide and entire presentation) 3. Enter text in tri-pane view 4. Import text from Microsoft Word 5. Change the text alignment 6. Create a text box for entering text 7. Use the Wrap text in TextBox feature 8. Use the Office Clipboard 9. Use the Format Painter 10. Promote and Demote text in slide and outline panes D. Working with Visual Elements 1. Add a picture from the Clip Art Gallery 2. Add and group shapes using WordArt or the Drawing Toolbar 3. Apply formatting 4. Add text to a graphic object using a text box 5. Scale and size an object including clip art 6. Create tables within PowerPoint 7. Rotate and fill an object E. Customizing a Presentation 1. Add AutoNumber bullets 2. Add speaker notes 3. Add graphical bullets 4. Add slide transitions 5. Animate text and objects file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C127.htm[4/8/2013 1:25:38 PM] BSOT C127 F. Creating Output 1. Preview presentation in black and white 2. Print slides in a variety of formats 3. Print audience handouts 4. Print speaker notes in a specified format G. Delivering a Presentation 1. Start a slide show on any slide 2. Use on screen navigation tools 3. Print a slide as an overhead transparency 4. Use the pen during a presentation H. Managing Files 1. Save changes to a presentation 2. Save as a new presentation 3. Publish a presentation to the Web 4. Use the Microsoft Office Assistant 5. Insert hyperlink 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Laboratory; 2. Lecture; 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to Assigned readings from the text. Reports on problem solving. Students are required to create a number of presentations, building on learned skills. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to 16 Presentation Projects Mid-term and final theory tests 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Zimmerman and Zimmerman. (2011) New Perspectives on Microsoft PowerPoint 2010 Comprehensive , 1, Course Technology Cengage Learning Manuals Periodicals Software Other 29. METHOD OF DELIVERY: iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality ;Online with some required face-to-face meetings (â€œHybridâ€);Online (purely online no face-to-face contact) ;Face to face;Online course with on ground testing; 30. MINIMUM QUALIFICATIONS: Computer Information Systems;Office Technologies; 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision 03/11/2011 Curriculum Committee Approval Board of Trustees CSU Approval 04/14/2011 05/02/2011 State Approval UC Approval 03/11/2011 UC Approval Status 50 = Summer 2011 IGETC Approval CSU GE Approval CSU Approval Status Approved IGETC Approval Status CSU GE Approval Status file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C127.htm[4/8/2013 1:25:38 PM] BSOT C127 Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000373458 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Not part of Coop Work Exp; Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): CAN-Code Seq (CB15): Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C127.htm[4/8/2013 1:25:38 PM] BSOT C131 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE BSOT C131 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: BSOT C131 2. COURSE TITLE: Basic Computer Keyboarding 3. SHORT BANWEB TITLE: Basic Computer Keyboarding 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: Learners are introduced to a microcomputer keyboard with an emphasis on learning and skill-building correct touch typing techniques for alphanumeric, symbol, and punctuation keys. A foundation for keyboarding speed and accuracy is developed. Advisory: Reading level 1, Writing Level 1 CSCI C070 12. GRADING METHOD S = Standard Letter Grade Default: CR;Pass/NoPass;P = Pass/No Pass;A = Audit;A = Audit Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Elective: 21. GENERAL EDUCATION APPLICABILITY Local: IGETC: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C131.htm[4/8/2013 1:25:39 PM] BSOT C131 CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Key straight-copy alphanumeric material including symbols and punctuation using correct touch techniques at a minimum rate of 15 words per minute (wpm) with 4 or few errors on a 2-minute timing. 2. Identify and perform correct ergonomics for body position at a workstation. 23. REQUISITES Corequisite: CSCI C070 Advisory: Advisory Reading - 1 Level Prior to Transfer Advisory Writing - 1 Level Prior to Transfer 24. DETAILED TOPICAL OUTLINE: Lecture: A Keystroking and Ergonomics 1 Correct keystroking for alphabet keys 2 Correct keystroking for numeric keys 3 Correct keystroking for punctuation/symbol keys 4 Ergonomics and body position A, B Lab: Learners practice correct keyboarding techniques using a computer based training program and text. 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; 2. Lecture; 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to Where possible, students practice keyboarding at home to augment classroom practice. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to This will be assessed and scored by a pre- and post-test. Keyboarding Drills and Lesson work (A, B) Two-minute Timed Writings (A, B) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks VanHyss, S., Forde C., & Woo, D. (2008) Keyboarding and Formatting Essentials, Lessons 1-60 , 2nd ed. , Thomson-SouthWestern Manuals Periodicals Software Other file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C131.htm[4/8/2013 1:25:39 PM] BSOT C131 29. METHOD OF DELIVERY: Online (purely online no face-to-face contact) ;iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality ;Online with some required face-to-face meetings (â€œHybridâ€); 30. MINIMUM QUALIFICATIONS: Computer Information Systems; 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision Curriculum Committee Approval 09/25/2009 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 50 = Summer 2000 IGETC Approval CSU Approval Status IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000370765 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): D = Possible Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): XXXXXXXX = Not qualified for SEQ code (qual for CAN only); Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C131.htm[4/8/2013 1:25:39 PM] BSOT C132 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE BSOT C132 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: BSOT C132 2. COURSE TITLE: Inter Computer Keyboarding 3. SHORT BANWEB TITLE: Inter Computer Keyboarding 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: Learners in this course build on a basic keyboarding foundation with correct touch typing techniques, including alphabetic, numeric, and symbol keyboarding as well as 10-Key numeric keypad. Skill-building includes introductory formatting of documents. Successful completion of this class will result in minimum keyboarding speed of 30 wpm net. Advisory: BSOT C131 12. GRADING METHOD S = Standard Letter Grade Default: CR;Pass/NoPass;P = Pass/No Pass;A = Audit;A = Audit Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Elective: 21. GENERAL EDUCATION APPLICABILITY Local: IGETC: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C132.htm[4/8/2013 1:25:39 PM] BSOT C132 CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Key straight-copy alphanumeric material using correct touch techniques at a minimum rate of 30 words per minute (wpm) with 5 or few errors on a 3-minute timing. 2. Key numeric copy using correct touch typing techniques on the 10-key numeric keypad with increased speed and accuracy. 3. Identify and perform correct ergonomics for body position at the workstation. 23. REQUISITES Advisory: BSOT C131 24. DETAILED TOPICAL OUTLINE: Lecture: A Key-stroking (A, B, C ) 1 Correct key-stroking for alphabet keys 2 Correct key-stroking for numeric keys 3 Correct key-stroking for punctuation/symbol keys 4 Correct key-stroking for 10-Key Numeric Keypad B Ergonomics and body position. (C) C Word Processing (A, B, C) 1 Skill-building using basic word processing methods. 2 Introductory document formatting. Lab: Learners practice correct keyboarding techniques using a computer based training program and text. 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to Where possible, students practice keyboarding at home to augment classroom practice. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to This will be assessed and scored by a pre- and post-test. Keyboarding Drills and Lesson work (A, B, C) Three-minute Timed Writings (A, B, C) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks VanHyss, S., Forde C., & Woo, D. (2008) Keyboarding and Formatting Essentials, Lessons 1-60 , 2nd ed., Thomson-SouthWestern - file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C132.htm[4/8/2013 1:25:39 PM] BSOT C132 Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online (purely online no face-to-face contact) ;iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality ;Online with some required face-to-face meetings (â€œHybridâ€); 30. MINIMUM QUALIFICATIONS: Computer Information Systems; 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision Curriculum Committee Approval 05/01/2009 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 50 = Summer 2000 IGETC Approval CSU Approval Status IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000296801 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): XXXXXXXX = Not qualified for SEQ code (qual for CAN only); Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C132.htm[4/8/2013 1:25:39 PM] BSOT C133 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE BSOT C133 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: BSOT C133 2. COURSE TITLE: Advanced Computer Keyboarding 3. SHORT BANWEB TITLE: Advanced Computer Keyboarding 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: Learners in this course build on an intermediate keyboarding foundation with correct touch typing techniques, including alphabetic, numeric, and symbol keyboarding as well as 10-Key numeric keypad. Skill-building includes formatting of documents and individualized remedial drills. Successful completion of this class will result in minimum keyboarding speed of 45 wpm net. Advisory: BSOT C132 12. GRADING METHOD S = Standard Letter Grade Default: A = Audit;CR;P = Pass/No Pass;Pass/NoPass;A = Audit Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C133.htm[4/8/2013 1:25:39 PM] BSOT C133 IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Keyboard with speed and accuracy to a minimum of 45 net words per minute on a 5 minute timed writing. 2. Accurately and efficiently prepare block and modified block letters, standard memos, simple reports references, title pages and e-mail. 23. REQUISITES Advisory: BSOT C132 24. DETAILED TOPICAL OUTLINE: Lecture: A Key-stroking 1 Review key-stroking for alphabet keys 2 Review key-stroking for numeric keys 3 Review key-stroking for punctuation/symbol keys 4 Review key-stroking for 10-Key Numeric Keypad B Document Formatting 1 Skill-building using word processing methods. 2 techniques Block letters 3 Modified Block letters 4 Memorandums 5 Title Pages 6 Document formatting techniques for email A,B A, B Lab: Learners practice correct keyboarding techniques using a computer based training program and text. 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C133.htm[4/8/2013 1:25:39 PM] BSOT C133 2. Lecture; 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to Where possible, students practice keyboarding at home to augment classroom practice. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to This will be assessed and scored by a pre- and post-test. Keyboarding Drills and Lesson work (A, B) Five-minute Timed Writings (A, B) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks VanHyss, S., Forde C., & Woo, D. (2008) Keyboarding and Formatting Essentials, Lessons 1-60 , 2nd ed. , Thomson-SouthWestern Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online (purely online no face-to-face contact) ;iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality ;Online with some required face-to-face meetings (â€œHybridâ€); 30. MINIMUM QUALIFICATIONS: Computer Information Systems; 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision Curriculum Committee Approval 05/01/2009 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 50 = Summer 2000 IGETC Approval CSU Approval Status IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000373170 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C133.htm[4/8/2013 1:25:39 PM] BSOT C133 Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): XXXXXXXX = Not qualified for SEQ code (qual for CAN only); Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C133.htm[4/8/2013 1:25:39 PM] BSOT C154 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE BSOT C154 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: BSOT C154 2. COURSE TITLE: Office Personnel Seminar 3. SHORT BANWEB TITLE: Office Personnel Seminar 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: Capstone course designed to integrate and refine office skills. Students gain skills in communication, information processing, time management, ethics, records management, administrative procedures, customer service, and job search. The workplace of today as well as team work, problem-solving, and decision-making skills will be emphasized. Advisory: CSCI C151, BSAD C145. 12. GRADING METHOD S = Standard Letter Grade Default: A = Audit;CR;P = Pass/No Pass;Pass/NoPass;A = Audit Optional: 13. TOTAL UNITS: 3 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 3 Lab 0 Min Hours 54 0 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C154.htm[4/8/2013 1:25:40 PM] BSOT C154 IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Describe the roles and responsibilities of the administrative professional in the workplace including collaboration, teamwork, leadership skills, and management characteristics. This will be assessed by a project and scored with a rubric. 2. Recognize and display proficiency with various workplace technologies. This will be assessed by exam. 3. Demonstrate effective business communication. This will be assessed by a writing project and scored with a rubric. 4. Demonstrate elements of an effective records management system. This will be assessed by exam. 5. Differentiate between various forms of effective customer service. This will be assessed by exam. 6. Prepare job search related documents and practice effective job search strategies. This will be assessed by a project and scored with a rubric. 23. REQUISITES Advisory: CSCI C151 BSAD C145 24. DETAILED TOPICAL OUTLINE: Lecture: A. The Ever Changing Workplace (A, F) 1. The Workplace - 2050 2. The Labor Force 3. Work Environment 4. Organizational Types B. Ethics (A, C, E, F) 1. Ethical Behavior 2. Business Ethics 3. Characteristics of Ethical Organizations 4. The Ethical Administrative Professional 5. Ethical Change C. Stress, Anger, and Time Management (A) 1. Stress in Our Lives 2. Stress in the Workplace 3. Anger 4. Time Management D. Information Processing (A, B, D) 1. Information Processing and the Administrative Professional 2. Desktop and Mobile Computing 3. Computer Hardware 4. Computer Software 5. Electronic File Management 6. Computer Ergonomics 7. Networks, the Internet, and the World Wide Web 8. Computer and Web Ethics 9. The Future E. Telecommunications (A, B) 1. The Telecommunication Revolution 2. Workplace Collaboration Tools 3. Telephone Communication 4. The Ongoing Revolution F. Written Communication (A, C, F) 1. Written Communication in the Workplace 2. Choosing a Communication Method 3. Planning and Organizing Written Materials 4. Assuring Effective Correspondence 5. Writing Letters 6. Preparing Reports 7. Writing Collaboratively 8. Writing Internationally 9. Observing Ethical and Legal Considerations G. Records Management (A, D) file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C154.htm[4/8/2013 1:25:40 PM] BSOT C154 1. Paperless Office – Myth or Reality 2. Records Management Defined 3. Components of a Records Management System 4. Indexing Rules 5. Effective Decision Making 6. The Future of Records Management H. Presentations (A, B, C) 1. Enhance Written and Verbal Skills 2. Prepare Mentally for the Verbal Presentation 3. Prepare Your Presentation 4. Rehearse 5. Dress Appropriately 6. Control Fear 7. Presentation Day 8. After the Presentation 9. Team Presentations I. The Workplace Team (A, C, E) 1. Building Teams 2. Demographics of the Present and Future Workforce 3. Global Nature of Organizations 4. Generational Characteristics 5. Teamwork 6. Verbal Communication Process 7. Individual and Team Values 8. Verbal Communication Barriers 9. Effective Verbal Communication 10. Non-verbal Communication 11. An Effective Workplace Team J. Customer Service (A, E) 1. The Customer Service Organization 2. Future Customers 3. Customer Service Defined 4. Develop Your Customer Service Skills 5. Face-to-Face Customer Service Skills 6. Telephone Customer Service Skills 7. E-Mail Customer Service Skills 8. Call Center Customer Service Skills 9. Web Customer Service Skills 10. Inappropriate Customer Behavior K. Workplace Mail and Copiers (B) 1. Mail and Other Special Services 2. USPS Services 3. U.S. Postal Service Classifications 4. Private Mail Services 5. Outgoing and Incoming Mail 6. Office Copiers 7. Shredders 8. Recycling L. Travel Arrangements (A) 1. Corporate America – A Global Enterprise 2. Domestic Travel 3. International Travel 4. Organizational Travel Procedures M. Meetings and Conferences (A, C) 1. Meetings – A Way of Life in the Workplace 2. Types of Meetings 3. Effective Meetings 4. Meeting Format 5. International Meetings 6. Meeting Responsibilities 7. Conferences 8. Conflict Resolution N. Job Search (C, F) 1. Skills and Interests 2. Sources of Job Information 3. Various Organizations 4. Letter of Application 5. Resume 6. Employment Applications 7. Job Interview Skills 8. Advance on the Job 9. Leave a Job O. Teleworker/Virtual Assistant (A, B) 1. Teleworking, Teleworker, and Virtual Assistant Defined file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C154.htm[4/8/2013 1:25:40 PM] BSOT C154 2. Job Growth 3. Advantages/Disadvantages of Telework 4. Traits/Skills 5. Telework Challenges 6. Home Workspace 7. Health, Life Insurance, and Retirement Benefits 8. Survival Strategies 9. Career Growth of the Teleworker/Virtual Assistant P. Leadership Skills (A) 1. Leading and Managing 2. Effective Leadership Defined and Practiced 3. Leadership Today 4. Leadership Traits 5. Leadership and Management Contrasted 6. Management Responsibilities 7. The Right to Lead 9. LAB CONTENT DESCRIPTION (if applicable): 10. METHODS OF PRESENTATION: Course instructional methods may include but are not limited to A. Discussion on all course topics. B. Written lectures C. Computer aided instruction such as presentations, videos, and exercises. D. Critical thinking case problems E. Presentation software 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to Text and other Readings Homework exercises including writing and research on topics Internet Research 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to Professional Development Journal Practical exercises that simulate the workplace environment Discussion Items Individual and Group Integrated Workplace Projects Written Communication Internet Research 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Fulton-Calkins, P. (2007) The Administrative Professional: Technology and Procedures, , Thomson-SouthWestern Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online (purely online no face-to-face contact) ; 30. MINIMUM QUALIFICATIONS: 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision Curriculum Committee Approval 02/29/2008 Board of Trustees State Approval UC Approval CSU Approval UC Approval Status 50 = Summer 2000 IGETC Approval CSU GE Approval CSU Approval Status IGETC Approval Status CSU GE Approval Status file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C154.htm[4/8/2013 1:25:40 PM] BSOT C154 Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000354265 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 3 Course Units of Credit Minimum Low (CB07): 3 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): B = Advance Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): YYYYYYYY = Not qualified for CAN code; Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/BSOT%20C154.htm[4/8/2013 1:25:40 PM] CSCI C070 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE CSCI C070 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: CSCI C070 2. COURSE TITLE: Computer Literacy 3. SHORT BANWEB TITLE: Computer Literacy 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: 70 = Fall, 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This hands-on course is designed for those with little or no computer experience. Learners practice file management, email, instant messaging, Internet browsing and searching. This course includes a brief introduction to industry standard word processing, spreadsheet, and presentation application programs. Computer terminology and identification of fundamental hardware and software applications is introduced. Advisory: Reading Level 2. 12. GRADING METHOD S = Standard Letter Grade Default: CR;Pass/NoPass;P = Pass/No Pass;A = Audit;A = Audit Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Human Services AS (AS Degree Program) Human Services Worker Cert (Certificate of Achievement) Industrial Technology AS (AS Degree Program) Industrial Technology AS (revised) (AS Degree Program) Industrial Technology Cert (Certificate) Industrial Technology Certificate (Certificate of Achievement) Vocational Nursing (AS Degree Program) file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C070.htm[4/8/2013 1:25:40 PM] CSCI C070 Vocational Nursing Cert (Certificate of Achievement) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. demonstrate fundamental knowledge of computer hardware and software functions to perform basic computing tasks including but not limited to startup, login, shutdown, and basic input and output procedures. 2. recognize and use programs to create and edit introductory word processing, spreadsheet, and presentation software files, including MS Office and other available software programs. 3. access and manage login accounts and documents effectively, including downloading, creating, naming, copying, deleting, retrieving, and decompressing files and folders with an awareness of file size, location of saved files and folders, and available space on storage media with a clear distinction between various email, and course login accounts. 4. open and use an e-mail account including sending and receiving email with attachments, saving files, and managing the inbox. 5. search and navigate the Internet and other types of media environments with an awareness of relevance, authenticity, authority, and currency. 23. REQUISITES Advisory: Advisory 5 Level 2 Reading 24. DETAILED TOPICAL OUTLINE: Lecture: A B Â Computing Fundamentals A, B, C, D 1 Computer Hardware Â 2 Input, Output, Storage Â 3 Peripheral Devices Â 4 Software and Application Programs Â 5 Windows and Operating Systems Â 6 Files and Folders Â Â Application Programs 1 Word Processing Documents Â 2 Creating, Editing, and Saving Documents Â 3 Spreadsheet worksheets Â 4 Formulas, labels, values, cells Â 5 Borders and backgrounds Â 6 Columns and rows sizing Â 7 Presentations Â 8 Slides, charts, graphics A, B, C, D Â file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C070.htm[4/8/2013 1:25:40 PM] CSCI C070 9 Transitions, animations Â 10 Finalizing a presentation Â C Â File Management B, C, D Â 1 Files and folders Â Â 2 Download and upload Â Â 3 Create, Save, Name, Delete, Rename Â Â 4 Zip and File Size Â Â 5 Storage and Backup Â Â 6 Network folders Â D Â Online Communication Â 1 Network basics Â Â 2 The Internet Â Â 3 E-Commerce Â Â 4 Browser software and functions Â Â 5 E-mail accounts Â Â 6 Send and receive e-mail Â Â 7 Inbox and Sent folders Â Â 8 E-mail attachments Â Â 9 Instant Messaging Â D, E Lab: Students will work on assignments and projects relevant to the topics during the lab portion of the class. 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; 2. Lecture; 3. Other Methods: Individual instruction 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to Hands-on assignments (A, B, C, D, E) Example: Following a demonstration, the learner will set up a free e-mail account and send the instructor an e-mail. Skills tests on textbook companion CD (A, B, C, D, E) Comprehensive practice tests. (A, B, C, D, E) Example: Show an understanding of computer terminology through correct identification of mix and match, multiple choice, and fill-in the blank tests. Example: Create, edit, and save a word processing document using appropriate file management procedures. Example: Browse the Internet using the URL address window, set a â€œFavoritesâ€ listing in Windows send the link to instructor by email. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to This will be assessed by a performance, scored with a rubric. This will be assessed by a project, scored with a rubric. file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C070.htm[4/8/2013 1:25:40 PM] CSCI C070 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Parsons, J. J., & Oja, D. . (2008) New Perspectives on Computer Concepts Brief , 11th , Course Technology Manuals Periodicals Software Other 29. METHOD OF DELIVERY: ;Other; iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality 30. MINIMUM QUALIFICATIONS: 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision 09/25/2009 Curriculum Committee Approval Board of Trustees State Approval UC Approval UC Approval Status CSU Approval CSU Approval Status IGETC Approval IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000368833 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) C = Not Transferable Course Units of Credit Maximum High (CB06): 1 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): D = Possible Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): XXXXXXXX = Not qualified for SEQ code (qual for CAN only); Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C070.htm[4/8/2013 1:25:40 PM] CSCI C070 file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C070.htm[4/8/2013 1:25:40 PM] CSCI C121 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE CSCI C121 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: CSCI C121 2. COURSE TITLE: Beginning Word 3. SHORT BANWEB TITLE: Beginning Word 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This hands-on computer course is designed to provide basic understanding of word processing concepts using Microsoft Word. Learners create, edit, and format documents including business letters, multiple-page reports, newsletters, and cover letters. This course begins preparation for the core level Microsoft Office Specialist certification exam for Microsoft Word. Advisory: CSCI C070, Reading Level I, Writing Level I. 12. GRADING METHOD S = Standard Letter Grade Default: CR;Pass/NoPass;P = Pass/No Pass;A = Audit;A = Audit Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Industrial Technology AS (AS Degree Program) Industrial Technology AS (revised) (AS Degree Program) Industrial Technology Cert (Certificate) Industrial Technology Certificate (Certificate of Achievement) Elective: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C121.htm[4/8/2013 1:25:40 PM] CSCI C121 21. GENERAL EDUCATION APPLICABILITY Local: IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Apply basic word processing formatting features to create, edit, merge, and print documents including business and cover letters, multiple page reports, newsletters. 2. Manage files and folders for efficient saving and retrieval of word processing documents. 3. Apply basic features of working with images, graphics, Smart Art, and Word Art in documents including inserting, cropping, drawing, and resizing, 4. Determine and apply appropriate problem solving techniques using Help and reference material off and online for successful creation of basic documents using Microsoft Office. 23. REQUISITES Prerequisite: CSCI C070 CSCI C101 Advisory: Advisory 5 Reading Level I, Writing Level I, CSCI C070 24. DETAILED TOPICAL OUTLINE: Lecture: A B Â Working with Text 1 Use the Undo, Redo, and Repeat commands Â 2 Apply font formats (bold, italic, and underline) Â 3 Use the Spelling and Grammar command Â 4 Use the Thesaurus Â 5 Insert page breaks Â 6 Highlight text in document Â 7 Insert and move text Â 8 Cut, copy, paste, and paste special using the Office Clipboard Â 9 Copy formats using the Format Painter Â 10 Select and change font and font size Â 11 Find and replace text Â 12 Apply character effects (superscript, subscript, strikethrough, small caps, and outline) Â 13 Insert date and time Â 14 Insert symbols Â 15 Create and apply frequently used text with AutoCorrect Â Â Working with Paragraphs 1 Align text in paragraphs (center, left, right, and justified) Â 2 Add bullets and numbering Â 3 Set character, line, and paragraph spacing options Â A, C A, C file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C121.htm[4/8/2013 1:25:40 PM] CSCI C121 C 4 Apply borders and shading to paragraphs Â 5 Use indentation options (left, right, first line, and hanging indent) Â 6 Use Tabs command (center, decimal, left, and right) Â 7 Create an outline-style numbered list Â 8 Set tabs with leaders Â Â Editing and Formatting Documents A, B, C 1 Print a document Â 2 Use print preview Â 3 Use Web Page Preview Â 4 Navigate through a document Â 5 Insert page numbers Â 6 Set page orientation Â 7 Set margins Â 8 Use GoTo to locate specific elements in a document Â 9 Create and modify page numbers Â 10 Create and modify headers and footers Â 11 Align text vertically Â 12 Create and use newspaper columns Â 13 Revise column structure Â 14 Prepare and print envelopes and labels Â 15 Apply styles Â 16 Create sections with formatting that differs from other sections Â 17 Use Click and Type Â Â 18 Use Format Painter to copy paragraph formatting Â D Â E Managing Files A, B, C 1 Use save Â 2 Locate and open an existing document Â 3 Use Save As (different name, location, or format) Â 4 Create a folder Â 5 Create a new document using a wizard Â 6 Save as Web Page Â 7 Use templates to create a new document Â 8 Create Hyperlinks Â 9 Use the Microsoft Office Assistant Â 10 Send a Word document via e-mail Â Â Using Tables A, C file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C121.htm[4/8/2013 1:25:40 PM] CSCI C121 1 Create and format tables Â 2 Add borders and shading to tables Â 3 Table headers and row sorting Â 4 Revise tables (insert and delete rows and columns and change cell formats) Â 5 Modify table structure (merge cells, change height, and width) Â 6 Rotate text in a table Â F Â Â 1 Use the drawing toolbar Â Â 2 Insert graphics into a document (clip art, and images) Â Â 3 Resizing and cropping images Â Â 4 Smart Art Â G Â 1 H I Working with Pictures and Charts Multiple Page Reports Working with Headings A, B, C A-D Â 2 Quick Styles Â 3 Footnotes and Endnotes Â 4 Sections Â 5 Cover and Title Pages Â Â Desktop Publishing and Mail Merge A-D 1 Using Word Art Â 2 Creating columns in a newsletter Â 3 Balancing columns Â 4 Text wrapping around graphics Â 5 Drop Caps Â 6 Symbols and Special Characters Â 7 Page Borders Â Â Mail Merge A-D 1 Understanding the mail merge process Â 2 Â file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C121.htm[4/8/2013 1:25:40 PM] CSCI C121 Selecting a data source 3 Inserting merge fields Â 4 Previewing the merged document Â 5 Merging the main document and data source Â 6 Creating a blog post Â Lab: In lab hours, students create projects demonstrating the ability to master topics presented in the course. 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; 2. Lecture; 3. Other Methods: A. Lecture and demonstration of application techniques and functions B. One-on-one instruction and guidance for troubleshooting and problem solving 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Text readings B. Preparation of project work 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to This will be assessed by a project, scored with a rubric. This will be assessed by a demonstration, scored with a rubric. A. Creation of documents: Students create documents that demonstrate skills throughout the course. (A- D) B. Projects: At the end of each tutorial, a hands-on project is completed at the mastery level relevant to content for the chapter. (AD) C. Theory tests: Open book mid-term and final exams contribute to theoretical understanding of the material and the use of available resources (index, help, and tutorials) to find information. (A- D) D. Problem solving and critical thinking reports: Students report on special instances of engaging in the process of problem solving, exploring beyond basic features, and troubleshooting, when performing application software tasks. (A- D) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Learning Zimmerman, S., & Zimmerman, B.. (2008) New Perspectives on Microsoft Office Word 2007 Comprehensive , , Course Technology Cengage Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online with some required face-to-face meetings (â€œHybridâ€);iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality ;Other; 30. MINIMUM QUALIFICATIONS: 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision Curriculum Committee Approval Board of Trustees State Approval UC Approval UC Approval Status file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C121.htm[4/8/2013 1:25:40 PM] CSCI C121 CSU Approval 50 = Summer 2000 IGETC Approval CSU Approval Status IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000215604 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): D = Possible Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): YYYYYYYY = Not qualified for CAN code; Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C121.htm[4/8/2013 1:25:40 PM] CSCI C123 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE CSCI C123 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: CSCI C123 2. COURSE TITLE: Beginning Excel 3. SHORT BANWEB TITLE: Beginning Excel 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This hands-on computer course is designed to provide a basic understanding of spreadsheets. Spreadsheet design, creation, revision, formatting and printing are covered. The learner will create basic sales or expense reports, family budgets and basic business related spreadsheet documents using Microsoft Excel features and functions. This course begins preparation for the Microsoft Application Specialist certification exam for Excel. Advisory: Reading Level 1, Writing Level 1, CSCI C070 12. GRADING METHOD S = Standard Letter Grade Default: CR;Pass/NoPass;P = Pass/No Pass;A = Audit;A = Audit Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Industrial Technology AS (AS Degree Program) Industrial Technology AS (revised) (AS Degree Program) Industrial Technology Cert (Certificate) Industrial Technology Certificate (Certificate of Achievement) Elective: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C123.htm[4/8/2013 1:25:41 PM] CSCI C123 21. GENERAL EDUCATION APPLICABILITY Local: IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Plan, create, edit, and print Excel spreadsheet files using basic spreadsheet features for cells, worksheets, and workbooks. 2. Work with formulas and functions in an Excel spreadsheet. 3. Work with a variety of charts and graphs to represent data in an Excel spreadsheet. 4. Determine and apply appropriate problem solving techniques using Help and reference material off and online for successful creation of basic documents using Microsoft Excel. 23. REQUISITES Prerequisite: CSCI C101 CSCI C070 Advisory: Advisory 5 Reading Level I, Writing Level I 24. DETAILED TOPICAL OUTLINE: Lecture: A B Â Getting Started with Excel 1 Introducing Excel Â 2 Planning a workbook Â 3 Enter text, dates, and numbers Â 4 Editing cell content Â 5 Working with columns and rows Â 6 Insert and delete selected cells Â 7 Cut, copy, paste, paste special, and move selected cells Â 8 Working with cells and cell ranges Â 9 Working with formulas Â 10 Introducing Functions Â 11 Entering Functions with Auto Sum Â Â Working With Worksheets 1 Inserting and deleting a worksheet Â 2 Renaming a worksheet Â 3 Moving and Copying a Worksheet Â 4 Editing (Undo, Redo, Find & Replace, Spell Checker) Â 5 Previewing and printing Â 6 Changing worksheet views. Â 7 Viewing and printing worksheet formulas Â A, B, C, D A, B, C, D file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C123.htm[4/8/2013 1:25:41 PM] CSCI C123 C D E Â Formatting a Workbook 1 Formatting workbooks Â 2 Formatting text Â 3 Working with color Â 4 Formatting data Â 5 Formatting worksheet cells Â 6 Working with the format cells dialog box Â 7 Copying and pasting formats Â 8 Applying styles Â 9 Working with themes Â Â Formatting Worksheets 1 Applying font styles (typeface, size, color, and styles) Â 2 Applying number formats (currency, percent, dates, and commas) Â 3 Modifying row and column size Â 4 Modifying alignment of cell content Â 5 Adjusting decimal places Â 6 Using the Format Painter Â 7 Applying Autoformat Â 8 Applying cell borders and shading Â 9 Merging cells Â 10 Rotating text and changing indents Â 11 Defining, applying, and removing a style Â 12 Introducing conditional formats Â 13 Hiding worksheet data Â 14 Formatting the worksheet for printing Â Â Working with Formulas and Functions 1 Understanding cell references when copying formulas Â 2 Using Relative,Â Absolute, and Mixed references Â 3 Working with functions Â 4 Understanding syntax Â 5 Inserting and typing a function Â 6 Entering formulas in a cell and use the formula bar Â 7 Using Autofill Â 8 Using Â the Paste Function to insert a function Â 9 Using basic functions (AVERAGE, SUM, COUNT, MIN, and MAX) Â 10 Using date functions (NOW and DATE) Â 11 Using financial functions (FV and PMT) Â 12 Using logical functions (IF) Â 13 Using the PMT function to determine a monthly loan payment Â A, C A, C A, B, D file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C123.htm[4/8/2013 1:25:41 PM] CSCI C123 F Â Â Lab: Working With Charts and Objects A, B, C, D 1 Create, preview and print charts Â 2 Use the Chart Wizard to create a chart Â 3 Designing and modifying charts (chart elements, title, layout, legend) Â 4 Formatting a pie chart Â 5 Editing chart data Â 6 Working with column charts Â 7 Formatting column chart elements Â 8 Formatting the chart axes Â 9 Formatting the chart columns Â 10 Creating a line chart (labels, units, legend) Â 11 Adding a data series to an existing chart Â 12 Creating a combination chart Â 13 Working with shapes (inserting, resizing, copying, aligning, grouping) Â In lab hours, students create projects demonstrating the ability to master topics presented in the course. 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; 2. Lecture; 3. Other Methods: A. Lecture and demonstration of application techniques and functions B. One-on-one instruction and guidance for troubleshooting and problem solving 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Text readings B. Preparation of project work 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to This will be assessed by a project, scored with a rubric. This will be assessed by a demonstration, scored with a rubric. A. Creation of documents: Students create documents that demonstrate skills throughout the course. (A, B, C,D) B. Projects: At the end of each tutorial, a hands-on project is completed at the mastery level relevant to content for the chapter. (A, B, C, D) C. Theory tests: Open book mid-term and final exams contribute to theoretical understanding of the material and the use of available resources (index, help, tutorials) to find information. (A, B, C, D) D. Problem solving and critical thinking reports: Students report on special instances of engaging in the process of problem solving, exploring beyond basic features, and troubleshooting, when performing application software tasks. (A, B, C, D) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Parsons, J. J., & Oja, D.. (2008) New Perspectives on Microsoft Office Excel 2007 Comprehensive. , , Course Technology Cengage Learning Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online with some required face-to-face meetings (â€œHybridâ€);iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality ;Other; 30. MINIMUM QUALIFICATIONS: Computer Information Systems; 31. APPROVALS: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C123.htm[4/8/2013 1:25:41 PM] CSCI C123 Origination Date 08/18/2010 Last Outline Revision Curriculum Committee Approval 10/31/2008 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 50 = Summer 2000 IGETC Approval CSU Approval Status IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000081957 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): D = Possible Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): YYYYYYYY = Not qualified for CAN code; Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C123.htm[4/8/2013 1:25:41 PM] CSCI C125 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE CSCI C125 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: CSCI C125 2. COURSE TITLE: Beginning Access 3. SHORT BANWEB TITLE: Beginning Access 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This hands-on computer course is designed to provide an intermediate understanding of database programs. Fundamental relational database design and management as well as building and editing basic tables, forms, queries, and reports is introduced. This course begins preparation for the core level Microsoft Access Office Specialist certification exam. Advisory: Reading Level 1, Writing Level 2, CSCI C070 12. GRADING METHOD S = Standard Letter Grade Default: CR;Pass/NoPass;Pass/NoPass;P = Pass/No Pass;P = Pass/No Pass;A = Audit;A = Audit;A = Audit Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C125.htm[4/8/2013 1:25:41 PM] CSCI C125 IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Apply a basic understanding of relational database concepts and structure to create a new database and define relationships between tables. 2. Manage a database including backup, compacting, and converting. 3. Plan, design, build, modify, and print basic database tables, forms, queries, and reports. 4. Apply guidelines for designing databases and tables and for field properties including primary key. 5. Determine and apply appropriate problem solving techniques using Help and reference material off and online for successful creation of enhanced database objects using Microsoft Access. 23. REQUISITES Prerequisite: CSCI C070 CSCI C101 Advisory: Advisory 5 Reading Level I, Writing Level II 24. DETAILED TOPICAL OUTLINE: Lecture: A Database Concepts and Terminology 1 Fields, records, tables 2 Relational database, primary key, foreign key Database objects (tables, forms, queries, reports) B Database Management 1 Backup 2 Restore 3 Compact 4 Convert C Design Guidelines (A, C, D, E) 1 Fields and properties 2 Table creation 3 Input and import data 4 Relationships 5 Referential integrity (A, C, D) (B, E) file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C125.htm[4/8/2013 1:25:41 PM] CSCI C125 D Table Creation and Modification 1 Create tables by using the Table Wizard 2 Set primary keys 3 Modify field properties 4 Use multiple data types 5 Modify tables using Design View 6 Use the Lookup Wizard 7 Use the Input Mask Wizard E Query Creation and Modification 1 Design view 2 Create, run, save queries 3 Update data with a query 4 Sort and filter data in a query 5 Exact match query 6 Comparison operators 7 And/Or logical operators 8 Calculated fields in a query F Form Creation and modification 1 Form Wizard 2 AutoFormat 3 Find data using a form 4 Preview and print form records 5 Maintain table data 6 Form with subform G Report Creation and Modification 1 Report Wizard (C, D, E) (C, E) (C, E) (C, E) file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C125.htm[4/8/2013 1:25:41 PM] CSCI C125 2 Report edit 3 Add a graphic 4 Preview and print Lab: In lab hours, students create projects demonstrating the ability to master topics presented in the course. Students will create databases and database objects: tables, queries, forms, and reports, as well as apply all skills in the topical outline to projects, review, and case studies. (A, B, C, D, E) 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; 2. Lecture; 3. Other Methods: Tutorials 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Textbook Readings of Tutorial chapters B. Lab work not completed in class including tutorial, review, and case study projects. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to This will be assessed by a project, scored with a rubric. This will be assessed by a demonstration, scored with a rubric. A. Hands-on database assignments scored by rubrics (A, B, C, D, E) a. Example: Learners apply skills learned to work with data for a new business in the health and fitness industry. b. Example: Learners use skills learned to create queries that display information about a zoo and its patrons. c. Example: Learners use skills learned to create forms and reports to work with and display data about video photography events. B. Problem solving and critical thinking reports: Students report on special instances of engaging in the process of problem solving, exploring beyond basic features, and troubleshooting, when performing application software tasks. (A, B, C, D, E) C. Mid-term and final assessment theory exams (A, B, C, D, E) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Adamski, J. et al. . (2008) New Perspectives on Microsoft Access 2007 Comprehensive. , 2nd , Course Technology Manuals Periodicals Software Other 29. METHOD OF DELIVERY: ;Other; iTV – Interactive video = Face to face course with significant required activities in a distance modality 30. MINIMUM QUALIFICATIONS: Computer Information Systems;Computer Science (Masters Required); 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision Curriculum Committee Approval Board of Trustees State Approval UC Approval CSU Approval UC Approval Status 50 = Summer 2000 IGETC Approval CSU GE Approval CSU Approval Status IGETC Approval Status CSU GE Approval Status file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C125.htm[4/8/2013 1:25:41 PM] CSCI C125 Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000371032 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): YYYYYYYY = Not qualified for CAN code; Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C125.htm[4/8/2013 1:25:41 PM] CSCI C129 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE CSCI C129 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: CSCI C129 2. COURSE TITLE: Microsoft Outlook 3. SHORT BANWEB TITLE: Microsoft Outlook 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: 70 = Fall, 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This course introduces students to personal management software integrating electronic mail, contact information, task features, a journal, and scheduling with the calendar functions. Advisory: CSCI C070, Reading Level 1, Writing Level 1. 12. GRADING METHOD S = Standard Letter Grade Default: CR;Pass/NoPass;P = Pass/No Pass;A = Audit;A = Audit Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Elective: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) 21. GENERAL EDUCATION APPLICABILITY Local: IGETC: file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C129.htm[4/8/2013 1:25:42 PM] CSCI C129 CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Compose, edit, attach, send, reply, and print electronic mail. This will be measured by an exam. 2. Customize files, folders, and various areas of Outlook for efficient saving and retrieval. This will be assessed through a final project, as evaluated by a rubric. 3. Create and modify contacts, electronic business cards, distribution lists, and secondary address books. This will be assessed through a final project, as evaluated by a rubric. 4. Develop and Manage appointments, meetings, events, tasks, and shared calendars. This will be assessed through a final project, as evaluated by a rubric. 5. Apply appropriate problem solving techniques using the Help, Find, and Rule functions. This will be assessed through a final project, as evaluated by a rubric. 6. Demonstrate preparedness for the Microsoft Outlook certification exam. This will be measured by an exam. 23. REQUISITES Prerequisite: CSCI C101 CSCI C070 Advisory: Advisory 5 Reading Level 1, Writing Level 1 24. DETAILED TOPICAL OUTLINE: Lecture: A. Electronic Mail (A, F) a. Creation b. Stationary c. Signature d. Attachments e. Sending and resending f. Replying g. Printing B. Contact Management (B, C, E, F) a. Creating and Modifying Contacts b. Electronic Business Cards c. Distribution Lists d. Secondary Address Book e. Viewing and Printing C. Managing Scheduling (B, D. F) a. Navigating Calendar b. Creating Appointments, Meetings, and Events c. Sending Meeting Requests d. Updating, Canceling, and Responding to Meeting Requests e. Customizing Calendar Settings f. Sharing a Calendar g. Viewing Other Calendars D. Task Management (B, C, D, F) a. Creating, modifying, and completing b. Assigned Tasks E. Managing E-Mail Efficiently (B, E, F) a. Configuring i. Settings ii. Message sensitivity and importance settings iii. Security Settings iv. Message Delivery Options b. Creating and Managing signature and Automated Settings c. Organizing Folders d. Creating Modifying, and Removing Rules e. Search Feature F. Categorizing and Managing Data Files (A-F) a. Categories b. Creation c. Customization d. Assignments file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C129.htm[4/8/2013 1:25:42 PM] CSCI C129 e. Sorting Lab: Students will work on case studies throughout each lesson plan using various applications. This will give students hands-on experience from realistic business situations. 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; 2. Lecture; 3. Other Methods: Lesson Application Exercises 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Lesson Applications B. Skill Building Exercises C. Critical Thinking Assignments 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to A. Hands-on Assignments (A-F) Example: Learners will demonstrate ability to create, edit, and send documents using appropriate file management procedures. B. Concept and Skill Review (A-F) Example: Students will be given scenarios to apply lesson applications for problem solving. C. Comprehensive Practice Tests (A-F) Example: Demonstrate an understanding of terminology, location, and various processes through critical thinking quizzes. 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Nickles D. J. & Oghawa, M. D. . (2009) Microsoft Office Outlook 2007: The Professional Approach Series , , The McGraw-Hill Companies, Inc. Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online with some required face-to-face meetings (“Hybrid”);Other; 30. MINIMUM QUALIFICATIONS: Business (Masters Required);Computer Information Systems;Computer Science (Masters Required);Office Technologies; 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision 04/25/2008 09/25/2009 Curriculum Committee Approval Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 30 = Spring 2002 IGETC Approval CSU Approval Status IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C129.htm[4/8/2013 1:25:42 PM] CSCI C129 Course ID (CB00) CCC000375436 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): D = Possible Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): XXXXXXXX = Not qualified for SEQ code (qual for CAN only); Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C129.htm[4/8/2013 1:25:42 PM] CSCI C135 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE CSCI C135 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: CSCI C135 2. COURSE TITLE: Beginning Adobe Acrobat 3. SHORT BANWEB TITLE: Beginning Adobe Acrobat 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This is a hands-on microcomputer course designed to provide basic understanding of Adobe Acrobat. Topics include creating portable document files (PDF), working with PDF files, as well as annotation and editing of files. Advisory: CSCI C070, Level 1 Reading, Level 1 Writing. 12. GRADING METHOD S = Standard Letter Grade Default: CR;Pass/NoPass;P = Pass/No Pass;A = Audit;A = Audit Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Elective: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Web Design-- (Certificate of Achievement) Web Professional -- (Certificate of Achievement) 21. GENERAL EDUCATION APPLICABILITY file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C135.htm[4/8/2013 1:25:42 PM] CSCI C135 Local: IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Demonstrate an ability to perform basic file manipulation functions. This will be measured by project, scored with a rubric. 2. Identify appropriate techniques for generating and validating PDF files for prepress use. This will be measured by project, scored with a rubric. 3. Create interactive PDF forms and develop a PDF file distribution and management system. This will be measured by project, scored with a rubric. 23. REQUISITES Advisory: CSCI C070 Advisory 5 Level 1 Reading, Level 1 Writing 24. DETAILED TOPICAL OUTLINE: Lecture: A. Basic file manipulation functions (A) 1. PDF files created from source files 2. PDF file editing and annotating 3. Interactive features 4. The Web and PDF 5. Electronic Portfolios 6. PDF file protection 7. PDF collections catalogs 8. Accessible PDF documents B. Generate PDF files for prepress use (B) 1. Default settings files 2. Custom settings file 3. Color management and color management preferences 4. Appropriate color management workflow and conversions 5. Printer output simulations 6. Color spaces C. Validate PDF files (B) 1. Box sizes, printer marks, and hairlines 2. Color Separations and color warnings 3. Ink Manager dialog box 4. Trap Presets dialog box 5. Settings for transparency flattening 6. Potential problems in a print production workflow 7. Preflight profiles file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C135.htm[4/8/2013 1:25:42 PM] CSCI C135 8. Preflight reports 9. Preflight droplets 10. PDF/X compliance D. Create interactive PDF forms (C) 1. Customize the Adobe LiveCycle Designer environment 2. Adobe LiveCycle Designer form creation 3. Library palette 4. Form objects 5. Form preview and testing E. Develop a PDF file distribution and management system (C) 1. Content redaction 2. Document export 3. Usage rights 4. Form distribution 5. Data compilation Lab: Students will be required to demonstrate their ability to use the software to create, manipulate, organize, modify, and preflight PDF documents and create interactive forms. Examples: Protect sensitive data contained in distributed documents and use PDF forms for data collection. 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; 2. Laboratory; 3. Lecture; 4. Other Methods: A. Classroom lecture and demonstration of software. B. Laboratory application of concepts including practical applications such as creating interactive forms and applying appropriate security measures to files. C. Textbook tutorials. 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Chapter reading B. Weekly lab assignments 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to Assessment of student performance may include but is not limited to Lab assignments demonstrating student’s ability to apply learning to real-world activities. (A-C) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Fink, D. . (2007) Acrobat 8 Professional: Advanced, ACE Edition + CertBlaster, Student Manual with Data , , Axzo Press Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online with some required face-to-face meetings (“Hybrid”);Other; 30. MINIMUM QUALIFICATIONS: Computer Information Systems; 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision 04/25/2008 file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C135.htm[4/8/2013 1:25:42 PM] CSCI C135 Curriculum Committee Approval 09/25/2009 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 50 = Summer 2003 IGETC Approval CSU Approval Status IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000077564 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): XXXXXXXX = Not qualified for SEQ code (qual for CAN only); Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C135.htm[4/8/2013 1:25:42 PM] CSCI C151 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE CSCI C151 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: CSCI C151 2. COURSE TITLE: Intermediate Word 3. SHORT BANWEB TITLE: Intermediate Word 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This hands-on computer course is designed to provide an intermediate understanding of word processing concepts using Microsoft Word. Learners create, edit, and format documents including a business plan, form letters, mailing labels, and learn how to collaborate with others on the creation of complex documents. Features of templates, outlines, mail merge, and online distribution of web based documents are also included. This course continues preparation for the Microsoft Office Application Specialist certification exam for Microsoft Word. Advisory: CSCI C121. 12. GRADING METHOD S = Standard Letter Grade Default: P = Pass/No Pass;Pass/NoPass;A = Audit;A = Audit;CR Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Elective: 21. GENERAL EDUCATION APPLICABILITY file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C151.htm[4/8/2013 1:25:42 PM] CSCI C151 Local: IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Apply intermediate word processing formatting features to create styles, outlines, templates, table of contents, as well as advanced merge functions for form letters and mailing labels. 2. Work effectively with documents in a collaborative setting by using features of tracking and comments, as well as compare and combine. 3. Integrate elements of office products such as Microsoft Excel spreadsheets with word processing documents. 4. Modify documents for online distribution. 5. Determine and apply problem solving techniques using Help and reference material for successful creation of intermediate level business documents using Microsoft Office products. 23. REQUISITES Advisory: CSCI C121 24. DETAILED TOPICAL OUTLINE: Lecture: A Working with Templates 1 Installed templates 2 Document themes 3 Customizing themes (colors, fonts) 4 Saving a document as a template B Working with Styles 1 Style sets 2 Modifying styles (character and paragraph spacing) 3 Creating new styles C Outlines and Table of Contents 1 Creating a table of contents 2 Using Research task pane 3 Inserting Date 4 Promoting and demoting headings in an outline 5 Outline view D Using Mail Merge 1 Understanding the mail merge process 2 Merge fields and records 3 Selecting a main document 4 Using the mail merge task pane 5 Creating a data source 6 Editing a main document A, E A, E A, E A, E file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C151.htm[4/8/2013 1:25:42 PM] CSCI C151 E F G Lab: 7 Previewing merged document 8 Merging the main document and data source 9 Editing a data source 10 Sorting records 11 Selecting records to merge 12 Creating mailing labels 14 Creating a telephone directory 15 Converting text to tables and tables to text 16 Working with lists Collaborate With Others (A, B, C, D, E) 1 Tracking changes and making comments in a document 2 Revising a document with tracked changes and comments 3 Adjusting tracking changes options 4 Comparing and combining documents 5 Accepting and rejecting changes Embedding and linking objects from other programs 1 Embedding an excel worksheet 2 Modifying the embedded worksheet 3 Linking an Excel chart 4 Modifying the linked chart Creating Web Pages 1 Distributing documents online 2 Publishing documents as web pages 3 Using hyperlinks in Word 4 Bookmark in the same document with hyperlinks 5 Creating hyperlinks to other documents 6 Viewing a document in web layout view 7 Apply a background effect 8 Saving a Word document as a web page 9 Formatting a web page 10 Inserting horizontal lines 11 Modifying text size and color 12 Creating and editing hyperlinks in a web page 13 Breaking a link between objects 14 Viewing the web page in a browser A, B, C, E, A, C, E A, D, E During in-class lab hours, students create projects demonstrating the ability to master topics presented in the course with one-on-one instruction by the faculty. A cohort collaborative environment is encouraged among students during lab hours. 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C151.htm[4/8/2013 1:25:42 PM] CSCI C151 2. Lecture; 3. Other Methods: A. Lecture and demonstration of application techniques and functions B. One-on-one instruction and guidance for troubleshooting and problem solving 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Text readings B. Preparation of project work 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to This will be assessed by a project, scored with a rubric. This will be assessed by a demonstration, scored with a rubric. A. Creation of documents: Students create documents that demonstrate skills throughout the course. (A, B, C, D, E) B. Projects: At the end of each tutorial, a hands-on project is completed at the mastery level relevant to content for the chapter. (A, B, C, D, E) C. Theory tests: Open book mid-term and final exams contribute to theoretical understanding of the material and the use of available resources (index, help, and tutorials) to find information. (A, B, C, D, E) D. Problem solving and critical thinking reports: Students report on special instances of engaging in the process of problem solving, exploring beyond basic features, and troubleshooting, when performing application software tasks. (A, B, C, D, E) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Learning Zimmerman, S., & Zimmerman, B. . (2008) New Perspectives on Microsoft Office Word 2007 Comprehensive , , Course Technology Cengage Manuals Periodicals Software Other 29. METHOD OF DELIVERY: ;Other; iTV – Interactive video = Face to face course with significant required activities in a distance modality 30. MINIMUM QUALIFICATIONS: 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision Curriculum Committee Approval Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 70 = Fall 2005 IGETC Approval CSU Approval Status IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000001520 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C151.htm[4/8/2013 1:25:42 PM] CSCI C151 Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): XXXXXXXX = Not qualified for SEQ code (qual for CAN only); Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C151.htm[4/8/2013 1:25:42 PM] CSCI C153 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE CSCI C153 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: CSCI C153 2. COURSE TITLE: Intermediate Excel 3. SHORT BANWEB TITLE: Intermediate Excel 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This hands-on computer course is designed to provide an intermediate understanding of spreadsheets. Learn how to analyze data through list management, using autofilter, sort and pivot table features. Work with multiple worksheets and workbooks, and then create a shared workbook, resolve conflicts, and track changes. Finally, plan and prepare an application using Excel''s data validation feature and button creation using macros. This course completes topics required in preparation for Microsoft Application Specialist exam for Excel. Advisory: CSCI C123. 12. GRADING METHOD S = Standard Letter Grade Default: P = Pass/No Pass;Pass/NoPass;A = Audit;A = Audit;CR Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Elective: 21. GENERAL EDUCATION APPLICABILITY file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C153.htm[4/8/2013 1:25:43 PM] CSCI C153 Local: IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Analyze data using list management features such as sort and autofilter. 2. Work with multiple worksheets and workbooks. 3. Collaborate on a workbook and a web page. 4. Develop intermediate spreadsheet applications. 5. Determine and apply appropriate problem solving techniques using Help and reference material off and online for successful creation of intermediate level documents using Microsoft Excel. 23. REQUISITES Advisory: CSCI C123 24. DETAILED TOPICAL OUTLINE: Lecture: A B Â Working with Excel Tables, Pivot Tables, and Pivot Charts A, B, C, D, E 1 Planning a structured range of data (freezing rows and columns) Â 2 Creating an Excel table (renaming, formatting) Â 3 Maintaining an Excel table (adding, finding, editing, and deleting records) Â 4 Sorting data using sort buttons, multiple columns, and a custom list Â 5 Filtering Data Â 6 Sorting Data (Columns and Lists) Â 7 Using the Total Row and Summary Statistics Â 8 Inserting Subtotals Â 9 Analyzing data with pivot tables Â 10 Creating a pivot table Â 11 Refreshing a pivot table Â 12 Grouping pivot table items Â 13 Creating a pivot table chart Â Â Managing Multiple Worksheets and Workbooks 1 Using multiple worksheets Â 2 Grouping worksheets Â 3 Copying worksheets Â 4 Referencing cells and ranges in other worksheets Â 5 Using 3-D references Â 6 Printing a worksheet group Â 7 Linking workbooks Â 8 Updating Linked workbooks Â A, B, C, D, E file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C153.htm[4/8/2013 1:25:43 PM] CSCI C153 9 C D E Lab: Opening destination workbooks with source Â 10 Workbooks closed Â 11 Creating an Excel workspace Â 12 Creating a hyperlink Â 13 Creating templates Â 14 Creating custom workbook template Â 15 Saving a workbook as a web page Â Â Using Advanced Functions, Conditional Formatting, and Filtering 1 Working with logical functions Â 2 Using Lookup tables and functions Â 3 Checking for data entry errors Â 4 Summarizing data conditionally Â 5 Using advanced filtering Â 6 Using database functions to summarize data Â Â Developing an Excel Application 1 Planning an Excel Application Â 2 Naming cells and ranges Â 3 Validating data entry Â 4 Protecting a worksheet and a workbook Â 5 Adding worksheet comments Â 6 Working with macros Â 7 Protecting against macro viruses Â 8 Recording a macro Â 9 Working with the macro editor Â 10 Creating macro buttons Â 11 Saving workbooks with macros Â Â Working with Text Functions and Creating Custom Formats 1 Opening and saving workbooks created in earlier versions of Excel Â 2 Using text functions Â 3 Adding special and custom formatting Â 4 Using special formats Â 5 Creating custom formats Â 6 Formatting Dates Â A, B, C, D, E A, B, C, D, E A, B, C, D, E In lab hours, students create projects demonstrating the ability to master topics presented in the course. Students will create spreadsheets and apply all skills in the topical outline to projects, review, and case studies. 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; 2. Lecture; 3. Other Methods: A. Lecture and demonstration of application techniques and functions Example: Demonstration file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C153.htm[4/8/2013 1:25:43 PM] CSCI C153 of table styles, conditional formatting, and data bars. B. One-on-one instruction and guidance for troubleshooting and problem solving 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Text readings B. Preparation of project work: Students complete tutorial projects, review projects, and case studies. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to This will be assessed by a project, scored with a rubric. This will be assessed by a demonstration, scored with a rubric. A. Creation of documents: Students create documents that demonstrate skills throughout the course. (A, B, C, D, E) B. Projects: At the end of each tutorial, a hands-on project is completed at the mastery level relevant to content for the chapter. (A, B, C, D, E) C. Theory tests: Open book mid-term and final exams contribute to theoretical understanding of the material and the use of available resources (index, help, tutorials) to find information. (A, B, C, D, E) D. Problem solving and critical thinking reports: Students report on special instances of engaging in the process of problem solving, exploring beyond basic features, and troubleshooting, when performing application software tasks. (A, B, C, D, E) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Parsons, J. J., & Oja, D.. (2008) New Perspectives on Microsoft Office Excel 2007 Comprehensive , , Course Technology Cengage Learning Manuals Periodicals Software Other 29. METHOD OF DELIVERY: ;Other; iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality 30. MINIMUM QUALIFICATIONS: Computer Information Systems; 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision Curriculum Committee Approval 10/31/2008 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 70 = Fall 2005 IGETC Approval CSU Approval Status IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000357982 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1 file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C153.htm[4/8/2013 1:25:43 PM] CSCI C153 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): XXXXXXXX = Not qualified for SEQ code (qual for CAN only); Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C153.htm[4/8/2013 1:25:43 PM] CSCI C151 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE CSCI C151 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: CSCI C151 2. COURSE TITLE: Intermediate Word 3. SHORT BANWEB TITLE: Intermediate Word 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This hands-on computer course is designed to provide an intermediate understanding of word processing concepts using Microsoft Word. Learners create, edit, and format documents including a business plan, form letters, mailing labels, and learn how to collaborate with others on the creation of complex documents. Features of templates, outlines, mail merge, and online distribution of web based documents are also included. This course continues preparation for the Microsoft Office Application Specialist certification exam for Microsoft Word. Advisory: CSCI C121. 12. GRADING METHOD S = Standard Letter Grade Default: CR;Pass/NoPass;P = Pass/No Pass;A = Audit;A = Audit Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Elective: 21. GENERAL EDUCATION APPLICABILITY file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C155.htm[4/8/2013 1:25:43 PM] CSCI C151 Local: IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Apply intermediate word processing formatting features to create styles, outlines, templates, table of contents, as well as advanced merge functions for form letters and mailing labels. 2. Work effectively with documents in a collaborative setting by using features of tracking and comments, as well as compare and combine. 3. Integrate elements of office products such as Microsoft Excel spreadsheets with word processing documents. 4. Modify documents for online distribution. 5. Determine and apply problem solving techniques using Help and reference material for successful creation of intermediate level business documents using Microsoft Office products. 23. REQUISITES Advisory: CSCI C121 24. DETAILED TOPICAL OUTLINE: Lecture: A Working with Templates 1 Installed templates 2 Document themes 3 Customizing themes (colors, fonts) 4 Saving a document as a template B Working with Styles 1 Style sets 2 Modifying styles (character and paragraph spacing) 3 Creating new styles C Outlines and Table of Contents 1 Creating a table of contents 2 Using Research task pane 3 Inserting Date 4 Promoting and demoting headings in an outline 5 Outline view D Using Mail Merge 1 Understanding the mail merge process 2 Merge fields and records 3 Selecting a main document 4 Using the mail merge task pane 5 Creating a data source 6 Editing a main document A, E A, E A, E A, E file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C155.htm[4/8/2013 1:25:43 PM] CSCI C151 E F G Lab: 7 Previewing merged document 8 Merging the main document and data source 9 Editing a data source 10 Sorting records 11 Selecting records to merge 12 Creating mailing labels 14 Creating a telephone directory 15 Converting text to tables and tables to text 16 Working with lists Collaborate With Others (A, B, C, D, E) 1 Tracking changes and making comments in a document 2 Revising a document with tracked changes and comments 3 Adjusting tracking changes options 4 Comparing and combining documents 5 Accepting and rejecting changes Embedding and linking objects from other programs 1 Embedding an excel worksheet 2 Modifying the embedded worksheet 3 Linking an Excel chart 4 Modifying the linked chart Creating Web Pages 1 Distributing documents online 2 Publishing documents as web pages 3 Using hyperlinks in Word 4 Bookmark in the same document with hyperlinks 5 Creating hyperlinks to other documents 6 Viewing a document in web layout view 7 Apply a background effect 8 Saving a Word document as a web page 9 Formatting a web page 10 Inserting horizontal lines 11 Modifying text size and color 12 Creating and editing hyperlinks in a web page 13 Breaking a link between objects 14 Viewing the web page in a browser A, B, C, E, A, C, E A, D, E During in-class lab hours, students create projects demonstrating the ability to master topics presented in the course with one-on-one instruction by the faculty. A cohort collaborative environment is encouraged among students during lab hours. 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C155.htm[4/8/2013 1:25:43 PM] CSCI C151 2. Lecture; 3. Other Methods: A. Lecture and demonstration of application techniques and functions B. One-on-one instruction and guidance for troubleshooting and problem solving 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Text readings B. Preparation of project work 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to This will be assessed by a project, scored with a rubric. This will be assessed by a demonstration, scored with a rubric. A. Creation of documents: Students create documents that demonstrate skills throughout the course. (A, B, C, D, E) B. Projects: At the end of each tutorial, a hands-on project is completed at the mastery level relevant to content for the chapter. (A, B, C, D, E) C. Theory tests: Open book mid-term and final exams contribute to theoretical understanding of the material and the use of available resources (index, help, and tutorials) to find information. (A, B, C, D, E) D. Problem solving and critical thinking reports: Students report on special instances of engaging in the process of problem solving, exploring beyond basic features, and troubleshooting, when performing application software tasks. (A, B, C, D, E) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Learning Zimmerman, S., & Zimmerman, B. . (2008) New Perspectives on Microsoft Office Word 2007 Comprehensive , , Course Technology Cengage Manuals Periodicals Software Other 29. METHOD OF DELIVERY: ;Other; iTV – Interactive video = Face to face course with significant required activities in a distance modality 30. MINIMUM QUALIFICATIONS: 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision Curriculum Committee Approval Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 70 = Fall 2005 IGETC Approval CSU Approval Status IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000001520 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C155.htm[4/8/2013 1:25:43 PM] CSCI C151 Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): XXXXXXXX = Not qualified for SEQ code (qual for CAN only); Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C155.htm[4/8/2013 1:25:43 PM] CSCI C161 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE CSCI C161 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: CSCI C161 2. COURSE TITLE: Advanced Word 3. SHORT BANWEB TITLE: Advanced Word 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This hands-on computer course is designed to provide an advanced understanding of word processing concepts using Microsoft Word. Learners create a document template, apply advanced word processing features, import and run Visual Basic for Applications (VBA) macros, create an on-screen forms and calculations with advanced table techniques, record macros, and work with long documents and subdocuments. This course completes preparation for the Microsoft Office Application Specialist certification exam for Microsoft Word. 12. GRADING METHOD S = Standard Letter Grade Default: P = Pass/No Pass;Pass/NoPass;A = Audit;CR;A = Audit Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Elective: Computer Information Systems (AS Degree Program) Computer Information Systems- (Certificate of Achievement) file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C161.htm[4/8/2013 1:25:43 PM] CSCI C161 21. GENERAL EDUCATION APPLICABILITY Local: IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Apply advanced word processing formatting features to customize word processing documents, create on-screen forms using advanced table techniques, and manage long documents. 2. Employ a basic understanding of Visual Basic for Applications (VBA) when creating macros in Word. 3. Determine and apply problem solving techniques using Help and reference material for successful creation of complex business documents using Microsoft Office applications. 23. REQUISITES Prerequisite: CSCI C151 24. DETAILED TOPICAL OUTLINE: Lecture: A Â Customizing Word and automating work A, C 1 Creating templates Â 2 Adding color to the background Â 3 Adding a picture Â 4 Compressing pictures Â 5 Adding a shape with text to a template Â 6 Managing multiple documents Â 7 Customizing quick styles Â 8 Creating a quick style definition Â 9 CreatingÂ new quick styles Â 10 Adding custom paragraph borders Â 11 Creating a watermark Â 12 Using Smart Tags Â 13 Automating with Building Blocks Â 14 Creating and Inserting Quick Parts Â 15 Managing Building Blocks Â 16 Customizing Auto Correct Â 17 Creating columns of different widths Â 18 Inserting formatted text boxes Â B Â Understanding Document Properties Â 1 Adding document properties Â Â 2 Inserting a document property as a quick part Â C Â Automating Document Properties Using Fields A, C A, C file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C161.htm[4/8/2013 1:25:43 PM] CSCI C161 Â 1 Viewing Fields in the document Â Â 2 Inserting and updating the date field Â Â 3 Inserting and editing the fill-in field Â D Â Customizing Word Options Â 1 Customizing the Quick Access Toolbar Â Â 2 Removing Buttons from the Quick Access Toolbar Â E Â Â 1 Import a VBA macro Â Â 2 Run and edit a macro Â Â 3 Record a macro Â Â 4 Edit using VBA editor Â Â 5 Shortcut keys Â Â 6 Record anÂ automacro Â F Â Â 1 On screen form design Â Â 2 Draw, erase, rules and gridlines Â Â 3 Rotate text, Â Â 4 Shade cells Â Â 5 Insert graphics Â Â 6 Split or merge cells Â Â 7 Text form fields Â Â 8 Drop down list form fields Â Â 9 Check box form fields Â Â 10 Automatic form calculations Â Â 11 Record macros for special functions Â Â 12 Protect, save, fill-in, route and fax Â or email Â D Â Â 1 Using formulas in a table Â Â 2 Using Legacy text form fields to perform calculations Â Â 3 Protecting and saving the on-screen form Â Â 4 Filling in the on screen form Â Â 5 Faxing or emailing a document directly from Word Â Â 6 Sending a document as an email attachment directly from Word Â E Â Â 1 Working with Master documents Â Â 2 Converting a document into a Master document Â A, C Macros On Screen Forms and Advanced Tables Using Legacy form fields Managing Long Documents A, B, C A, C A, C A, C file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C161.htm[4/8/2013 1:25:43 PM] CSCI C161 Â 3 Create, split, merge, and remove subdocuments Â Â 4 Text flow and page breaks Â Â 5 Automatic heading numbers and numbered captions Â Â 6 Inserting a graph or chart Â Â 7 Â 8 Protecting a document Â Â 9 Editing a protected document Â Â 10 Checking a document with the document inspector Â Â 11 Managing multiple documents simultaneously with synchronous scrolling Â Â 12 Navigating using thumbnails Â Â 13 Numbering pages with number formats Â Â 14 Changing the footer and page layout for odd and even pages Â Â 15 Inserting a style reference into a footer. Â Â 16 Creating an index Â Â 17 Creating a bibliography Â Â 18 Creating a table of contents and a table of figures Â Â Lab: 19 Creating digital signatures and encrypting and finalizing a document Â Creating cross-references Â During in-class lab hours, students create projects demonstrating the ability to master topics presented in the course with one-on-one instruction by the faculty.Â A cohort collaborative environment is encouraged among students during lab hours. 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; 2. Lecture; 3. Other Methods: Lecture and demonstration of application techniques and functions One-on-one instruction and guidance for troubleshooting and problem solving 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to Text readings Preparation of project work 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to This will be assessed by a project, scored with a rubric. This will be assessed by a demonstration, scored with a rubric. Creation of documents: Students create documents that demonstrate skills throughout the course. (A, B, C) Projects: At the end of each tutorial, a hands-on project is completed at the mastery level relevant to content for the chapter. (A, B, C) Theory tests: Open book mid-term and final exams contribute to theoretical understanding of the material and the use of available resources (index, help, and tutorials) to find information. (A, B, C) Problem solving and critical thinking reports: Students report on special instances of engaging in the process of problem solving, exploring beyond basic features, and troubleshooting, when performing application software tasks. (A, B, C) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Learning Zimmerman, S., & Zimmerman, B.. (2008) New Perspectives on Microsoft Office Word 2007 Comprehensive , , Course Technology Cengage Manuals Periodicals Software Other file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C161.htm[4/8/2013 1:25:43 PM] CSCI C161 29. METHOD OF DELIVERY: Online with some required face-to-face meetings (â€œHybridâ€);Other; 30. MINIMUM QUALIFICATIONS: Computer Information Systems; 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision Curriculum Committee Approval 02/26/2010 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 70 = Fall 2005 IGETC Approval CSU Approval Status IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000343855 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): XXXXXXXX = Not qualified for SEQ code (qual for CAN only); Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C161.htm[4/8/2013 1:25:43 PM] CSCI C163 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE CSCI C163 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: CSCI C163 2. COURSE TITLE: Advanced Excel 3. SHORT BANWEB TITLE: Advanced Excel 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This hands-on computer course is designed to provide an advanced understanding of spreadsheets using Microsoft Excel. Data Tables, Scenario Management, using Solver, importing and exporting data, enhancing with Visual Basic for applications and modifying Excel default settings are covered. this course completes preparation for the Microsoft Application Specialist certification exam for Excel. 12. GRADING METHOD S = Standard Letter Grade Default: P = Pass/No Pass;Pass/NoPass;A = Audit;A = Audit;CR Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Elective: Computer Information Systems (AS Degree Program) Computer Information Systems- (Certificate of Achievement) 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C163.htm[4/8/2013 1:25:44 PM] CSCI C163 IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Develop financial analysis using advanced Excel functions 2. Perform What-If analyses to predict financial scenarios for business 3. Integrate Excel date through Import and Export 4. Demonstrate a fundamental understanding of expanding Excel with Visual Basic for Applications 5. Determine and apply appropriate problem solving techniques using Help and reference material off and online for successful creation of advanced level documents using Microsoft Excel. 23. REQUISITES Prerequisite: CSCI C153 24. DETAILED TOPICAL OUTLINE: Lecture: A B C D Â Developing a Financial Analysis 1 Manage scenarios Â 2 Project values using analysis tools. Â 3 Add, show, close, edit, merge, and summarize scenarios Â 4 Cost-volume, profit relationships Â 5 Create and use array formulas Â 6 Structure workbooks using XML. Â Â Performing What-If Analyses 1 One and two variable data tables Â 2 Perform What-If Analysis. Â 3 Use the Solver Ad-In. Â 4 Goal seek for trial and error Â Â Connecting to External Data A, C, E 1 Add, modify and delete maps Â 2 Manage elements and attributes Â 3 Import data from text Â 4 Import from a database Â 5 Filter and sort a database query Â 6 Save, modify, and refresh a database query Â 7 Use a query in a PivotTable Â Â Expanding Excel with Visual Basic for Applications 1 Edit macros using the Visual Basic editor. Â 2 Modify Excel default setting. Â 3 Create a VB project Â A, E A, B, E A- E file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C163.htm[4/8/2013 1:25:44 PM] CSCI C163 4 Sub procedures and modules Â 5 Macro buttons Â 6 Custom toolbars and menus Â 7 Customize graphics and screen elements Â 8 Visual Basic editor Lab: A.Â Â Â In lab hours, students create projects demonstrating the ability to master topics presented in the course. B.Â Â Â Students will create spreadsheets and apply all skills in the topical outline to projects, review, and case studies. Â 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; 2. Lecture; 3. Other Methods: A. Lecture and demonstration of application techniques and functions B. Example: Demonstration of table styles, conditional formatting, and data bars. C. One-on-one instruction and guidance for troubleshooting and problem solving 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Text readings B. Preparation of project work: Students complete tutorial projects, review projects, and case studies. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to This will be assessed by a project, scored with a rubric. This will be assessed by a demonstration, scored with a rubric. A. Creation of documents: Students create documents that demonstrate skills throughout the course. (A, B, C, D, E) B. Projects: At the end of each tutorial, a hands-on project is completed at the mastery level relevant to content for the chapter. (A, B, C, D, E) C. Theory tests: Open book mid-term and final exams contribute to theoretical understanding of the material and the use of available resources (index, help, and tutorials) to find information. (A, B, C, D, E) D. Problem solving and critical thinking reports: Students report on special instances of engaging in the process of problem solving, exploring beyond basic features, and troubleshooting, when performing application software tasks. (A, B, C, D, E) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Parsons, J. J., & Oja, D. . (2008) Parsons, J. J., & Oja, D. (2008). New Perspectives on Microsoft Office Excel 2007 Comprehensive , , Technology Cengage Learning Manuals Periodicals Software Other 29. METHOD OF DELIVERY: ;Other; iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality 30. MINIMUM QUALIFICATIONS: 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision 09/25/2009 Curriculum Committee Approval 02/26/2010 Board of Trustees State Approval UC Approval CSU Approval UC Approval Status 70 = Fall 2005 IGETC Approval CSU GE Approval CSU Approval Status IGETC Approval Status CSU GE Approval Status file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C163.htm[4/8/2013 1:25:44 PM] CSCI C163 Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000366809 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): XXXXXXXX = Not qualified for SEQ code (qual for CAN only); Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C163.htm[4/8/2013 1:25:44 PM] CSCI C165 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE CSCI C165 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: CSCI C165 2. COURSE TITLE: Advanced Access 3. SHORT BANWEB TITLE: Advanced Access 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This hands-on computer course is designed to provide an advanced understanding of entry level creation and modification of database applications in business. Action queries, table relationship properties, automating tasks with micros are covered including Switchboard development. Visual Basic for Applications is introduced to enhance database construction and functionality. Managing with replication and synchronization as well securing with user level Security Wizard is included. This course completes study of skills required in preparation for Microsoft Application Specialist exam for Access. 12. GRADING METHOD S = Standard Letter Grade Default: P = Pass/No Pass;Pass/NoPass;A = Audit;CR;A = Audit Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) Elective: Computer Information Systems (AS Degree Program) Computer Information Systems- (Certificate of Achievement) file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C165.htm[4/8/2013 1:25:44 PM] CSCI C165 21. GENERAL EDUCATION APPLICABILITY Local: IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Identify and employ application of one-to-many, many-to-many, and one-to-one table relationships and apply inner-join, outer-join, and self-join principles to query design. 2. Create action queries, including make-table, append, delete, and update, and Automate tasks and switchboard creation using macros. 3. Create custom forms using SQL statement in a query to retrieve database information and execute, view, and modify and create a procedure using Visual Basic for Applications (VBA). 4. Analyze database performance using the Performance Analyzer, and manage database distribution with replication, synchronization or splitting. 5. Implement Access security features such as passwords, encryption, and permissions to protect a database from unauthorized use. 6. Determine and apply appropriate problem solving techniques using Help and reference material off and online for successful creation of enhanced database objects using Microsoft Access. 23. REQUISITES Prerequisite: CSCI C155 24. DETAILED TOPICAL OUTLINE: Lecture: A Action Queries 1 Make-table 2 Append 3 Delete 4 Update B Relationship and Query Join Types 1 One-to-many 2 Many-to-many 3 One-to-one 4 Inner-join query 5 Outer-join query 6 Self-join query C Automate Tasks with Macros (B, F) (A, F) (B, F) file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C165.htm[4/8/2013 1:25:44 PM] CSCI C165 1 Run and add modifications to a macro 2 Macro grouping 3 Single step a macro 4 Command buttons D Create a QueriesDialogBoxForm using SQL 1 List box for forms 2 Using SQL statements 3 Modifying form properties 4 Testing a QueriesDialogBox form E Switchboard Creation and Modification 1 Switchboard pages 2 Adding macros to command buttons 3 Add pictures and labels 4 Switchboard properties 5 Using and Writing Visual Basic for Applications Code F Function and sub procedures 1 Modules 2 Review and modification of subroutine 3 Create a function in a standard module 4 Create, compile, and test functions, subroutines, and event procedures 5 Hide text and change display colors 6 Dialog box event procedures. 7 Database Management 8 Performance analyzer 9 Linked table manager 10 Database replication and design master 11 Database synchronization (C, F) (B, F) (C, E, F) file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C165.htm[4/8/2013 1:25:44 PM] CSCI C165 E Database splitter 1 Database startup options 2 Database Security 3 Encrypting (D, F) Lab: A. In lab hours, students create projects demonstrating the ability to master topics presented in the course. B. Students will create databases and database objects: tables, queries, forms, and reports, as well as apply all skills in the topical outline to projects, review, and case studies. (A- E) 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; 2. Lecture; 3. Other Methods: Tutorials 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Textbook Readings of Tutorial chapters B. Lab work not completed in class including tutorial, review, and case study projects. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to This will be assessed by a project, scored with a rubric. This will be assessed by a demonstration, scored with a rubric. A. Hands-on database assignments scored by rubrics (A-E) B. Hands-on database assignments (A-E) a. Example: In a business simulation, learners define many-to-many, and one-to-many relationship between tables in an existing database and create new queries as requested. b. Example: Learners create a user-friendly interface including switchboard and dialog boxes for a simulated business. c. Example: Learners implement management and security features on a simulated business database. C. Problem solving and critical thinking reports: Students report on special instances of engaging in the process of problem solving, exploring beyond basic features, and troubleshooting, when performing application software tasks. (A- E) D. Mid-term and final assessment theory exams (A- E) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Adamski, J. et al. . (2008) New Perspectives on Microsoft Access 2007 Comprehensive , 2nd , Course Technology Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online with some required face-to-face meetings (“Hybrid”);iTV – Interactive video = Face to face course with significant required activities in a distance modality ;Other; 30. MINIMUM QUALIFICATIONS: Business (Masters Required);Computer Information Systems;Computer Science (Masters Required); 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision 09/25/2009 Curriculum Committee Approval 02/26/2010 Board of Trustees State Approval UC Approval CSU Approval UC Approval Status 70 = Fall 2005 IGETC Approval CSU Approval Status IGETC Approval Status file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C165.htm[4/8/2013 1:25:44 PM] CSCI C165 CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000269460 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): XXXXXXXX = Not qualified for SEQ code (qual for CAN only); Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C165.htm[4/8/2013 1:25:44 PM] CSCI C171 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE CSCI C171 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: CSCI C171 2. COURSE TITLE: Introduction to the Internet and the World Wide Web 3. SHORT BANWEB TITLE: Intro to Internet/www 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 30 = Spring 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC Course Revision 9. START TERM: 50 = Summer, 2011 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This course provides a hands-on introduction to the Internet and World Wide Web, including electronic mail, file transfer protocol (FTP), browser use, web page development, security, e-commerce, search strategies, copyrights, and social networking. Advisory: CSCI C070, Reading level 1, Writing Level 1. 12. GRADING METHOD S = Standard Letter Grade Default: A = Audit;CR;P = Pass/No Pass;Pass/NoPass;A = Audit Optional: 13. TOTAL UNITS: 1 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0.5 Lab 0.5 Activity Min Hours 9 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Elective: Business Office Technology (AS Degree Program) Business Office Technology- (Certificate of Achievement) 21. GENERAL EDUCATION APPLICABILITY Local: IGETC: file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C171.htm[4/8/2013 1:25:44 PM] CSCI C171 CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Describe the origins of the Internet and significant events in its evolution. This will be measured by exam. 2. Formulate effective strategies for using the Internet. This will be measured by a project and scored with a rubric. 3. Assess security threats and develop effective countermeasures. This will be measured by project and scored with a rubric. 4. Differentiate between legal and illegal uses of resources. This will be measured by exam. 5. Analyze the Internet as a communications tool. This will be measured by exam. 23. REQUISITES Prerequisite: CSCI C070 Advisory: Advisory 5 Reading Level 1, Writing Level 1 24. DETAILED TOPICAL OUTLINE: Lecture: A. History of the Internet and World Wide Web (A) 1. History of the Internet and World Wide Web B. Browser Basics (B) 1. Internet and the World Wide Web 2. Web page display elements 3. Web Page Addresses 4. Web Browser Functions 5. Browser customization 6. Bookmark (favorites) organization 7. New documents C. E-mail {B, C) 1. Functions of E-mail 2. E-mail client customization 3. E-mail programs and services D. Searching the Web (B, C) 1. Types of research questions 2. Web search strategies 3. Web search engines, directories, and metasearch engines 4. Boolean logic and filtering techniques 5. Advanced search options 6. Validity and quality of search results 7. Future of Web search tools E. Information Resources (B, D) 1. Current news and weather, maps and city guides 2. Businesses and people 3. Library and text resource citations 4. Copyrights analysis 5. Graphic and multimedia resources 6. Future of online publishing F. Downloading and Storing Data (B, D) 1. FTP (File Transfer Protocol) 2. FTP client evaluation 3. File compression and viruses 4. Connection between a user’s computer and a remote computer 5. Storage options on the Internet 6. New technologies for collaborative authoring G. Real-Time Communication (C, E) 1. Internet chat 2. Chat rooms devoted to specific topics 3. Businesses that allow users to create their own chat rooms 4. Virtual communities and their use in business 5. History of the wireless Internet 6. Wireless networks and devices 7. Wireless carriers 8. Wireless broadband networks file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C171.htm[4/8/2013 1:25:44 PM] CSCI C171 H. Mass Communication (B, C, E) 1. Availability of mailing lists 2. Joining and leave mailing lists 3. Mailing list message composition and retrieval 4. Usenet newsgroups 5. Newsgroup configuration and subscriptions 6. Newsgroup posts and replies 7. RSS (Really Simple Syndication) 8. Newsfeeds on specific topics 9. Aggregators 10. Podcasting I. Creating Effective Web Pages (E) 1. HTML (Hypertext Markup Language) 2. The tools used to create HTML documents 3. Tags and attributes 4. HTML document creation 5. Microsoft FrontPage and Adobe Dreamweaver 6. JavaScript, Flash, and Shockwave 7. Web hosting services 8. Search engine submission and search engine optimization J. Security (C, D) 1. Security basics 2. hackers and crackers 3. Online crime, warfare, and terrorism 4. Protect copyrighted material 5. Web client, online communications, and Web server threats and countermeasures 6. Sources of current information and updates about online security K. Electronic Commerce (B, C, D) 1. Business Web sites 2. Basics of electronic commerce 3. Online revenue generation 4. New ways of doing business online 5. Consumer concerns 6. International, legal, and ethical concerns Lab: Students will be required to demonstrate their ability to use software and services to obtain and use information, collaborate with others via the Internet, and make informed decisions about security and social networking. Examples: design a personal Web site and professionally evaluate and upgrade security measures. 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; 2. Laboratory; 3. Lecture; 4. Other Methods: A. Classroom lecture and demonstration of software and Web services. B. Laboratory application of concepts including practical applications such as creating web sites and applying appropriate security measures to computers. C. Synchronous and asynchronous discussions about social issues and the impact they have on making decisions about computers, information, and society. D. Textbook tutorials. 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Chapter readings B. Lab assignments 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to A. Objective tests/quizzes demonstrating student’s knowledge of fundamental Internet concepts and protocols. (A, E) B. Lab assignments demonstrating student’s ability to apply learning to real-world activities. (A-E) C. Essays in an asynchronous environment demonstrating a student’s ability to perform critical analyses and defend opinions. (A, C, E) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Schneider, G. P. & Evans, J. . (2008) New Perspectives on the Internet--Comprehensive , 7th , Cengage Learning Manuals Periodicals Software Other file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C171.htm[4/8/2013 1:25:44 PM] CSCI C171 29. METHOD OF DELIVERY: Online with some required face-to-face meetings (“Hybrid”);Other; 30. MINIMUM QUALIFICATIONS: Computer Information Systems;Computer Science (Masters Required); 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision 04/25/2008 Curriculum Committee Approval 04/25/2008 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 50 = Summer 2000 IGETC Approval CSU Approval Status IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000373611 TOP Code (CB03) 0514.00 - Office Technology/Office ; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1 Course Units of Credit Minimum Low (CB07): 1 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): D = Possible Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): YYYYYYYY = Not qualified for CAN code; Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/CSCI%20C171.htm[4/8/2013 1:25:44 PM] EMTC C070 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE EMTC C070 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: EMTC C070 2. COURSE TITLE: CPR for the Healthcare Provide 3. SHORT BANWEB TITLE: CPR for the Healthcare Provide 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: HCRS CPR for the Healthcare Provide 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This is a Healthcare Provider - CPR Course that meets or exceeds the current American Heart Association standards. The course provides training in emergency treatment for life-threatening cardiopulmonary arrest, airway and breathing management, and foreign body obstructed airway for all age groups. This course also includes one and two rescuer CPR, use of barrier devices, AED use and the prevention of disease transmission. 12. GRADING METHOD P = Pass/No Pass Default: A = Audit Optional: 13. TOTAL UNITS: 0.5 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0 Lab 0 Min Hours 0 0 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0.5 0 0 0 0 10 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Job Skills Certificate;Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Vocational Nursing (AS Degree Program) Vocational Nursing Cert (Certificate of Achievement) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/...Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C070.htm[4/8/2013 1:25:45 PM] EMTC C070 IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. A. Describe the steps of CPR a. When to start CPR b. When to give breaths, including with barrier devices c. When to check for a pulse d. How to give compressions at the proper depth and rate and with complete chest recoil e. When to use an AED This will be assessed by the student passing the written component at 82% or better 2. B. Describe the signs and actions for severe airway obstruction in the responsive and unresponsive victim This will be assessed by the student passing the written component at 82% or better 3. C. Describe the links in the Chain of Survival, including the importance of a. Activating the appropriate emergency response system b. Performing CPR c. Providing early defibrillation d. Ensuring the arrival of early advanced care by activating the appropriate emergency response system This will be assessed by the student passing the written component at 82% or better 4. D. Describe the signs of four common life threatening emergencies in adults a. Cardiac arrest b. Choking c. Stroke d. Heart attack This will be assessed by the student passing the written component at 82% or better 5. E. Demonstrate the following skills a. Activating the emergency response system b. Giving breaths for adult, child and infants using i. Mouth to mouth ventilation ii. Mouth to mask ventilation iii. Bag mask ventilation c. Giving compressions for adult, child and infant victims i. Pushing hard and fast ii. Allowing full chest recoil iii. Minimizing interruptions in compressions d. Performing one and two rescuer CPR for adult, child, and infant victims e.Using an AED for victims > 1 year of age f. Relieving choking in the responsive and unresponsive victim of any age This will be assessed by the student demonstrating 100% competency of the skills check sheet 23. REQUISITES 24. DETAILED TOPICAL OUTLINE: Lecture: A. Chest Compressions on an Adult (A-E) i. Proper hand placement ii. Perform 3 sets of 30 compressions to correct depth without stopping iii. Push Hard-Push Fast iv. Allow full chest recoil B. Airway and Breathing on an Adult (A-E) i. Perform head tilt-chin lift ii. Give 5 sets of 2 mouth to mouth breaths iii. Give 5 sets of 2 breaths with mask C. Compressions and Breaths on an Adult (A-E) i. Learn how to put compressions and breaths together with 30:2 ratio ii. Perform 3 cycles of 30:2 D. Assessment on an Adult (A-E) i. Assess responsiveness ii. Activate emergency response, get AED iii. Check breathing iv. Give 2 breaths v. Check carotid pulse E. One Rescuer Adult CPR Demo (A-E) i. Understand full sequence of 1-rescuer CPR with mask ii. Demonstrate full sequence of 1-rescuer CPR for adult F. One Rescuer Child CPR Sequence (A-E) i. Recognize similarities and differences between adult and child CPR ii. Demonstrate full sequence of 1 rescuer CPR for a Child G. Adult Rescue Breathing with Bag Mask (A-E) i. Provide 1 minute of rescue breathing using bag mask, 1 breath every 5 to 6 seconds H. Two Rescuer CPR (A-E) i. Understand how to do 2 rescuer CPR I. Using the AED Trainer (A-E) i. Know how to use the trainer J. Two Rescuer CPR with AED (A-E) i. Understand how to do 2 rescuer CPR with AED ii. Demonstrate full sequence of CPR with AED iii. Understand special situations when using an AED K. Advanced Airway and 2 rescuer CPR (A-E) i. First rescuer performs 1 minute of rescue breathing using bag mask, 1 breath every 6 to 8 seconds ii. Second rescuer continues chest compressions L. Infant CPR (A-E) file:///G|/...Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C070.htm[4/8/2013 1:25:45 PM] EMTC C070 i. Perform chest compressions ii. Show proper finger position (2 finger technique) iii. Perform 3 sets of 30 compressions to correct depth without stopping iv. Push Hard-Push Fast v. Allow full chest recoil M. One Rescuer Infant CPR (A-E) i. Perform full sequence of 1 rescuer CPR for infant N. Infant Rescue Breathing with Bag Mask (A-E) i. Give 1 minute of rescue breaths with bag mask, giving 1 breath every 3 to 5 seconds ii. Show chest rise with breaths O. Two Rescuer Infant CPR (A-E) i. Demonstrate how to perform 2 rescuer CPR P. Adult/Child Choking (A-E) i. Understand how to relieve choking in a responsive victim aged 1 year and older ii. Know how to activate the emergency response system iii. Know to start CPR if a choking adult/child becomes unresponsive Q. Infant Choking (A-E) i. Identify the signs of choking in the responsive infant ii. Demonstrate how to relieve choking in the responsive infant iii. Know to start CPR if a choking infant becomes unresponsive R. Special Considerations (A-E) i. Scene safety ii. Personal protection iii. Cricoid pressure iv. Jaw thrust v. Agonal gasps vi. Recovery position vii. Chain of Survival viii. Recognition of 4 common life threatening emergencies 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Demonstration; 2. Discussion; 3. Laboratory; 4. Lecture; 5. Other Methods: Activity, work experience, video/DVD, textbook exercises 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to Written test provided by AHA Demonstration of skills 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks American Heart Association. (2006) BLS for Healthcare Provider, , AHA National Center Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Face to face; 30. MINIMUM QUALIFICATIONS: Emergency Medical Technologies;Nursing (Masters Required); 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision Curriculum Committee Approval Board of Trustees State Approval file:///G|/...Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C070.htm[4/8/2013 1:25:45 PM] EMTC C070 UC Approval UC Approval Status CSU Approval CSU Approval Status IGETC Approval IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000362627 TOP Code (CB03) 1250.00 - Emergency Medical Service; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) C = Not Transferable Course Units of Credit Maximum High (CB06): 0.5 Course Units of Credit Minimum Low (CB07): 0.5 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): XXXXXXXX = Not qualified for SEQ code (qual for CAN only); Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/...Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C070.htm[4/8/2013 1:25:45 PM] EMTC C105 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE EMTC C105 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: EMTC C105 2. COURSE TITLE: Emergency Medical Technician 3. SHORT BANWEB TITLE: E.M.T. 4. COURSE AUTHOR: Metcalf, Michael J. 5. COURSE SEATS: 6. COURSE TERMS: 30 = Spring; 70 = Fall; 50 = Summer 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC Course Revision 9. START TERM: 30 = Spring, 2012 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This course provides instruction in pre-hospital techniques in the evaluation and emergency medical care through the recognition of signs and symptoms of illnesses and injuries. This course also includes instruction in the care rendered on scene and during transportation by EMT personnel. The student shall meet health requirements to participate in the clinical section of the course. Any expenses involved in meeting the health requirements are at the student's expense. Failure to meet the health requirements results in student ineligibility for clinical objectives. Upon successful completion of the mandated course criteria the student receives a Certificate of Completion and this qualifies the student to apply and take the national exam for the Emergency Medical Technician, to ultimately qualify for application within the State of California to become certified. The student must provide a valid American Heart Association Healthcare Provider CPR/AED card to the instructor at the first class session to remain enrolled in this course. 12. GRADING METHOD S = Standard Letter Grade Default: P = Pass/No Pass;A = Audit Optional: 13. TOTAL UNITS: 6.5 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 5 Lab 1.5 Activity Min Hours 90 81 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Legally Mandated Training Limit: Unlimited 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Emergency Medical Services (AS Degree Program) file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 Emergency Medical Technician- (Job Skills Certificate) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Recognize minor to major medical and trauma patient conditions 2. Demonstrate appropriate scene survey, patient assessment, management and treatment of medical and trauma patients, in a safety conscious manner, to the training level of an EMT. 3. Identify the basic topographical anatomy of the human body organ systems. 4. Demonstrate knowledge and ability according to the standards established by the U.S. National Highway Traffic Safety Administration by passing the Emergency Medical Technician level national practical and cognitive exams. 5. Explain how the human organ systems react in various medical and traumatic conditions. 23. REQUISITES Advisory: Advisory Students in this course will read technical language in texts and other resource materials written at the college level. Students must be able to have a college level competency in reading to interpret, identify central points, and disseminate the material presented to progress throughout the course. Reading, Level I Advisory Students in this course must be able to articulate information related to patient evaluation and care in a written form using the English language, medical terminology and anatomical terms. Students must have the ability to provide written patient information in a clear, concise, structured, and logical manner. Writing, Level I HCRS C150 24. DETAILED TOPICAL OUTLINE: Lecture: Emergency Medical Technician Instructional Guidelines National Emergency Medical Services Education Standards Preparatory EMS Systems EMT Education Standard I. The Emergency Medical Services System A. History 1. 1960s 2. Evolution to current EMS systems B. NHTSA Technical Assistance Program Assessment Standards 1. Regulation and policy 2. Resource management 3. Human resources and training 4. Transportation 5. Facilities C. Access to Emergency Medical Services D. Education 1. Levels of EMS licensure 2. National EMS Education Agenda for the Future: A Systems Approach E. Authorization to Practice 1. Legislative decisions on scope of practice 2. State EMS office oversight 3. Medical oversight a. Clinical protocols i. Offline file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 ii. Online iii. Standing orders b. Quality improvement c. Administrative 4. Local credentialing 5. Administrative 6. Employer policies and procedures II. Roles, Responsibilities, and Professionalism of EMS Personnel A. Roles and Responsibilities 1. Maintain vehicle and equipment readiness 2. Safety a. Personal b. Patient c. Others on the scene 3. Operate emergency vehicles 4. Provide scene leadership 5. Perform patient assessment 6. Administer emergency medical care to a variety of patients with varied medical conditions 7. Provide emotional support a. Patient b. Patient’s family c. Other responders 8. Integration with other professionals and continuity of care a. Medical personnel b. Law enforcement c. Emergency management d. Home healthcare providers e. Other responders 9. Resolve emergency incident 10. Maintain medical and legal standards 11. Provide administrative support 12. Enhance professional development 13. Develop and maintain community relations B. Professionalism 1. Characteristics of professional behavior a. Integrity b. Empathy c. Self-motivation d. Appearance and hygiene e. Self-confidence f. Time management g. Communication i. verbal ii. written h. Teamwork and diplomacy i. Respect for patients, co-workers and other healthcare professionals j. Patient advocacy k. Careful delivery of service 2. Maintenance of certification and licensure a. Personal responsibility b. Continuing education c. Skill competency verification d. Criminal implications e. Fees III. Quality Improvement A. System for Continually Evaluating and Improving Care B. Continuous Quality Improvement (CQI) C. Dynamic Process IV. Patient Safety A. Significant – One of the Most Urgent Health Care Challenges B. High-Risk Activities 1. Hand-off 2. Communication issues 3. Dropping patients 4. Ambulance crashes 5. Spinal immobilization file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 C. How Errors Happen 1. Skills-based failure 2. Rules-based failure 3. Knowledge-based failure D. Preventing Errors 1. Environmental a. Clear protocols b. Light c. Minimal interruptions d. Organization and packaging of drugs 2. Individual a. Reflection in action b. Constantly question assumptions c. Reflection bias d. Use decision aids e. Ask for help Preparatory Research I. Evidence-Based Decision-Making A. Traditional Medical Practice Is Based on 1. Medical knowledge 2. Intuition 3. Judgment B. High-Quality Patient Care Should Focus on Procedures Proven Useful in Improving Patient Outcomes C. The Challenge for EMS Is the Relative Lack of Prehospital Research D. Evidence-Based Decision-Making Technique 1. Formulate a question about appropriate treatments 2. Search medical literature for related research 3. Appraise evidence for validity and reliability 4. If evidence supports a change in practice, adopt the new therapy allowing for unique patient needs Preparatory Workforce Safety and Wellness I. Standard Safety Precautions A. Hand washing B. Adherence to Standard Precautions/OSHA Regulation C. Safe Operation of EMS/Patient Care Equipment D. Environmental Control E. Occupational Health and Blood borne Pathogens 1. Immunizations 2. Sharps II. Personal Protective Equipment III. Stress Management A. Types of Stress Reactions 1. Acute stress reaction 2. Delayed stress reaction 3. Cumulative stress reaction B. Stress Management 1. Change in lifestyle 2. Balance in life 3. Recognize response to family and friends 4. Change in work environment 5. Seek professional assistance C. Dealing With Death and Dying (stages) 1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance IV. Prevention of Work-Related Injuries A. Vehicle restraint systems B. Safe lifting techniques file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 C. Adequate sleep D. Physical fitness and nutrition E. Hazard awareness F. Adherence to Standard Precautions/OSHA regulations G. Disease transmission prevention 1. Communicable 2. Blood borne V. Lifting and Moving Patients A. Lifting techniques 1. Safety Precautions 2. Guidelines for lifting B. Safe Lifting of Cots and Stretchers 1. Power-lift or squat lift position 2. Power grip 3. Back in locked-in position 4. Carrying a. Precautions for carrying b. Guidelines for carrying c. Correct carrying procedure d. One-handed carrying technique e. Correct carrying procedure on stairs 5. Reaching a. Guidelines for reaching b. Application for reaching techniques c. Correct reaching for log rolls 6. Pushing and pulling guidelines a. Emergency move i. fire or danger of fire ii. explosives or other hazardous materials iii. other hazards at the scene iv. gain access to other patients in a vehicle who need lifesaving care v. patient’s location or position (e.g., a cardiac arrest patient sitting in a chair or lying on a bed) b. Indications for urgent move i. altered mental status ii. inadequate breathing iii. shock (hypoperfusion) c. Non-urgent move 7. Emergency moves a. Danger to patient b. Techniques 8. Urgent moves a. Danger to patient b. Techniques C. Techniques 1. Non-urgent moves a. Direct ground lift (no suspected spine injury) b. Extremity lift (no suspected extremity or back injuries) c. Transfer of supine patient from bed to stretcher i. direct carry ii. draw sheet method D. Equipment 1. Stretchers/cots a. Wheeled stretcher b. Portable stretcher c. Stair chair d. Scoop or orthopedic stretcher e. Flexible stretcher f. Bariatric stretcher g. Pneumatic or electronic stretchers 2. Standard 3. Tracked systems (i.e. backboards) i. long ii. short 4. Neonatal Isolette 5. Maintenance—follow manufacturer’s directions for inspection, cleaning, repair, and upkeep E. Patient Positioning file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 1. Unresponsive patient without suspected spine injury 2. A patient with chest pain, discomfort, or difficulty breathing 3. A patient with suspected spine injury 4. Pregnant patient with hypotension 5. A patient who is nauseated or vomiting 6. Bariatric patients 7. Patient Size F. Medical Restraint 1. Use of Force Doctrine 2. Reasonable Prevention of Harm a. Suicidal b. Homicidal c. Ambulances d. Ramps e. Winches G. Personnel Considerations VI. Disease Transmission VII. Wellness Principles A. Physical Wellbeing 1. Physical Fitness a. Cardiovascular endurance b. Muscle strength c. Muscle flexibility 2. Sleep 3. Disease prevention 4. Injury prevention B. Mental Wellbeing 1. Alcohol and drug issues 2. Smoking cessation 3. Stress management 4. Relationship issues Preparatory Documentation I. Principles of Medical Documentation and Report Writing A. Minimum Dataset 1. Patient information a. Chief complaint b. Initial assessment c. Vital signs d. Patient demographics 2. Administrative information a. Time incident reported b. Time unit notified c. Time of arrival at patient d. Time unit left scene e. Time of arrival at destination f. Time of transfer of care 3. Accurate and synchronous clocks B. Prehospital Care Report 1. Functions a. Continuity of care b. Legal document i. documented what emergency medical care was provided, the status of the patient on arrival at the scene, and any changes upon arrival at the receiving facility ii. the person who completed the form ordinarily must go to court with the form iii. information should include objective and subjective information and be clear c. Educational—used to demonstrate proper documentation and how to handle unusual or uncommon cases d. Administrative i. billing ii. service statistics e. Research f. Evaluation and continuous quality improvement file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 2. Uses a. Types i. traditional written form with check boxes and a section for narrative ii. computerized version where information is filled in by means of an electronic device or over the Internet b. Sections i. run data ii. patient data iii. check boxes a) be sure to fill in the box completely b) avoid stray marks iv. narrative section (if applicable) a) describe, don’t conclude b) include pertinent negatives c) record important observations about the scene d) avoid radio codes e) use abbreviations only if they are standard f) when information of a sensitive nature is documented, note the source of that information g) State reporting requirements h) be sure to spell words correctly, especially medical words i) for every reassessment, record time and findings v. other State or local requirements c. Confidentiality d. Distribution e. Health Information Portability and Accountability Act of 1996 (HIPAA) 3. Falsification Issues a. When an error of omission or commission occurs, document what did or did not happen and what (if any) steps were taken to correct the situation b. Falsification of information on the prehospital care report c. Specific areas of difficulty i. vital signs—document only the vital signs that were actually taken ii. treatment—if a treatment like oxygen was overlooked, do not chart that the patient was given oxygen C. Documentation of Patient Refusal 1. Competent adult patients have the right to refuse treatment 2. Before leaving the scene a. Try again to persuade the patient to go to a hospital b. Ensure the patient is able to make a rational, informed decision c. Inform the patient why he should go and what may happen to him if he does not d. Consult medical direction as directed by local protocol e. If the patient still refuses, document any assessment f. Have a family member, police officer or bystander sign the form as a witness. If the patient refuses to sign the refusal form, have a family member, police officer, or bystander sign the form verifying that the patient refused to sign. g. Complete the prehospital care report i. complete patient assessment ii. if the patient refused care or did not allow a complete assessment, document that the patient did not allow for proper assessment and document whatever assessments were completed iii. care EMT wished to provide for the patient iv. statement that the EMT explained to the patient the possible consequences of failure to accept care, including potential death v. offer alternative methods of gaining care vi. state willingness to return D. Special Situations/Reports/Incident Reporting 1. Correction of errors a. Errors discovered while the report form is being hand-written i. draw a single horizontal line through the error, initial it, and write the correct information beside it ii. do not try to obliterate the error—this may be interpreted as file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 an attempt to cover up a mistake b. Errors discovered after a hand-written report form is submitted i. preferably in a different color ink, draw a single line through the error, initial and date it, and add a note with the correct information ii. if information was omitted, add a note with the correct information, the date, and the EMT’s initials c. Errors discovered while/after completing an electronic report i. most electronic prehospital care report systems have a method for entering and amending the report ii. if there is no way to electronically submit a change or addendum one should follow the correction method used for a handwritten report that has already been submitted on the printout of the electronic report 2. Multiple-Casualty Incidents (MCI) a. When there is not enough time to complete the form before the next call, the EMT will need to fill out the report later b. The local MCI plan should have some means of recording important medical information temporarily c. The standard for completing the form in an MCI is not the same as for a typical call 3. Special situation reports a. Used to document events that should be reported to local authorities, or to amplify and supplement primary report b. Should be submitted in timely manner and should include the names of all agencies, people, and facilities involved c. Should be accurate and objective; be descriptive and don’t make conclusions d. The EMT should keep a copy for his own records, as appropriate e. The report, and copies if appropriate, should be submitted to the authority described by local protocol f. Exposure g. Injury 4. Information gathered from the prehospital care report can be used to analyze various aspects of the EMS system 5. This information can then be used to improve different components of the system and prevent problems from occurring 6. Drop report/transfer report a. Goal should be to provide a report prior to departing from the hospital – needs to contain minimum data set and a transfer signature b. EMT should keep a copy of this transfer report for use as a reference during the primary prehospital care report and should submit the copy with the final prehospital care report Preparatory EMS System Communication I. EMS Communication System A. System Components 1. Base station 2. Mobile radios (transmitter/receivers) a. Vehicular mounted device b. Mobile transmitters usually transmit at lower power than base stations (typically 20-50 watts) c. Typical transmission range is 10-15 miles over average terrain 3. Portable radios (transmitter/receivers) a. Handheld device b. Typically have power output of 1-5 watts, limiting their range 4. Repeater/base station 5. Digital radio equipment 6. Cellular telephones B. Radio Communications 1. Radio frequencies 2. Response to the scene a. The dispatcher needs to be notified that the call was received b. Dispatch needs to know that the unit is en route 3. Arrival at the scene – dispatcher must be notified 4. Depart the scene a. Dispatcher must be notified file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 b. Prolonged on-scene times with absence of communications 5. Arrival at the receiving facility or rendezvous point – dispatcher must be notified 6. Arrival for service after patient transfer – dispatcher must be notified II. Communication With Other Health Care Professionals A. Communication With Medical Control 1. Medical control a. At the receiving facility b. At a separate site 2. EMTs may need to contact medical control for consultation and to get orders for administration of medications 3. EMTs must be accurate 4. After receiving an order for a medication or procedure—repeat the order back word for word 5. Orders that are unclear or appear to be inappropriate should be questioned or clarified for the EMT B. Communication With Receiving Facilities 1. EMT having the right room, equipment, and personnel prepared or allow the facility to plan for the patient 2. Patient reporting concepts a. When speaking on the radio, keep these principles in mind: i. make sure the radio is on and volume is properly adjusted ii. listen to the frequency and ensure it is clear before beginning a transmission iii. press the “press to talk” (PTT) button on the radio and wait for one second before speaking iv. speak with lips about two to three inches from the microphone v. address the unit being called, and then give the name of the unit vi. the unit being called will signal that the transmission should start vii. speak clearly, calmly, and slowly in a monotone voice viii. keep transmissions brief ix. use clear text x. avoid codes or agency-specific terms xi. avoid meaningless phrases like “be advised” xii. courtesy is assumed, one should limit saying “please,” “thank you,” and “you’re welcome” xiii. when transmitting a number that might be confused (e.g., a number in the teens), give the number, then give the individual digits xiv. the airwaves are public and scanners are popular xv. remain objective and impartial in describing patients xvi. do not use profanity on the air xvii. avoid words that are difficult to hear like “yes” and “no;” use “affirmative” and “negative” xviii. use the standard format for transmission of information xix. When the transmission is finished, indicate this by saying “over” xx. avoid codes xxi. avoid offering a diagnosis of the patient’s problem xxii. use EMS frequencies only for EMS communication xxiii. reduce background noise b. Notify the dispatcher when the unit leaves the scene c. When communicating with medical direction or the receiving facility, a verbal report should be given. The essential elements of such a report, in an order that is efficient and effective, are: i. identify unit and level of provider (can utilize the name of the provider giving the report as well as the unit identification) ii. estimated time of arrival iii. current patient condition iv. patient’s age and sex v. mental status vi. chief complaint vii. brief, pertinent history of the present illness viii. major past illnesses ix. baseline vital signs x. pertinent findings of the physical exam file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 xi. emergency medical care given xii. response to emergency medical care d. After giving this information, the EMT will continue to assess the patient e. Arrival at the hospital i. the dispatcher must be notified ii. in some systems, the hospital should also be notified f. Leaving the hospital for the station – dispatcher should be notified g. Arrival at the station – dispatcher should be notified C. System Maintenance 1. Communication equipment needs to be checked to ensure that a radio is not drifting form its assigned frequency 2. As technology changes, new equipment becomes available that may have a role in EMS systems 3. EMT need to be able to consult on-line medical direction, and EMS system must provide back-up D. Phone/Cellular Communications 1. Should be treated similar to radio communications when it comes to content and strategies for delivery of pertinent information 2. The EMT should be familiar with important and commonly utilized telephone numbers, such as medical control, local hospital Emergency Departments, dispatch centers 3. The EMT should also have a familiarity with cellular technologies and knowledge of the location of cellular dead spots in the area 4. There should be another plan for when a cellular transmission fails during a report or communication with another agency III. Team Communication and Dynamics IV. Communication A. Interpersonal Communication 1. The EMT should self-introduce at the start of any conversation 2. Make and keep eye contact, if appropriate 3. When practical, position yourself at a level lower than the patient or on the same level 4. Be honest with the patient 5. Use language the patient can understand and avoid medical jargon 6. Be aware of your own body language 7. Speak calmly, clearly, slowly and distinctly 8. Use the patient’s proper name, either first or last, depending on the circumstances 9. If a patient has difficulty hearing, speak clearly with lips visible 10. Allow the patient enough time to answer a question before asking the next one 11. Act and speak in a calm, confident manner B. Communication With Hearing-Impaired, Non-English Speaking Populations and Use of Interpreters—Be Positioned to Address Any of These Special Situations Preparatory Therapeutic Communication I. Principles of Communicating With Patients in a Manner That Achieves a Positive Relationship A. Adjusting Communication Strategies 1. Age-appropriate 2. Stage of development 3. Patients with special needs (i.e. hearing-impaired patients) 4. Differing cultures a. Transcultural considerations i. introduce yourself and the way in which you want to be called ii. both the EMT and the patient will bring cultural stereotypes to a professional relationship iii. ethnocentrism iv. cultural imposition v. space a) intimate zone b) personal distance c) social distance d) public distance file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 vi. cultural issues a) variety of space b) accept the sick role in different ways c) nonverbal communication may be perceived differently d) Asians, Native Americans, Indochinese, and Arabs may consider direct eye contact impolite or aggressive vii. touch viii. language barrier B. Interviewing Techniques 1. Non-verbal skills a. Physical appearance i. interviewer ii. patient b. Posture and gestures i. interviewer ii. patient iii. gestures a) facial expressions b) eye contact c) voice d) touch 2. Using questions a. Open-ended questions b. Closed or direct questions c. One question at a time d. Choose language the patient understands 3. Hazards of interviewing a. Providing false assurance or reassurance b. Giving advice c. Leading or biased questions d. Talking too much e. Interrupting f. Using “why” questions g. Authority h. Professional jargon C. Verbal Defusing Strategies 1. Interviewing a Hostile Patient a. Build rapport with patient b. Maintain professional non-threatening demeanor D. Family Presence Issues 1. Family presence issues a. Situations i. adult ii. children iii. elderly b. Department policies c. EMT response d. Family preference II. Communication A. Communication Process and Components 1. Encoding 2. Message 3. Decoding 4. Receiver 5. Feedback III. Types of Responses A. Facilitation B. Silence C. Reflection D. Empathy E. Clarification F. Confrontation G. Interpretation H. Explanation I. Summary file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 IV. Developing Patient Rapport A. Put the Patient at Ease B. Put Yourself at Ease V. Strategies to Ascertain Information A. Obtaining Information on Complaints 1. Resistance 2. Shifting focus 3. Defense mechanisms 4. Distraction VI. Special Interview Situations A. Patients Unmotivated to Talk 1. Most patients are more than willing to talk 2. Techniques to use a. Start the interview in the normal manner b. Attempt to use open-ended questions c. Provide positive feedback d. Make sure the patient understands the questions e. Continue to ask questions f. Utilize language line if available B. Patients Under the Influence of Street Drugs or Alcohol C. Communication With Elderly 1. Potential for visual deficit 2. Potential for auditory deficit 3. Obtain glasses and hearing aid D. Communication With Pediatric Patient 1. Use parent and caregiver 2. Clear explanations Preparatory Medical/Legal and Ethics I. Consent/Refusal of Care A. Consent to Care a. Nature of illness b. Treatments recommendations c. Risks (i.e. refusal) d. Alternatives B. Types of Consent 1. Expressed consent -- Non-verbal 2. Informed consent -- Research 3. Implied consent (emergency doctrine) a. Physical incapacitation b. Mental incapacitation 4. Involuntary consent a. Mental health b. Incarceration 5. Minors a. Parental permission i. in loco parentis ii. emergency doctrine b. Emancipation i. married ii. armed services iii. independence 6. Medical restraint -- use of force doctrine a. reasonable prevention of harm i. suicidal ii. homicidal b. non-punitive C. Legal Complications Related to Consent 1. Abandonment 2. False imprisonment 3. Assault 4. Battery D. Refusal of Care and/or Transportation 1. Patient must be alert and oriented to person, place, and time 2. Patient must be informed of the risks of refusing care (e.g., death) 3. Patient must be informed if problems return/persist they should call EMS file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 or see a physician 4. Against medical advice a. Due diligence i. standard of care ii. medical control b. Documentation II. Confidentiality A. Obligation to Protect Patient Information B. Health Information Portability and Accountability Act (HIPAA) C. Responsibility Arising From Physician – Patient Relationship 1. Assessment findings 2. Treatments rendered D. Privileged Communications 1. Need to know 2. Education 3. Legally mandated a. Child abuse reported b. Subpoena 4. Third party billing 5. Release of medical information E. Breach of Confidentiality 1. Libel 2. Slander III. Advanced Directives A. Patient Self-Determination Act 1. Do Not Resuscitate (DNR) 2. Living wills 3. Durable power of attorney IV. Tort and Criminal Actions A. Criminality 1. Breaches of conduct a. Assault b. Battery c. Kidnapping 2. Mandatory reporting requirements a. Abuse and assault i. child abuse or neglect ii. elder abuse iii. domestic violence b. Criminality i. sexual assault ii. penetrating trauma a) gunshot b) stab wounds c. Communicable diseases i. reportable ii. animal bites B. Civil Tort 1. Concept of Negligence a. Res Ispa Loquitur b. Negligence per se 2. Elements of negligence a. Duty to act b. Breach of duty c. Damages to plaintiff i. physical (e.g., lost earnings) ii. psychological (e.g., pain and suffering) iii. punitive d. Proximate causation e. Defenses i. good samaritan ii. governmental immunity iii. statute of limitations iv. contributory negligence f. Protection from liability i. professionalism ii. standard of care iii. liability insurance file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 C. Mandatory Reporting 1. Legally compelled to notify authorities a. Abuse b. Neglect 2. Arises from special relationship with patient 3. Legal liability for failure to report V. Evidence Preservation VI. Statutory Responsibilities VII. Mandatory Reporting VIII. Ethical Principle/Moral Obligations A. Morals – concept of right and wrong B. Ethics 1. Branch of philosophy 2. Study of morality C. Applied Ethics (i.e., Use of Ethical Values) D. Ethical Conflicts 1. Futility of care (cardiac arrest in the wilderness) 2. Allocation of limited resources – medical rationing (e.g., Triage) 3. Professional misconduct (e.g., patient abuse) 4. Economic triage (e.g., patient dumping) Anatomy and Physiology I. Anatomy and Body Functions A. Anatomical Planes 1. Frontal or coronal plane 2. Sagittal or lateral plane 3. Transverse or axial plane B. Standard Anatomic Terms C. Body Systems 1. Skeletal a. Components i. skull ii. face iii. vertebral column iv. thorax v. pelvis vi. upper extremities vii. lower extremities b. Joints c. Function 2. Muscular a. Types i. skeletal ii. smooth iii. cardiac b. Function 3. Respiratory system a. Structures i. upper airway a) nose b) mouth/teeth c) tongue/jaw d) nasopharynx e) oropharynx f) epiglottis g) larynx ii. lower airway a) trachea b) bronchi c) bronchioles d) alveoli iii. structures that support ventilation a) chest wall b) pleura c) diaphragm file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 d) intercostal muscles e) phrenic nerve f) pulmonary capillaries b. Anatomic differences between pediatric and adult airway anatomy c. Function i. ventilation ii. respiration iii. alveolar/capillary gas exchange iv. buffer 4. Circulatory system a. Structures i. heart a) chambers b) coronary arteries ii. arterial a) aorta b) arteries c) arterioles iii. capillaries a) pulmonary b) tissue/cells iv. venous a) venae cava b) veins c) venules b. Blood components i. red blood cells ii. white blood cells iii. clotting factors iv. plasma c. Function i. perfusion ii. tissue/cell gas exchange iii. reservoir iv. blood buffer v. infections response vi. coagulation 5. Nervous system a. Structural division i. central nervous system (CNS) a) brain b) spinal cord ii. peripheral nervous system (PNS) b. Functional i. autonomic a) sympathetic b) parasympathetic c. Functions of the nervous system i. consciousness a) cerebral hemispheres b) reticular activating system (center of consciousness) ii. sensory function iii. motor function iv. fight-or-flight response 6. Integumentary (skin) a. Structures i. epidermis ii. dermis iii. subcutaneous layer b. Functions of the Skin i. protection ii. temperature control 7. Digestive system a. Structures i. esophagus ii. stomach iii. intestines iv. liver v. pancreas 8. Endocrine system file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 a. Structures i. pancreas ii. adrenal glands a) epinephrine b) norepinephrine b. Function i. control of blood glucose level ii. stimulate sympathetic nervous system a) receptors b) beta 2 stimulation 9. Renal system a. Structures i. kidneys ii. bladder iii. urethra b. Function i. blood filtration ii. fluid balance iii. buffer 10. Reproductive system a. Male i. structures a) testicles b) penis ii. functions a) reproduction b) urination c) hormones b. Female i. structures a) ovaries b) fallopian tubes c) uterus d) vagina ii. functions a) reproduction b) hormones II. Life Support Chain A. Fundamental Elements 1. Oxygenation a. Alveolar/capillary gas exchange b. Cell/capillary gas exchange 2. Perfusion a. Oxygen b. Glucose c. Removal of carbon dioxide and other waste products 3. Cell environment a. Aerobic metabolism i. high ATP (energy) production ii. byproduct of water and carbon dioxide b. Anaerobic metabolism i. low ATP (energy) production ii. byproduct of lactic acid B. Issues Impacting Fundamental Elements 1. Composition of ambient air 2. Patency of the airway 3. Mechanics of ventilation 4. Regulation of respiration 5. Ventilation/perfusion ratio 6. Transport of gases 7. Blood volume 8. Effectiveness of the heart as a pump 9. Vessel size and resistance (systemic vascular resistance) 10. Effects of acid on cells and organs III. Age-Related Variations for Pediatrics and Geriatrics (see Special Patient Populations) Medical Terminology file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 I. Medical Terminology A. Prefixes B. Root Words C. Suffixes D. Combining Forms II. Medical Terms A. Associated With Body Structure B. Associated With Body Systems C. Associated With Body Direction or Position III. Standard Medical Abbreviations and Acronyms Pathophysiology I. Composition of Ambient Air A. Oxygen B. Nitrogen C. Carbon Dioxide D. Fraction of Inspired Oxygen E. Fraction of Delivered Oxygen II. Patency of the Airway A. Anatomical Considerations B. Airway Obstruction 1. Various anatomic levels a. Nasopharynx b. Oropharynx c. Pharynx d. Larynx e. Trachea f. Bronchi 2. Causes of obstruction III. Respiratory Compromise A. Changes in Structure or Function of 1. Anatomic boundaries of the thorax 2. Pleural lining 3. Muscles of ventilation 4. Accessory muscles of ventilation 5. Inhalation a. Muscle activity b. Changes in intrapleural and intrapulmonary pressures c. Active process 6. Exhalation a. Muscle activity b. Changes in intrapleural and intrapulmonary pressures c. Passive process 7. Minute ventilation a. Tidal volume b. Respiratory rate 8. Alveolar ventilation a. Tidal volume b. Dead air space c. Respiratory rate 9. Signs of mechanical ventilation impairment 10. Effects of inadequate tidal volume and respiratory rate a. Minute ventilation b. Alveolar ventilation 11. Hypoxia caused by poor mechanical ventilation IV. Alteration in Regulation of Respiration Due to Medical or Traumatic Conditions A. Chemoreceptors B. Stretch receptors C. Medulla rhythm centers D. Effects of arterial carbon dioxide and oxygen content on respiration rate and depth E. Hypoxia caused by respiratory regulation disturbance V. Ventilation/Perfusion (V/Q) Ratio and Mismatch file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 A. Apex of Lung B. Base of Lung C. Ventilation Disturbance Related to Hypoxemia D. Perfusion Disturbance Related to Hypoxemia VI. Perfusion and Shock A. Oxygen 1. Dissolve in plasma 2. Attached to hemoglobin B. Carbon Dioxide 1. Dissolved in plasma 2. Attached to hemoglobin 3. Bicarbonate C. Alveolar/Capillary Gas Exchange 1. Oxygen 2. Carbon dioxide D. Cell/Capillary Gas Exchange 1. Oxygen 2. Carbon dioxide E. Cell Hypoxia Related to Oxygen Transport Disturbance F. Hypercarbia Related to Carbon Dioxide Transport Disturbance G. Blood Volume 1. Composition of blood a. Plasma b. Red blood cells c. White blood cells d. Platelets 2. Distribution a. Arteries b. Arterioles c. Capillaries d. Venules e. Veins f. Heart g. Pulmonary veins 3. Hydrostatic pressure 4. Plasma oncotic pressure H. Myocardial Effectiveness 1. Cardiac output a. Heart rate b. Stroke volume i. preload ii. myocardial contractility iii. afterload c. Impairment of cardiac output i. high heart rates ii. low hear rates iii. low blood volume iv. decrease in myocardial contractility v. high blood pressure 2. Influence of autonomic nervous system on cardiac output a. Sympathetic i. neural ii. hormonal a) epinephrine b) norepinephrine b. Parasympathetic I. Systemic Vascular Resistance (SVR) 1. Anatomy of the vessel 2. Influence of autonomic nervous system on SVR a. Sympathetic b. Parasympathetic 3. Effects of blood volume and vessel size on pressure inside the vessel VII. Microcirculation A. True Capillaries B. Arteriole-Venule Shunt C. Influence on Capillary 1. Local 2. Neural file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 3. Hormonal VIII. Blood Pressure A. Cardiac Output B. Systemic Vascular Resistance C. Baroreceptors D. Effects of Changes in Cardiac Output on Blood Pressure 1. Increase in heart rate 2. Decrease in heart rate 3. Increase in stroke volume 4. Decrease in stroke volume E. Effects of Changes in Systemic Vascular Resistance on Blood Pressure 1. Increase in SVR 2. Decrease in SVR F. Effects of Changes of Blood Pressure on Perfusion of Cells 1. Oxygen delivery 2. Glucose delivery IX. Alteration of Cell Metabolism A. Aerobic Metabolism 1. Glucose 2. Oxygen 3. Energy (ATP) released 4. Byproducts a. Carbon dioxide b. Water B. Anaerobic Metabolism 1. Glucose 2. Lack of oxygen 3. Energy (ATP) released 4. Byproducts a. Lactic acid b. Effects of acidic environment on cell structure and function C. Effects of Inadequate Perfusion on Cells 1. Lack of glucose 2. Lack of oxygen 3. Lack of energy a. Sodium/potassium pump shutdown b. Cell membrane rupture c. Cell death Life Span Development I. Infancy (Birth to 1 Year) A. Physiology 1. Vital signs a. Heart rate i. 100 to 160 beats per minute during first 30 minutes ii. settling around 120 beats per minute b. Respiratory rate i. initially 40-60 ii. dropping to 30-40 after first few minutes of life iii. slowing to 20-30 by one year iv. tidal volume v. 6-8 ml/kg initially vi. increasing to 10-15 ml/kg by 1 year c. Blood pressure -- average systolic blood pressure increases from 70 at birth to 90 at 1 year d. Temperature ranges -- 98 to 100 degrees Fahrenheit is the thermoneutral range 2. Weight a. Normally 3.0-3.5 kg at birth b. Normally drops 5 to 10 percent in the first week of life c. Infants head equal to 25 percent of the total body weight 3. Pulmonary system a. Airways, shorter, narrower, less stable, more easily obstructed b. Infants primarily nose breathers until four weeks c. Lung tissue is fragile and prone to trauma from pressure d. Fewer alveoli with decreased collateral ventilation e. Accessory muscles immature, susceptible to early fatigue file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 f. Chest wall less rigid g. Diaphragmatic breathing h. Rapid respiratory rates lead to rapid heat, and fluid loss 4. Immune system a. Passive immunity retained through the first six months of life b. Based on maternal antibodies 5. Nervous system a. Movements i. strong, coordinated suck and gag ii. well flexed extremities iii. extremities move equally when infant is stimulated b. Reflexes c. Fontanelles i. posterior fontanelle closes at three months ii. anterior fontanelle closes between 9 and 18 months iii. fontanelles may provide an indirect estimate of hydration 6. Growth and development in infants a. Rapid changes over first year i. two months a) tracks objects with eyes b) recognizes familiar faces ii. six months a) sits upright in a highchair b) makes one syllable sounds (e.g., ma, mu, da, di) iii. 12 months a) walks with help b) knows own name B. Psychosocial development 1. Crying a. Basic cry b. Anger cry c. Pain cry 2. Situational crisis – parental separation reactions a. Protest b. Despair c. Withdrawal II. Toddler (12 to 36 Months) and Preschool Age (3 to 5) A. Physiological 1. Vital signs a. Heart rate i. toddlers—80 to 130 beats per minute ii. preschoolers—80 to 120 beats per minute b. Respiratory rate i. toddlers—20 to 30 breaths per minute ii. preschoolers—20 to 30 breaths per minute c. Systolic blood pressure i. toddlers—70 to 100 mmHg ii. preschoolers—80 to 110 mmHg d. Temperature—96.8 to 99.6 degrees Fahrenheit 2. Pulmonary system a. Terminal airways continue to branch b. Alveoli increase in number 3. Immune system a. Passive immunity lost, more susceptible to minor respiratory and gastrointestinal infections b. Develops immunity to common pathogens as exposure occurs 4. Nervous system a. Brain 90 percent of adult brain weight b. Development allows effortless walking and other basic motor skills c. Fine motor skills developing 5. Musculoskeletal system a. Muscle mass increases b. Bone density increases 6. Elimination patterns a. Toilet training i. physiologically capable by 12 to 15 months ii. psychologically ready between 18 and 30 months iii. average age for completion – 28 months B. Psychosocial file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 1. Cognitive a. Basics of language mastered by approximately 36 months, with continued refinement throughout childhood b. Understands cause and effect between 18-24 months c. Develops separation anxiety—approximately 18 months 2. Play a. Able to play simple games and follow basic rules b. Begin to display competitiveness III. School-Age Children (6 to 12 Years) A. Physiological 1. Vital signs a. Heart rate—70 to 110 beats per minute b. Respiratory rate—20 to 30 breaths per minutes c. Systolic blood pressure—80 to 120 mmHg d. Temperature—98.6 degrees Fahrenheit 2. Bodily functions a. Brain function increases in both hemispheres b. Loss of primary teeth and replacement with permanent teeth begins B. Psychosocial 1. Develop self-concept (i.e. more interaction with adults and children a. begin comparing themselves with others b. develop self-esteem IV. Adolescence (13 to18 Years) A. Physiological 1. Vital signs a. Heart rate—55 to 105 beats per minute b. Respiratory rate—12 to 20 breaths per minute c. Blood pressure—100 to 120 mmHg d. Temperature—98.6 degrees Fahrenheit 2. Growth rate a. Most experience a rapid two- to three-year growth spurt i. begins distally with enlargement of feet and hands ii. enlargement of the arms and legs follows iii. chest and trunk enlarge in final stage b. Girls are mostly done growing by age 16, boys are mostly done growing by age 18 c. Secondary sexual development occurs d. Endocrine changes e. Reproductive maturity f. Muscle mass and bone growth nearly complete B. Psychological 1. Family a. Conflicts arise 2. Develop identity a. Self-consciousness increases b. Peer pressure increases c. Interest in the opposite sex increases d. Want to be treated like adults e. Anti-social behavior peaks around eighth or ninth grade f. Body image of great concern i. continual comparison amongst peers ii. eating disorders are common g. Self-destructive behaviors begin i. tobacco ii. alcohol iii. illicit drugs h. Depression and suicide more common than any other age group V. Early Adulthood (20 to 40 Years) A. Physiological 1. Vital signs a. Heart rate—average 70 beats per minute b. Respiratory rate—average 16 to 20 breaths per minutes c. Blood pressure—average 120/80 mmHg d. Temperature—98.6 degrees Fahrenheit 2. Peak physical conditioning between 19 and 26 years of age 3. Adults develop lifelong habits and routines during this time 4. All body systems at optimal performance file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 5. Accidents are a leading cause of death in this age group B. Psychological 1. Experience highest levels of job stress during this time 2. Love develops a. Romantic love b. Affectionate love 3. Childbirth most common in this age group 4. This period is less associated with psychological problems related to well being VI. Middle Adulthood (41 to 60 Years) A. Physiological 1. Vital signs a. Heart rate—average 70 beats per minute b. Respiratory rate—average 16 to 20 breaths per minute c. Blood pressure—average 120/80 mmHg d. Temperature—98.6 degrees Fahrenheit 2. Body still functioning at high level with varying degrees of degradation 3. Vision changes 4. Hearing less effective 5. Cardiovascular health becomes a concern a. Cardiac output decreases throughout this period b. Cholesterol levels increased 6. Cancer strikes in this age group often 7. Weight control more difficult 8. Menopause in women in late 40s early 50s B. Psychological 1. Approach problems more as challenges than threats 2. Empty-nest syndrome 3. Often burdened by financial commitments for elderly parents as well as young adult children VII. Late Adulthood (61 Years and Older) A. Physiological 1. Vital signs a. Heart rate—depends on patient’s physical and health status b. Respiratory rate—depends on patient’s physical and health status c. Blood pressure—depends on patient’s physical and health status d. Temperature—98.6 degrees Fahrenheit 2. Life span—maximum approximately 120 years 3. Life expectancy—average length based on year of birth 4. Cardiovascular function changes a. Blood vessels i. thickening ii. increased peripheral vascular resistance iii. reduced blood flow to organs b. Heart i. increased workload ii. myocardium is less able to respond to exercise iii. tachycardia not well tolerated c. Blood cells 5. Respiratory system a. Changes in mouth, nose, and lungs b. Metabolic changes lead to decreased lung function c. Muscular changes i. diaphragm elasticity diminished ii. chest wall weakens d. Diffusion through alveoli diminished e. Lung capacity diminished f. Coughing ineffective i. weakened chest wall ii. weakened bone structure 6. Endocrine system changes a. Decreased glucose metabolism b. Decreased insulin production c. Reproductive organs atrophy in women 7. Gastrointestinal system a. Mouth, teeth, and saliva changes b. GI secretions decreased c. Vitamin and mineral deficiencies file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 8. Renal system a. 50 percent of nephrons lost b. Abnormal glomeruli more common c. Decreased elimination 9. Sensory changes a. Loss of taste buds b. Olfactory diminished c. Diminished pain perception d. Diminished kinesthetic sense e. Visual acuity diminished f. Reaction time diminished g. Hearing loss 10. Nervous system a. Neuron loss b. Sleep-wake cycle disrupted B. Psychological 1. Wisdom attributed to age in some cultures 2. 95 percent of older adults live in communities 3. Challenges a. Self-worth b. Declining well-being c. Financial burdens d. Death or dying of companions Public Health I. Basic Principles of Public Health A. Role of Public Health 1. Many definitions 2. Public health mission and functions 3. Public health differs from individual patient care 4. Review accomplishments of public health a. Widespread vaccinations b. Clean drinking water and sewage systems c. Declining infectious disease d. Fluoridated water e. Reduction in use of tobacco products f. Prenatal care g. Others B. Public Health Laws, Regulations, and Guidelines C. EMS Interface With Public Health 1. EMS is a public health system a. EMS provides a critical public health function b. Incorporate public health services into EMS system c. Collaborations with other public health agencies 2. Roles for EMS in public health a. Health prevention and promotion i. primary prevention—preventing disease development a) vaccination b) education ii. secondary prevention—preventing the complications and/or progression of disease iii. health screenings b. Disease surveillance i. EMS providers are first line care givers ii. patient care reports may provide information on epidemics of disease 3. Injury prevention a. Safety equipment b. Education i. car seat safety ii. seat belt use iii. helmet use iv. driving under the influence v. falls vi. fire c. Injury surveillance Pharmacology Principles of Pharmacology file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 I. Medication safety II. Kinds of Medications Used in an Emergency A. Forms of Medication 1. Solid a. Pills b. Tablets – compressed powders c. Powder – inhalation 2. Liquids a. Enteral (ingested) b. Parenteral (injected) 3. Gases; aerosols – inhalation B. Routes of Medication Administration 1. Enteral (ingested) a. Sublingual (e.g., nitroglycerin) b. Oral (e.g., glucose) 2. Parenteral (injected and inhaled) a. Inhaled (e.g., oxygen) b. Injection (e.g., epinephrine) c. Methods of injection i. subcutaneous ii. intramuscular iii. intravenous III. Basic Medication Terminology A. Drug Name 1. Generic 2. Trade B. Drug Profile 1. Actions a. Pharmacodynamics – impact of age and weight upon medication administration b. Indication c. Intended effects 2. Contraindications 3. Side effects a. Unintended effects b. Untoward effects 4. Dose 5. Route C. Prescribing Information I. Assist/Administer Medications to a Patient A. Administration versus Assistance of Medications 1. Assisting patients in taking prescribed medications 2. Administering medication 3. Medical Direction a. Off-line; standing orders, written protocols b. On-line; verbal order a) Confirmation – echo technique b) Confusion – clarification B. Medication Administration Procedure 1. The “rights” of drug administration a. Right patient – prescribed to patient b. Right medication – patient condition c. Right route – patient condition d. Right dose – prescribed to patient e. Right time – within expiration date C. Techniques of Medication Administration 1. Oral a. Advantages b. Disadvantages c. Techniques 2. Sublingual a. Advantages b. Disadvantages c. Techniques 3. Intramuscular injection by Auto injector a. Advantages b. Disadvantages file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 c. Techniques 4. Inhalation a. Advantages b. Disadvantages c. Techniques D. Reassessment 1. Data – indications for medication 2. Action – medication administered 3. Response – effect of medication E. Documentation Pharmacology Emergency Medications I. Specific Medications A. EMT – Administer Medications 1. Aspirin 2. Oral glucose 3. Oxygen B. EMT – Assisted Medications 1. Inhaled bronchodilators 2. Epinephrine 3. Nitroglycerin Airway Management, Respiration, and Artificial Ventilation Airway Management I. Airway Anatomy A. Upper Airway Tract 1. Nose – warm and humidify air 2. Mouth and oral cavity a. Alternative airway, especially in emergency b. Entrance to the digestive system c. Also involved in the production of speech d. Tongue 3. Jaw 4. Pharynx a. Nasopharynx b. Oropharynx c. Laryngopharyx 5. Larynx a. Epiglottis – muscular structure which protects the airway of conscious patients during swallowing b. Vocal cords – thin muscles which are the center for speech and protect the lower airways c. Thyroid cartilage d. Cricoid ring B. Lower Airway Tract 1. Trachea a. Hollow tube which passes air to the lower airways b. Supported by cartilage rings 2. Carina – the bifurcation of the trachea into the two mainstem bronchi 3. Bronchi a. Hollow tubes which further divide into lower airways of the lungs b. Supported by cartilage 4. Lungs a. Bronchioles i. thin hollow tubes leading to the alveoli ii. remain open through smooth muscle tone b. Alveoli i. the end of the airway ii. millions of thin walled sacs iii. each alveolus surrounded by capillary blood vessels iv. site where oxygen and carbon dioxide (waste) are exchanged c. Pulmonary capillary beds i. blood vessels that begin as capillary surrounding each alveolus ii. with adequate blood volume and blood pressure, the vessels return oxygenated blood to the heart file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 II. Airway Assessment A. Signs of Adequate Airway 1. Airway is open, can hear/feel air move in and out 2. Patient is speaking in full sentences 3. Sound of the voice is normal for the patient B. Signs of Inadequate Airway (Not every sign listed below is present in every patient who has inadequate airway) 1. Unusual sounds are heard with breathing a. stridor b. snoring 2. Awake patient is unable to speak or sounds hoarse 3. No air movement (apnea) 4. Airway obstruction a. Tongue b. Food c. Vomit d. Blood e. Teeth f. Foreign body C. Swelling Due to Trauma or Infection III. Techniques of Assuring a Patent Airway A. Manual Airway Maneuvers -- review and elaborate on the manual airway maneuvers used by EMRs B. Mechanical Airway Devices 1. Review and elaborate on the mechanical airway maneuvers used by EMRs 2. Nasopharyngeal a. Purpose b. Indications c. Contraindications d. Complications e. Procedure C. Relief of Foreign Body Airway Obstruction (refer to current American Heart Association guidelines) D. Upper Airway Suctioning -- review and elaborate on all material from the EMR Level IV. Consider Age-Related Variations in Pediatric and Geriatric Patients (see Special Patient Populations Section) Respiration I. Anatomy of the Respiratory System A. Includes All Airway Anatomy Covered in the Airway Management Section B. Additional Respiratory System Anatomy 1. Chest cage 2. Ribs 3. Muscles a. Intercostal b. diaphragm 4. Pleura 5. Phrenic nerve innervation C. Vascular Structures Which Support Respiration 1. Pulmonary capillary structures 2. The heart a. Right heart i. receives systemic circulation ii. drives pulmonary circulation b. Left heart i. receives pulmonary circulation ii. drives systemic circulation c. Automaticity 3. Arteries, arterioles, capillaries, venules, veins 4. Tissue/cellular beds D. Cells 1. All cells perform a specific function 2. Cells require chemicals in order to function, including oxygen, glucose, and electrolytes a. Cells must excrete waste products, including carbon dioxide and water file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 b. Aerobic versus anaerobic respiration 3. Respiratory regulation – influenced by carbon dioxide and oxygen levels in the blood and spinal fluid 4. Respiration; pulmonary ventilation – the movement of air in and out of the lungs a. External respiration – the exchange of respiratory gases between the alveoli and the pulmonary capillary bed b. Internal respiration – the exchange of respiratory gases between the systemic capillaries and their surrounding tissue beds c. Cellular respiration and metabolism – the use of oxygen and carbohydrates to produce energy and the creation of carbon dioxide and water as a by-product of metabolism II. Physiology of Respiration A. Pulmonary Ventilation 1. Ventilation is the movement of air in and out of the lungs 2. Adequate ventilation is necessary for, but does not assure, adequate respiration 3. The mechanics of ventilation a. Inhalation b. Exhalation 4. Alveolar Ventilation a. Tidal volume b. Dead space c. Vital capacity d. Respiratory Rate e. Minute volume f. Residual volume B. Oxygenation 1. Oxygenation is the process of loading oxygen molecules onto hemoglobin molecules in the bloodstream 2. Oxygenation is required for, but does not assure, internal respiration C. Respiration 1. Respiration is the exchange of oxygen and carbon dioxide and is essential for life a. External respiration – exchange of oxygen and carbon dioxide between the alveoli and the blood in the pulmonary capillaries b. Internal respiration – exchange of oxygen and carbon dioxide between the capillaries of the body tissues and the individual cells c. Cellular respiration i. each cell of the body performs a specific function ii. oxygen and sugar are essential to produce energy for cells to perform their function iii. produce carbon dioxide as a waste product 2. Adequate ventilation is required for, but does not assure, external respiration 3. Adequate external ventilation and perfusion are required for, but do not assure, internal respiration III. Pathophysiology of Respiration A. Pulmonary Ventilation 1. Interruption of nervous control a. Drugs b. Trauma c. Muscular dystrophy 2. Structural damage to the thorax 3. Bronchoconstriction 4. Disruption of airway patency a. Infection b. Trauma/burns c. Foreign body obstruction d. Allergic reactions e. Unconsciousness (loss of muscle tone) B. Oxygenation C. Respiration 1. External a. Altitude b. Closed environments c. Toxic or poisonous environments 2. Internal file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 a. Pathology typically related to changes in alveolar – capillary gas exchange b. Typical disease processes i. emphysema ii. pulmonary edema iii. pneumonia iv. environmental/occupational exposure v. drowning 3. Cellular D. Circulation compromise 1. Pathology typically related to derangement of pulmonary and systemic perfusion and oxygenation 2. Typical disease processes a. Obstruction of blood flow i. pulmonary embolism ii. tension pneumothorax iii. heart failure iv. cardiac tamponade b. Anemia c. Hypovolemia d. Vasodilatory shock E. Cells 1. Hypoxia 2. Hypoglycemia 3. Infection IV. Assessment of Adequate and Inadequate Ventilation A. Internal Respiration is Necessary for Life B. It Is Sometimes Difficult to Assess Internal Respiration C. It May Be Difficult to Determine If You Have a Respiration, Ventilation, or Oxygenation Problem as They May Coexist and One Can Cause Another D. Assessment of Ventilation 1. Signs of adequate ventilation a. Respiratory rate is normal b. Breath sounds are clear on both sides of the chest i. anterior ii. posterior c. Tidal volume d. Minute volume 2. Signs of inadequate ventilation (not every sign listed below is present in every patient who has inadequate ventilation and/or oxygenation) a. Abnormal work of breathing i. retractions ii. nasal flaring iii. abdominal breathing iv. diaphoresis b. Abnormal breath sounds i. stridor ii. wheezing iii. crackles iv. silent chest v. breath sounds are unequal a) trauma b) infection c) pneumothorax c. Minute volume (respiratory rate x tidal volume) d. Chest wall movement or damage i. trauma a) paradoxical b) splinting c) penetrating e. Irregular respiratory pattern i. head trauma ii. stroke iii. metabolic iv. toxic v. rapid respiratory rate without clinical improvement E. Assessment of Respiration 1. Ambient air is abnormal a. Enclosed space file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 b. High altitude c. Poison gas 2. Level of consciousness 3. Skin color/mucosa is not normal a. Cyanosis – etiology b. Pallor – etiology c. Mottling – etiology 4. Assessment of oxygenation a. Mental status i. baseline b. Skin color normal c. Oral mucosa normal d. Pulse oximeter reading within acceptable level e. Pulse oximetry i. purpose a) assesses oxygenation b) quantify hemoglobin saturation c) assess adequacy of oxygen delivery during positive pressure ventilation d) assess impact of interventions ii. indications – routine vital sign iii. contraindications iv. complications a) hypoperfusion b) carbon monoxide c) cold extremity d) time lag in detection of respiratory insufficiency v. procedure a) refer to the manufacturer’s instructions for the device being used b) considered alternative measurement sites V. Management of Adequate and Inadequate Respiration A. Assure an Adequate Airway B. Supplemental Oxygen Therapy 1. Ambient air is a. Oxygen b. Nitrogen c. Carbon dioxide 2. Supplemental oxygen therapy replaces some of the inert gas with oxygen and can improve internal respiration 3. Oxygen sources a. Portable oxygen cylinder i. cylinder size ii. assembly and use of cylinders iii. changing a cylinder a) safe residual for operation is 200 psi b) calculating cylinder duration iv. securing and handling cylinders b. Liquid oxygen 4. Oxygen delivery devices a. Nasal cannula i. purpose ii. indications iii. contraindications iv. complications v. procedure b. Partial re-breather face mask i. purpose ii. indications iii. contraindications iv. complications v. procedure c. Non-rebreather i. purpose ii. indications iii. contraindications iv. complications v. procedure d. tracheostomy mask file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 i. purpose ii. indications iii. contraindications iv. complications v. procedure e. Venturi mask i. purpose ii. indications iii. contraindications iv. complications v. procedure f. Humidifiers i. purpose ii. indications iii. contraindications iv. complications v. procedure C. Assisting Ventilation in Respiratory Distress/Failure 1. Purpose a. To improve oxygenation b. To improve ventilation 2. Indications a. Shows signs and symptoms of inadequate ventilation i. altered mental status ii. inadequate minute ventilation iii. fatigue from work of breathing iv. others 3. Complications a. Combative/hypoxic patients b. Inadequate mask seal c. Over pressure causing injury to the lung d. Risk of gastric inflation and vomiting 4. Procedure a. Explain the procedure to the patient b. Place the mask over the patient’s nose and mouth c. Initially assist at the rate at which the patient has been breathing d. Squeeze the bag each time the patient begins to inhale e. Over the next 5-10 breaths i. slowly adjust the rate and the delivered tidal volume ii. appropriate rate and volume are determined by minute ventilation VI. Consider Age-Related Variations in Pediatric and Geriatric Patients (see Special Patient Populations) Artificial Ventilation I. The Management of Inadequate Ventilation A. Assure an Adequate Airway B. Supplemental Oxygen Therapy C. Artificial Ventilation Devices 1. Bag-valve-mask with reservoir a. Advantages b. Disadvantages 2. Manually triggered ventilation device a. Advantages i. allows for a single rescuer to use both hands to maintain a mask-to-face seal while providing positive pressure ventilation to a patient ii. reduces rescuer fatigue during extended transport times b. Disadvantages i. difficult to maintain adequate ventilation without assistance ii. requires oxygen however, typical adult ventilation consumes 5 liters per minute O2 versus 15-25 liters per minute for a bag-valve-mask iii. typically used on adult patients only iv. requires special unit and additional training for use in pediatric patients v. the rescuer is unable to easily assess lung compliance vi. high ventilatory pressures may damage lung tissue file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 3. Automatic Transport Ventilator/Resuscitator a. Advantages b. Disadvantages i. requires oxygen, however typical adult ventilation consumes 5 liters per minute 02 versus 15-25 liters per minute for a bag-valve-mask ii. may require an external power source iii. must have bag-valve-mask device available iv. may interfere with timing of chest compressions during CPR v. must monitor to assure full exhalation vi. barotrauma D. Ventilation of an Apneic Patient 1. Purpose 2. Indications 3. Contraindications 4. Procedure E. Ventilation of the Protected Airway 1. Purpose 2. Indications 3. Contraindications 4. Complications 5. Procedure II. The Differences Between Normal and Positive Pressure Ventilation A. Air Movement 1. Normal ventilation a. Negative intrathoracic pressure b. Air is sucked into lungs 2. Positive pressure ventilation B. Blood Movement 1. Normal ventilation a. Blood return from the body happens naturally b. Blood is pulled back to the heart during normal breathing 2. Positive pressure ventilation a. Venous return is decreased during lung inflation b. Amount of blood pumped out of the heart is reduced C. Airway Wall Pressure 1. Normal ventilation 2. Positive pressure ventilation a. Walls are pushed out of normal anatomical shape b. More volume is required to have the same effect as normal breathing D. Esophageal Opening Pressure 1. Normal ventilation 2. Positive pressure ventilation a. Air is pushed into the stomach during ventilation b. Gastric distention may lead to vomiting 3. Sellick’s maneuver (cricoid pressure) a. Use during positive pressure ventilation b. Reduces amount of air in stomach c. Procedure i. identify cricoid cartilage ii. apply firm backward pressure to cricoid cartilage with thumb and index finger d. Do not use if i. patient is vomiting or starts to vomit ii. patient is responsive iii. breathing tube has been placed by advanced level providers E. Over Ventilation (Either by Rate or Volume) Can Be Detrimental to the Patient 1. Positive pressure ventilation may cause a. Hypotension b. Gastric distention c. Other unintended consequences III. Consider Age-Related Variations in Pediatric and Geriatric Patients (see Special Patient Considerations) Patient Assessment Scene Size-Up file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 I. Scene Safety A. Common Scene Hazards 1. Environmental 2. Hazardous substances a. Chemical b. Biological 3. Violence a. Patient b. Bystanders c. Crime scenes 4. Rescue a. Motor vehicle collisions i. extrication hazards ii. roadway operation dangers b. Special situations B. Evaluation of the Scene -- is the scene safe? 1. Yes -- establish patient contact and proceed with patient assessment. 2. No -- is it possible to quickly make the scene safe? a. Yes -- assess patient b. No -- do not enter any unsafe scene until minimizing hazards 3. Request specialized resources immediately II. Scene Management A. Impact of the Environment on Patient Care 1. Medical a. Determine nature of illness b. Hazards at medical emergencies 2. Trauma a. Determine mechanism of injury b. Hazards at the trauma scene 3. Environmental considerations a. Weather or extreme temperatures b. Toxins and gases c. Secondary collapse and falls d. Unstable conditions B. Addressing Hazards 1. Protect the patient a. After making the scene safe for the EMT, the safety of the patient becomes the next priority b. If the EMT cannot alleviate the conditions that represent a health or safety threat to the patient, move the patient to a safer environment 2. Protect the bystanders a. Minimize conditions that represent a hazard for bystanders b. If the EMT cannot minimize hazards, remove bystanders from the scene 3. Request resources a. Multiple patients – additional ambulances b. Fire hazard – fire department c. Traffic or violence issues – law enforcement 4. Scan the scene for information related to a. Mechanism of injury b. Nature of the illness C. Violence 1. EMTs should not enter a scene or approach a patient if the threat of violence exits 2. Park away from the scene and wait for the appropriate law enforcement officials to minimize the danger D. Need for Additional or Specialized Resources 1. A variety of specialized protective equipment and gear is available for specialized situations a. Chemical and biological suits can provide protection against hazardous materials and biological threats of varying degrees b. Specialized rescue equipment may be necessary for difficult or complicated extrications c. Ascent or descent gear may be necessary for specialized rescue situations 2. Only specially trained responders should wear or use the specialized equipment file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 E. Standard Precautions 1. Overview a. Based on the principle that all blood, body fluids, secretions, excretions (except sweat), non-intact skin, and mucous membranes may contain transmissible infectious agents b. Include a group of infection prevention practices that apply to all patients, regardless of suspected or confirmed infection status, in any healthcare delivery setting c. Universal precautions were developed for protection of healthcare personnel d. Standard precautions focus on protection of patients 2. Implementation a. The extent of standard precautions used is determined by the anticipated blood, body fluid, or pathogen exposure i. hand washing ii. gloves iii. gowns iv. masks v. protective eyewear 3. Personal Protective Equipment a. Personal protective equipment includes clothing or specialized equipment that provides some protection to the wearer from substances that may pose a health or safety risk b. Wear PPE appropriate for the potential hazard i. steel-toe boots ii. helmets iii. heat-resistant outerwear iv. self-contained breathing apparatus v. leather gloves F. Multiple-Patient Situations 1. Number of patients and need for additional support a. How many patients? b. Does the dispatch suggest the need for additional support? c. Protection of the patient i. weather or extreme temperatures ii. unstable conditions d. Protection of bystanders i. remove ii. isolate iii. barricade 2. Need for additional resources a. Incident Command System (ICS or IMS) b. Consider if this level of commitment is required Primary Assessment I. Primary Survey/Primary Assessment A. Initial General Impression – Based on the Patient’s Age-Appropriate Appearance 1. Appears stable 2. Appears stable but potentially unstable 3. Appears unstable B. Level of Consciousness 1. While approaching the patient or immediately upon patient contact attempt to establish level of consciousness a. Speak to the patient and determine the level of response b. EMT should identify himself or herself c. EMT should explain that he or she is there to help 2. Patient response a. Alert i. the patient appears to be awake ii. the patient acknowledges the presence of the EMT b. Responds to verbal stimuli i. the patient opens his/her eyes in respond to the EMT’s voice ii. the patient responds appropriately to a simple command c. Responds to painful stimuli i. the patient neither acknowledges the presence of the EMT nor responds to loud voice ii. patient responds only when the EMT applies some form of irritating stimulus file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 a) when an irritating stimulus is encountered, the human body will either attempt to move away from the stimulus or will attempt to move the stimulus away from the body b) acceptable stimuli i) pinch the patient’s ear ii) trapezius squeeze iii) others d. Unresponsive – the patient does not respond to any stimulus C. Airway Status 1. Unresponsive patient a. Medical patients i. open and maintain the airway with head-tilt, chin-lift technique ii. see the current American Heart Association guidelines for the steps in performing this procedure for victims of all ages b. Trauma patients i. open and maintain the airway with modified jaw thrust technique while maintaining manual cervical stabilization ii. see the current American Heart Association guidelines for the steps in performing this procedure for victims of all ages 2. Responsive patient a. If the patient speaks, the airway is functional but may still be at risk -- foreign body or substances in the mouth may impair the airway and must be removed i. finger sweep (solid objects) ii. suction (liquids) b. If the upper airway becomes narrowed, inspiration may produce a high-pitched whistling sound known as stridor i. foreign body ii. swelling iii. trauma c. Airway patency must be continually reassessed D. Breathing Status 1. Patient responsive a. Breathing is adequate (rate and quality) b. Breathing is too fast (>24 breaths per minute) c. Breathing is too slow (<8 breaths per minute) d. Breathing absent (choking) 2. Patient unresponsive a. Breathing is adequate (rate and quality) b. Breathing is inadequate c. Breathing is absent E. Circulatory Status 1. Radial pulse present (rate and quality) a. Normal rate b. Fast c. Slow d. Irregular rate 2. Radial pulse absent 3. Assess if major bleeding is present 4. Perfusion status a. Skin color b. Skin temperature c. Skin moisture d. Capillary refill (as appropriate) F. Identifying Life Threats 1. Assess patient and determine if the patient has a life-threatening condition a. Unstable – if a life threatening condition is found, treat immediately b. Stable – assess nature of illness or mechanism of injury G. Assessment of Vital Functions II. Integration of Treatment/Procedures Needed to Preserve Life III. Evaluating Priority of Patient Care and Transport A. Primary Assessment: Stable B. Primary Assessment: Potentially Unstable file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 C. Primary Assessment: Unstable History-Taking I. Investigation of the Chief Complaint A. The Chief Complaint Is a Very Brief Description of the Reason for Summoning EMS to the Scene B. Factors Influencing the Data Collection 1. What is the source of the information? a. Patient i. usually the best source for information b. Family c. Friends d. Bystanders e. Public safety personnel f. Medical identification jewelry or other medical information sources 2. How reliable is the data? C. History of the Present Illness 1. Detailed evaluation of the chief complaint 2. Provides a full, clear, chronological account of the signs and symptoms II. Components of a Patient History A. Statistical and Demographic 1. Obtain correct dates 2. Accurately document all times 3. Identifying data a. Age b. Sex c. Race B. Past Medical History (Pertinent to the Medical Event) 1. Medical 2. Trauma 3. Surgical 4. Consider medical identification tag C. Current Health Status (Pertinent to the Medical Event) 1. Focuses on present state of health 2. Environmental conditions 3. Individual factors a. Current medications b. Allergies c. Tobacco use d. Alcohol, drugs and related substances e. Diet f. Screening tests g. Immunizations h. Environmental hazards i. Use of safety measures (in and out of the home) j. Family history III. Techniques of History Taking A. Setting the Stage 1. Environment – personal space 2. EMS personnel demeanor and appearance a. Be aware of body language b. Clean, neat, and professional 3. Note-taking a. Difficult to remember all details b. Most patients comfortable with note-taking B. Learning About the Present Illness 1. Refer to the patient by name a. Refer to the patient by their last name with the proper title i. Mr., Mrs., or Ms. ii. if they inform you to address them by their first name, do so b. Avoid the use of unfamiliar or demeaning terms such as “granny” or “honey” C. Determine Chief Complaint 1. Use a general, open-ended question 2. Follow the patient’s lead file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 a. Facilitation i. posture, actions, or words should encourage the patient to say more ii. making eye contact or saying phrases such as “go on” or “I’m listening” may help the patient to continue b. Reflection i. repeating the patient’s words encourages additional responses ii. typically does not bias the story or interrupt the patient’s train of thought c. Clarification – used to clarify ambiguous statements or words d. Empathetic responses – use techniques of therapeutic communication to interpret feelings and your response e. Confrontation – some issues or responses may require you to confront patients about their feelings f. Interpretation – goes beyond confrontation, requires you to make an inference D. History of the Present Illness 1. Location (where is it?) 2. Onset (when did it start?) 3. Provocative, palliative, and positioning a. What makes it worse? b. What makes it better? c. What position is the patient comfortable? 4. Quality (what is it like?) 5. Radiation (does it move anywhere?) 6. Severity a. Attempt to quantify the pain b. Utilize the scale, 1-10 7. Time a. Duration b. When did it start? c. How long does it last? 8. Associated signs and symptoms 9. Pertinent negative(s) 10. For trauma patients, determine the mechanism of injury E. Assess Past Medical History (Pertinent to the Medical Event) 1. Pre-existing medical conditions or surgeries 2. Medications 3. Allergies 4. Family history 5. Social history; travel history F. Current Health Status 1. Tobacco use 2. Use of alcohol, drugs, and other related substances 3. Diet IV. Standardized Approach to History-Taking A. SAMPLE History 1. S = Signs and symptoms 2. A = Allergies a. Medication b. Environmental 3. M = Medications a. Over the counter (OTC) b. Prescribed c. Vitamins and herbal d. Birth control / erectile dysfunction e. Other people’s medications f. Recreational drugs 4. P = Past pertinent medical history – relevant information concerning the illness or injury 5. L = Last oral intake a. Fluids b. Food c. Other substances 6. E = Events leading to the illness or injury a. What was taking place just prior to the illness or injury? B. OPQRST History 1. O = Onset – time the signs or symptoms started file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 2. P = Provocative, palliative, and positioning a. What makes it worse? b. What makes it better? c. Positioning i. in what position is the patient found? ii. should the patient remain in that position? 3. Q = Quality of the discomfort a. Patient’s ability to describe the type of discomfort i. burning ii. stabbing iii. crushing 4. R = Radiation a. Does the discomfort move in any direction? 5. S = Severity a. Pain scale 6. T = Time a. Relating to onset, however, more definitive in regards to initial onset in the history V. Taking History on Sensitive Topics A. Alcohol and Drugs B. Physical Abuse or Violence C. Sexual History D. Special Challenges 1. Silent patient a. Silence is often uncomfortable b. Be alert for nonverbal clues of distress c. Silence may be the result of the interviewer’s lack of sensitivity 2. Overly talkative patients a. Give the patient free reign for the first several minutes b. Summarize frequently 3. Patient with multiple symptoms 4. Anxious patient a. Anxiety is natural b. Be sensitive to nonverbal clues c. Reassurance 5. Angry and hostile patient a. Understand that anger and hostility are natural b. Often the anger is displaced toward the clinician c. Do not get angry in return 6. Intoxicated patient a. Be accepting, not challenging b. Do not attempt to have the patient lower their voice or stop cursing; this may aggravate them c. Avoid trapping them in small areas d. Treat with dignity, despite their intoxication 7. Crying patient may provide valuable insight 8. Depressed patient a. Be alert for signs of depression b. Be willing to listen and be non-judgmental 9. Patient with confusing behavior or history 10. Patient with limited cognitive abilities a. Do not overlook the ability of these patients to provide you with adequate information b. Be alert for omissions 11. EMT-patient language barrier – take every possible step to find a translator 12. Patient with hearing problem – if the patient can write, have the patient write down questions and answers on paper 13. Patient with visual impairment – be careful to announce presence and provide careful explanations 14. Talking with family and friends a. Some patients may not be able to provide you with all information b. Try to find a third party who can help you get the whole story VI. Age-Related Variations for Pediatric and Geriatric Assessment and Management A. Pediatric (see Special Patient Population section) B. Geriatric (see Special Patient Population section) 1. Obtain eye glasses and hearing aids 2. Expect history to take more time file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 Secondary Assessment I. Techniques of Physical Examination A. General Approach 1. Examine the patient systematically 2. Place special emphasis on areas suggested by the present illness and chief complaint 3. Keep in mind that most patients view a physical exam with apprehension and anxiety—they feel vulnerable and exposed 4. Maintain professionalism throughout the physical exam while displaying compassion towards your patient B. Respiratory System 1. Expose the chest as appropriate for the environment 2. Chest shape and symmetry 3. Respiratory effort a. Accessory muscle use b. Retractions 4. Auscultation a. Technique – medical versus trauma b. Presence of breath sounds c. Absence of breath sounds C. Cardiovascular System 1. Pulse a. Rate b. Rhythm c. Predictable d. Adjust timing for irregularity e. Strength f. Location i. common locations ii. pelation to perfusion 2. Perfusion a. Blood pressure i. equipment size ii. placement of cuff iii. position of patient iv. position of arm v. methods of measurement a) auscultation b) palpation vi. relation to perfusion D. Neurological System 1. Mental status a. Appearance and behavior i. assess for level of consciousness (AVPU) a) alert b) response to verbal stimuli i) drowsiness ii) stupor (a) state of lethargy (b) person seems unaware of surroundings c) response to painful stimuli d) unresponsive i) coma (a) state of profound unconsciousness (b) absence of spontaneous eye movements (c) no response to verbal or painful stimuli (d) patient cannot be aroused by any stimuli ii. observe posture and motor behavior iii. facial expression a) anxiety b) depression c) anger d) fear e) sadness file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 f) pain b. Speech and language i. rate ii. appropriateness a) slurred b) garbled c) aphasia c. Mood i. nature ii. intensity iii. suicidal ideation d. Thought and perceptions i. assess thought processes a) logic b) organization ii. assess thought content a) unusual thoughts b) unpleasant thoughts iii. assess perceptions a) unusual b) hearing things c) seeing things e. Memory and attention i. person ii. place iii. time iv. purpose E. Musculoskeletal System 1. Pelvic region a. Symmetry b. Tenderness 2. Lower extremities a. Overview i. symmetry ii. surface findings b. General physical findings i. range of motion ii. sensory iii. motor function iv. circulatory function c. Peripheral vascular system i. tenderness ii. temperature of lower legs iii. distal pulses 3. Upper extremities a. Overview i. symmetry ii. strength iii. surface findings b. General physical findings i. range of motion ii. sensory iii. motor function iv. circulatory function v. arm drift 4. Back a. Overview i. symmetry ii. contour iii. surface findings b. General physical findings i. flank tenderness ii. spinal column tenderness F. All Anatomical Regions 1. Head a. Scalp b. Skull c. Face i. symmetry of expression ii. appropriate facial expression file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 d. Eyes i. pupil size, shape, and response a) normal – equal and reactive to light b) abnormal i) constricted ii) dilated iii) unequal ii. conjunctiva color and hydration e. Ears – fluids f. Nose i. symmetry ii. fluid in nares g. Mouth and pharynx i. odor ii. hydration iii. condition of teeth 2. Neck a. Physical findings b. Symmetry c. Masses d. Arterial pulses 3. Chest a. Overview i. expose appropriately ii. chest shape and symmetry iii. respiratory effort iv. surface findings – inspection b. Auscultation i. technique – medical versus trauma ii. lung sounds a) presence of breath sounds – wheezes b) absence of breath sounds c. Anterior chest i. auscultation findings – lungs ii. intercostal muscle use iii. retraction d. Posterior chest i. auscultation ii. spinal column 4. Abdomen a. Overview i. position patient for examination ii. shape and size iii. palpation method a) four quadrants b) palpate affected area last b. Physical findings i. symmetry ii. masses iii. organ margins iv. contour v. softness vi. tenderness vii. findings associated with pregnancy – physical changes of contour and shape II. Special Considerations for Pediatric and Geriatric Patients (see Special Patient Populations section) Monitoring Devices I. Pulse Oximetry A. Purpose 1. Assess oxygenation 2. Assess adequacy of oxygen delivery during positive pressure ventilation 3. Assess impact of interventions B. Indications C. Procedure 1. Refer to the manufacturer’s instructions for the specific device being used 2. Considered alternative measurement sites file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 D. Limitations 1. General a. Appropriateness of use b. Does not provide a direct measurement of blood oxygen content c. Does not indicate whether body cells can utilize the oxygen present 2. Specific a. Hypoperfusion b. Carbon monoxide c. Cold extremity d. Time lag in detection of respiratory insufficiency II. Non-Invasive Blood Pressure A. Purpose 1. Obtaining blood pressure after manual blood pressure B. Indication 1. Routine vital sign 2. Continuous monitoring of patient C. Procedure 1. Refer to the manufacturer’s instructions for the specific device being used D. Limitations 1. Erroneous readings or values III. Other Monitoring Devices A. As Additional Monitoring Devices Become Recognized as the “Standard of Care” in the Out-of-Hospital Setting, Those Devices Should Be Incorporated Into the Primary Education of Those Who Will Be Expected to Use Them in Practice B. State regulatory processes may elect to expand, delete, or modify the monitor devices in this section Reassessment I. How and When to Reassess II. Identify and Treat Changes in the Patient’s Condition in a Timely Manner A. Monitor the patient’s condition B. Monitor the effectiveness of interventions C. Identify trends in the patients vital signs III. Reassessments Should Be Performed at Regular Intervals A. Unstable Patients – Every Five Minutes, or as Often as Practical Depending on the Patient’s Condition B. Stable Patients – At Least Every 15 Minutes or as Deemed Appropriate by the Patient’s Condition IV. A Reassessment Includes: A. Primary Assessment B. Vital Signs C. Chief Complaint D. Interventions V. Compare to the Baseline Status of That Component A. Level of Consciousness – Is the Patient Maintaining the Same Level of Responsiveness or Becoming More/Less Alert? B. Airway – Recheck the Airway for Patency C. Breathing – Reassess the Adequacy of Breathing by Monitoring Both Breathing Rate and Tidal Volume D. Circulation – Reassess the Adequacy of Circulation by Checking Both Central and Peripheral Pulses VI. Vital Signs A. Repeat Vital Signs as Necessary B. Attention Should Be Paid to: 1. Respirations 2. Pulse 3. Blood pressure 4. Pupils VII. Chief Complaint A. Constantly Reassess the Patient’s Chief Complaint or Major Injury B. Determine If Their Pain/Discomfort Is Remaining the Same, Getting Worse, or Getting Better file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 C. Be Sure to Ask If There Are Any New or Previously Undisclosed Complaints VIII. Interventions – Reassess the Effectiveness of Each Intervention Performed and Consider the Need for New Interventions or Modifications to Care Already Being Provided IX. Age-Related Considerations for Pediatric and Geriatric Assessment and Management Medical Overview I. Assessment Factors A. Scene Safety B. Environment C. Chief Complaint 1. Primary reason for EMS response 2. Verbal or non-verbal 3. Possibly misleading D. Life-Threatening Conditions E. Non-Life Threatening Conditions F. Distracting Injuries G. Tunnel Vision H. Patient Cooperation I. EMT Attitude 1. Biases 2. Labeling II. Major Components of the Patient assessment A. Standard Precautions B. Scene Size-Up C. General Impression D. Initial Assessment E. SAMPLE History 1. Importance of a Thorough History a. Primary component of the overall assessment of the medical patient b. Requires a balance of knowledge and skill to obtain a thorough and accurate history c. Helps to ensure the proper care will be provided for the patient 2. Unresponsive patient a. Pill containers b. Medical jewelry c. Family members d. Bystanders e. Medical devices 3. Responsive patient a. Obtained directly from the patient b. Focused on the patient’s chief complaint c. Additional history may be obtained from evidence at the scene i. pill containers ii. medical jewelry iii. family members iv. bystanders 4. OPQRST mnemonic for evaluation of pain a. O – onset i. focuses on what the patient was doing when the problem began ii. question: what were you doing when the problem began? b. P – provoke i. focuses on what might provoke the problem for the patient ii. question: does anything you do make the problem better or worse? c. Q – quality i. focuses on the patient’s own description of the problem ii. questions a) Can you describe your pain/discomfort? b) What does if feel like? c) Is it sharp? Dull? d) Is it steady or does it come and go? d. R - region/radiate i. focuses on the specific area of the pain/discomfort ii. questions a) Can you point with one finger where you fee the file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 pain/discomfort the most? b) Does the pain/discomfort radiate to any other areas of your body? e. S – severity i. focuses on the severity of the pain/discomfort ii. questions a) Use a pain scale to ask the patient: How would you rate your pain right now? b) How would you rate your pain when it first began? c) Has there been any change since it first began? f. T – time i. focuses on the duration of the problem/pain/discomfort ii. question: when did your problem/pain/discomfort first begin? F. Baseline Vital Signs G. Secondary Assessment 1. May not be appropriate to perform a complete secondary assessment on all medical patients 2. Designed to identify any signs or symptoms of illness that may not have been revealed during the initial assessment a. Head/scalp i. pain ii. symmetry b. Face i. pain ii. symmetry of facial muscles c. Eyes i. pupil size ii. equality and reactivity to light iii. pink moist conjunctiva d. Ears i. pain ii. drainage e. Nose i. pain ii. nasal flaring f. Mouth i. foreign body ii. loose dentures iii. pink and moist mucosa g. Neck i. pain ii. accessory muscle use iii. jugular vein distention iv. medical jewelry v. stoma h. Chest i. pain ii. equal rise and fall iii. guarding iv. breath sounds v. retractions vi. scars vii. medication patches viii. medical devices i. Abdomen i. pain ii. rigidity iii. distention iv. scars v. medical devices j. Pelvis/genital i. pain ii. incontinence k. Arms i. pain ii. distal circulation iii. sensation iv. motor function v. track marks file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 vi. medical jewelry l. Legs i. pain ii. distal circulation iii. sensation iv. motor function v. track marks vi. medical jewelry m. Back i. pain ii. scars H. Continued Assessment 1. When practical, transport the patient in the recovery position to help ensure a patent airway 2. Consider the need for ALS backup I. Stroke/TIA A. Causes 1. Hemorrhage 2. Clot B. Review of Anatomy and Function of the Brain and Cerebral Blood Vessels C. Assessment Findings and Symptoms 1. Confused, dizzy, weak 2. Decreasing or increasing level of consciousness 3. Combative or uncooperative or restless 4. Facial drooping, inability to swallow, tongue deviation 5. Double vision or blurred vision 6. Difficulty speaking or absence speech 7. Decreased or absent movement of one or more extremities 8. Headache 9. Decreased or absent sensation in one or more extremities or other areas of body 10. Coma D. Stroke Alert Criteria 1. Cincinnati Prehospital Stroke Scale 2. Other stroke scales E. Management of Patient With Stroke Assessment Findings or Symptoms F. Scene Safety and Standard Precautions 1. ABCs /position 2. Oxygen/suction 3. Pulse oximetry 4. Emotional support 5. Rapid transport G. Transient Ischemic Attack (TIA) II. Seizures A. Incidence B. Causes C. Types of Seizures 1. Generalized tonic – clonic a. Aura b. Tonic c. Clonic d. Postictal 2. Partial seizures 3. Status epilepticus D. Assessment Findings 1. Spasms, muscle contractions 2. Bite tongue, increased secretions 3. Sweating 4. Cyanosis 5. Unconscious gradually increasing level of consciousness 6. May cause shaking or tremors and no loss of consciousness 7. Incontinent 8. Amnesia of event E. Management 1. Safety of patient/position 2. ABCs, consider nasopharyngeal airway 3. Oxygen/suction 4. Pulse oximetry 5. Emotional support III. Headache file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 A. As a Symptom B. As a Neurological Condition C. Assessment Findings and Symptoms D. Management IV. Age-Related Variations for Pediatric and Geriatric Assessment and Management A. Pediatrics 1. Epidemiology 2. Anatomic and physiologic differences in children 3. Pathophysiology 4. Causes of altered mental status in children 5. Assessment a. History b. Physical findings 6. Meningitis 7. Seizures 8. Altered mental status 9. Management B. Geriatrics – Stroke Common in This Age Group V. Communication and Documentation VI. Transport Decisions -- Rapid Transport to Appropriate Facility Abdominal and Gastrointestinal Disorders I. Define Acute Abdomen II. Anatomy of the Organs of the Abdominopelvic Cavity A. Stomach B. Intestines C. Esophagus D. Spleen E. Urinary Bladder F. Liver G. Gall Bladder H. Pancreas I. Kidney J. Reproductive Organs III. Assessment and Symptoms A. Techniques 1. Inspection 2. Palpation B. Normal Findings—Soft Non-Tender C. Abnormal Findings 1. Nausea/vomiting a. Excessive b. Hematemesis 2. Change in bowel habits/stool a. Constipation b. Diarrhea c. Dark tarry stool 3. Urination a. Pain b. Frequency c. Color d. Odor 4. Weight loss 5. Belching/flatulence 6. Concurrent chest pain 7. Pain, tenderness, guarding, distension 8. Other IV. General Management for Patients With an Acute Abdomen A. Scene Safety and Standard Precautions B. Airway, Ventilatory, and Circulation C. Position D. Emotional Support V. Specific Acute Abdominal Conditions—Definition, Causes, Assessment Findings and Symptoms, Complications, and Specific Prehospital Management file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 A. Acute and Chronic Gastrointestinal Hemorrhage B. Peritonitis C. Ulcerative Diseases VI. Consider Age-Related Variations for Pediatric and Geriatric Assessment and Management VII. Pediatrics A. Anatomic and Physiologic Differences in Children B. Pathophysiology C. Assessment 1. History 2. Physical findings a. Vomiting causes dehydration b. Appendicitis common in children c. Abdominal pain from constipation d. Vomiting e. GI Bleeding 3. Management D. Geriatric 1. May not exhibit rigidity or guarding 2. Abdominal pain related to cardiac conditions VIII. Communication and Documentation for Patients With an Abdominal or Gastrointestinal Condition or Emergency IX. Transport Decisions Immunology I. Introduction A. Definition of Terms 1. Allergic reaction 2. Anaphylaxis B. Risk Factors and Common Allergens II. Basic Immune System’s Response to Allergens A. The Purpose of the Response B. The Type of Response (Local versus Systemic) C. The Speed of the Response III. Fundamental Pathophysiology A. Increased Capillary Permeability B. Vasodilation C. Bronchoconstriction D. Increased Mucus Production IV. Assessment Findings for Allergic Reaction A. Respiratory System—Sneezing, Tightness in Chest, Cough, Rapid and Labored Breathing, Wheezing, Stridor B. Cardiovascular—Increased Heart Rate C. Skin—Pale or Redness, Hives, Swelling Locally or Generalized, Itching D. Other—Anxiety, Itchy and Watery Eyes, Dizziness V. Assessment Findings for Anaphylaxis A. Respiratory System—Severe Respiratory Distress, Wheezing to Silent Chest B. Cardiovascular—Rapid Pulse, Hypotension C. Skin—Pale, Red, or Cyanotic D. Other—Decreasing Mental Status VI. Management A. ABCs B. Position C. Oxygen D. Emotional Support E. Vitals F. Assist With Patient’s Auto injector G. Remove Allergen If Possible VII. Epinephrine as a Treatment for Allergic Reaction A. Indications – Severe Allergic Reaction or Hypersensitivity to Exposed Substance file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 B. Contraindications – Not Patient’s Drug, Expired, or Discolored C. Actions – Slows Allergic Response, Raises B/P, Dilates the Bronchioles D. Side Effects – Increased Pulse Rate and B/P, Anxiety, Cardiac Arrhythmias E. Auto injection Systems 1. Physician order 2. Expiration date and patient prescription 3. Prep site, remove needle cover 4. Lateral thigh; push against thigh; hold until drug fully injected 5. Monitor patient response 6. Dispose properly VIII. Consider Age-Related Variations for Pediatric and Geriatric Assessment and Management A. Pediatric – Pediatric Weight-Based Auto injector Available B. Geriatric – Possible Contraindication in Coronary Artery Disease IX. Communication and Documentation X. Transport Decisions Infectious Disease I. Causes of Infectious Disease A. Infectious Agents 1. Bacteria 2. Viruses 3. Fungi 4. Protozoa 5. Helminths (worms) II. Body Substance Isolation, Personal Protective Equipment, and Cleaning and Disposing of Equipment and Supplies A. Principles of Body Substance Isolation B. Hand Washing Guidelines C. Recommendations for PPE D. Recommendations for Cleaning or Sterilization of Equipment E. Recommendations for Disposing of Contaminated Linens and Supplies Including Sharps F. Recommendations for Decontaminating the Ambulance III. Consider Age-Related Variations in Pediatric and Geriatric Patients as They Relate Assessment and Management of Patients With a Gastrointestinal Condition or Emergency IV. Communication and Documentation for a Patient With a Communicable or Infectious Disease V. Transport Decisions Including Special Infection Control Procedures VI. Legal Requirements Regarding Reporting Communicable or Infectious Diseases/Conditions A. Exposure of Health Care Provider 1. Current recommended treatment modalities and follow-up 2. Prevention of exposure or immunizations/vaccines VII. Required Reporting to the Health Department or Other Health Care Agency Endocrine Disorders I. Introduction A. Definition of Terms 1. Diabetes—types I and II 2. Hypoglycemia 3. Hyperglycemia, diabetic ketosis B. Anatomy and Function of the Pancreas C. General Assessment Findings and Symptoms 1. Confusion, vertigo, headache, syncope 2. Decreasing level of consciousness 3. Combative or uncooperative or restless 4. Increasing level of consciousness 5. Visual changes file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 6. Speech changes 7. Movement and sensation changes II. Diabetes A. Overview of Condition 1. Incidence 2. Explanation of relationship of glucose and insulin 3. Normal Blood Glucose Levels (BGL) 4. Types a. Type 1 (formerly known as Insulin Dependent Diabetes or Type I) b. Type 2 (formerly known as Non-Insulin Dependent Diabetes or Type II) i. oral agents ii. diet-controlled 5. Diabetic medications a. Insulins b. Oral agents 6. Complications B. Hyperglycemia/Diabetic Ketoacidosis 1. Pathophysiology 2. Causes 3. History and assessment findings a. onset—slow changes in mental status b. Kussmaul’s breathing, acetone breath c. Dehydration, poor skin tugor, pale, warm and dry d. Weakness, nausea, and vomiting e. Weak and rapid pulse f. Polyuria, polydipsia, polyphagia g. Other h. Medical alert identification 4. Management a. ABCs (airway adjunct) b. Position c. Oxygen d. Pulse oximetry e. Emotional support C. Hypoglycemia 1. Causes 2. History and assessment findings a. Onset – rapid changes in mental status b. Bizarre behavior, tremors, shaking c. Sweating, hunger d. Rapid full pulse, rapid shallow respirations e. Seizures, coma late f. Medical alert identification 3. Management a. ABCs, oxygen b. Oral glucose as indicated (must be able to control airway) c. Emotional support 4. Oral glucose a. Indication/contraindications b. Actions c. Side effects d. Dose and route e. Medical control role f. When in doubt if hyper/hypoglycemia, give glucose D. Consider Age-Related Variations for Pediatric and Geriatric Assessment and Management 1. Pediatric a. Usually insulin dependant called juvenile diabetes b. Late stages of hyperglycemia may have cerebral edema c. Prone to seizures d. Prone to dehydration e. May be undiagnosed 2. Geriatric a. Can mask signs and symptoms of myocardial infarction b. Prone to dehydration and infections III. Communication and Documentation file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 IV. Transport Decisions—Rapid Transport for Altered Level of Consciousness Psychiatric I. Define A. Behavior B. Psychiatric Disorder C. Behavioral Emergency II. Epidemiology of Psychiatric Disorders III. Assessment A. General Appearance B. Speech C. Skin D. Posture/Gait E. Mental Status F. Mood, Thought, Perception, Judgment, Memory, and Attention IV. Behavioral Change A. Factors That May Alter a Patient’s Behavior – May Include Situational Stresses, Medical Illnesses, Psychiatric Problems, and Alcohol or Drugs B. Common Causes of Behavioral Alteration 1. Low blood sugar 2. Lack of oxygen 3. Hypoperfusion 4. Head trauma 5. Mind altering substances 6. Psychogenic – resulting in psychotic thinking, depression or panic 7. Excessive cold 8. Excessive heat 9. Meningitis 10. Seizure disorders 11. Toxic ingestions – overdose 12. Withdrawal of drugs or alcohol V. Psychiatric Emergencies A. Acute Psychosis B. Assessment for Suicide Risk 1. Depression 2. Risk factors/signs or symptoms a. Ideation or defined lethal plan of action which has been verbalized and/or written b. Alcohol and substance abuse c. Purposelessness d. Anxiety, agitation, unable to sleep or sleeping all the time e. Feeling trapped, no way out f. Hopelessness g. Withdrawal from friends, family and society h. Anger and/or aggressive tendencies i. Recklessness or engaging in risky activities j. Dramatic mood changes k. History of trauma or abuse l. Some major physical illness (cancer, CHF, etc.) m. Previous suicide attempt n. Job or financial loss o. Relational or social loss p. Easy access to lethal means q. Lack of social support and sense of isolation r. Certain cultural and religious beliefs 3. Important questions a. How does the patient feel? b. Determine suicidal tendencies c. Is patient threat to self or others? d. Is there a medical problem? e. Is there trauma involved? f. Interventions? C. Agitated Delirium 1. Emergency medical care a. Scene size-up, personal safety b. Establish rapport file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 i. utilize therapeutic interviewing techniques a) engage in active listening b) supportive and empathetic c) limit interruptions d) respect patient’s territory, limit physical touch ii. avoid threatening actions, statements and questions iii. approach slowly and purposefully c. Patient assessment i. intellectual functioning ii. orientation iii. memory iv. concentration v. judgment vi. thought content a) disordered thoughts b) delusions, hallucinations c) unusual worries, fears vii. language a) speech pattern and content b) garbled or unintelligible viii. mood a) anxiety, depression, elation, agitation b) level of alertness, distractibility i) appearance, hygiene, dress ii) psychomotor activity d. Calm the patient – do not leave the patient alone, unless unsafe situation; consider need for law enforcement e. Restrain if necessary f. Transport g. If overdose, bring medications or drugs found to medical facility VI. Medical-Legal Considerations A. Types of Restraints B. Transport Against Patient Will VII. Consider Age-Related Variations for Pediatric and Geriatric Assessment and Management A. Pediatric Behavioral Emergencies 1. Teenage suicide concerns 2. Aggressive behavior may be a symptom of an underlying disorder or disability B. Geriatrics -- suicide issues/depression common Cardiovascular I. Anatomy of the Cardiovascular System A. Heart 1. Chambers 2. Valves 3. Blood supply to myocardium 4. Myocardial muscle cells 5. Specialized electrical cells 6. Automaticity 7. Autonomic system control a. Sympathetic – “fight or flight” b. Parasympathetic B. Vessels 1. Aorta 2. Arteries 3. Arterioles 4. Capillaries 5. Venules 6. Veins 7. Vena cava C. Blood 1. Red blood cells 2. White blood cells 3. Platelets 4. Plasma II. Physiology file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 A. Cardiac Cycle 1. Systole 2. Diastole B. Pulses 1. Peripheral Pulses 2. Central pulses C. Blood Pressure 1. Systolic 2. Diastolic D. Blood Circulation Through a Double Pump 1. Respiratory system a. Deoxygenated blood to lungs b. Oxygenated blood back to heart 2. Body E. Cardiac Output 1. Heart rate X blood volume ejected/beat F. Perfusion 1. Function of red blood cells in oxygen delivery 2. Factors governing adequate perfusion a. Rate b. Pump c. Volume G. Oxygenation of Tissues 1. Delivery of oxygenated blood 2. Removal of tissue wastes III. Pathophysiology A. Cardiac Compromise 1. Inadequate circulation of blood and/ or perfusion of vital processes or organs 2. Atherosclerosis a. Plaque buildup in lumen of artery b. Obstruction of blood flow c. Interference with dilation and constriction of vessel d. Occlusion e. Ischemia is a result of decreased blood flow 3. Rate-related compromise 4. Inadequate pumping 5. Inappropriate circulating volume IV. Assessment A. Primary Survey 1. Level of responsiveness a. Restlessness, anxiety b. Feeling of impending doom 2. Airway 3. Breathing a. Rate and depth b. Effort c. Breath sounds d. Significance of findings 4. Circulation a. Pulse i. rate ii. quality b. Skin i. color ii. temperature iii. moisture iv. edema c. Blood pressure B. History 1. Chief complaint 2. History of the present illness a. Chest discomfort/pain i. signs and symptoms ii. OPQRST evaluation b. Respiratory i. dyspnea a) continuous file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 b) exertional c) non-exertional d) orthopneic ii. cough a) dry b) productive c. Related signs and symptoms i. nausea/vomiting ii. fatigue iii. palpitations iv. headache v. recent trauma 3. Past medical history a. SAMPLE history b. Previous heart disease/surgery i. angina ii. previous AMI iii. hypertension iv. heart failure v. valve disease vi. aneurysm vii. pulmonary disease viii. diabetes ix. COPD x. renal disease c. Current/past medications i. prescribed ii. over-the-counter iii. home remedies iv. recreational drug use d. Family history C. Secondary Survey V. Management (refer to the current American Heart Association guidelines) A. Place in proper position B. Evaluation and appropriate management of ventilations/respirations 1. Oxygen saturation evaluation 2. pulse oximetry C. May be unreliable in cardiac arrest, toxic inhalation 1. Appropriate management of any related ventilatory/respiratory compromise a. BVM assistance b. PEEP c. CPAP/BiPAP d. MTV/ATV 2. Appropriate oxygen therapy D. Evaluation and appropriate management of cardiac compromise 1. Manual and auto BP 2. Mechanical CPR 3. AED E. Pharmacological interventions 1. Aspirin 2. Nitroglycerin 3. Oral glucose F. Consider AEMT/Paramedic assistance at the scene G. Appropriate transportation VI. Specific Cardiovascular Emergencies (refer to current American Heart Association guidelines) A. Acute Coronary Syndromes (ACS) Heart Failure B. Hypertensive Emergencies 1. Systolic BP greater than 160 mmHg 2. Diastolic BP greater than 94 mmHg 3. Signs and symptoms a. Strong, bounding pulse b. Skin warm, dry, or moist c. Headache d. Ringing in ears e. Nausea/vomiting f. Nose bleed file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 4. Assessment C. Cardiogenic Shock D. Cardiac Arrest VII. Pharmacological Agents A. Aspirin 1. Generic and trade names 2. Indications 3. Contraindications 4. Actions 5. Side effects 6. Precautions 7. Expiration date 8. Dosage 9. Administration B. Nitroglycerin 1. Generic and trade names 2. Indications 3. Contraindications 4. Actions 5. Side effects 6. Precautions 7. Expiration date 8. Dosage 9. Administration C. Role of Medical Oversight in Medication Administration D. Patient Assisted Administration E. Documentation VIII. Consider Age-Related Variations for Pediatric and Geriatric Patients for Assessment and Management of Cardiac Compromise A. Pediatric 1. Cardiac problems typically associated with congenital heart condition 2. Cardiovascular compromise often caused by respiratory compromise B. Geriatric -- typical MI presentation often related to other underlying disease processes 1. Diabetes 2. Asthma 3. COPD Toxicology I. Introduction A. Define Toxicology, Poisoning, Overdose B. National Poison Control Center C. Routes of Absorption 1. Ingestion 2. Inhalation 3. Injection 4. Absorption II. Poisoning by Ingestion A. Examples B. Assessment Findings C. General Management Considerations III. Poisoning by Inhalation A. Examples B. Assessment Findings C. General Management Considerations IV. Poisoning by Injection A. Examples B. Assessment Findings C. General Management Considerations V. Poisoning by Absorption A. Examples B. Assessment Findings C. General Management Considerations file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 VI. Drugs of Abuse A. Opiates/Narcotics 1. Common causative agents 2. Assessment findings and symptoms a. Decreased level of consciousness, sedation b. Hypotension c. Respiratory depression/arrest d. Nausea, pinpoint pupils e. Seizures and coma 3. Management for a patient using opiates B. Alcohol 1. Overview of alcoholism including long-term effects 2. Alcohol abuse a. CNS changes—agitation to sedation to altered level of consciousness b. Respiratory depression c. Nausea and vomiting d. Uncoordination 3. Alcohol withdrawal a. Tremors, sweating weakness b. Hallucinations and seizures 4. Assessment findings and symptoms for patients with alcohol abuse and alcohol withdrawal 5. Management for a patient using alcohol or withdrawing from alcohol — airway, ventilation, and circulation C. Common Causative Agents, Assessment Findings and Symptoms, Management 1. Cannabis 2. Hallucinogens 3. Stimulants 4. Barbiturates/sedatives/ hypnotics VII. Poisonings and Exposures A. Scene Safety Issues B. Common Causative Agents, Assessment Findings and Symptoms, Management 1. Pesticides 2. Chemicals 3. Household cleaning poisonings 4. Poisonous plants VIII. Medication Overdose A. Common Causes of Overdoses (Other Than Drugs of Abuse) 1. Cardiac medications 2. Psychiatric medications 3. Non-prescription pain medications including Salicylates and Acetaminophen 4. Other B. Assessment Findings and Symptoms for Patients With Medication Overdose C. Management for a Patient With Medication Overdose IX. General Treatment Modalities for Poisonings A. Scene Safety B. Standard Precautions and Decontamination C. Airway Control D. Ventilation and Oxygenation E. Circulation F. Use of Activated Charcoal 1. Indications/contraindications/side effects 2. Physician order 3. Dose X. Consider Age-Related Variations for Pediatric and Geriatric Assessment and Management A. Pediatric 1. Toddler-aged prone to ingestions of toxic substance 2. Adolescent prone to experimentation with drugs of abuse B. Geriatric -- Alcoholism is common in elderly XI. Communication and Documentation for Patients With Toxicological Emergencies XII. Transport Decisions file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 Respiratory I. Anatomy of the Respiratory System A. Upper Airway B. Lower Airway C. Lungs and Accessory Structures II. Normal Respiratory Effort III. Assessment Findings and Symptoms and Management for Respiratory Conditions A. Respiratory Distress 1. Assessment a. Shortness of breath b. Restlessness c. Increased pulse rate d. Changes in respiratory rate or rhythm e. Skin color changes f. Abnormal sounds of breathing/lung sounds g. Inability to speak h. Retractions i. Altered mental status j. Abdominal breathing k. Coughing l. Tripod position 2. Management of respiratory distress a. Scene safety and Standard Precautions b. ABCs, position c. Oxygen/suction d. Pulse oximetry e. Emotional support f. Transport IV. Specific Respiratory Conditions—Definition, Causes, Assessment Findings and Symptoms, Complications, and Specific Prehospital Management and Transport Decisions A. Asthma B. Pulmonary Edema C. Chronic Obstructive Pulmonary Disease D. Pneumonia E. Spontaneous Pneumothorax F. Pulmonary Embolism G. Epiglottis H. Pertussis I. Cystic Fibrosis J. Environmental/Industrial Exposure/ Toxic Gasses K. Viral Respiratory Infections V. Metered-Dose Inhaler and Small Volume Nebulizer A. EMT Role in Assisting B. Indication/ Contraindications C. Actions D. Side Effects E. Dose and Route F. Medical Control Role VI. Communication and Documentation for Patients With Respiratory Emergencies VII. Consider Age-Related Variations for Pediatric and Geriatric Assessment and Management A. Pediatric 1. Upper airway obstruction (i.e. foreign body aspiration or tracheostomy dysfunction) 2. Lower airway disease (i.e. foreign body lower airway obstruction) B. Geriatrics—Pneumonia and Chronic Conditions Such as COPD Common 1. Upper airway obstruction a. Croup b. Foreign body aspiration c. Epiglottitis d. Tracheostomy dysfunction 2. Lower airway disease file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 a. Asthma b. Bronchiolitis c. Pneumonia d. Foreign body lower airway obstruction e. Pertussis f. Cystic fibrosis VIII. Transport Decisions Medicine Hematology I. Anatomy and Physiology A. Blood 1. Red blood cells 2. White blood cells 3. Platelets B. Plasma C. Blood-Forming Organs 1. Red cell production 2. Red cell destruction II. Pathophysiology of Sickle Cell III. Sickle Cell Crisis A. General Assessment 1. Level of consciousness 2. Skin 3. Visual disturbances 4. Gastrointestinal 5. Skeletal 6. Cardiorespiratory 7. Genitourinary B. General Management 1. Airway, ventilation, and circulation 2. Oxygen 3. Transport considerations 4. Psychological/communication strategies IV. Clotting Disorders V. Consider Age-Related Variations A. Pediatrics B. Geriatrics Genitourinary/Renal I. Anatomy and Physiology of Renal System II. Pathophysiology A. Kidney Failure B. Kidney Stones III. Dialysis A. Hemodialysis 1. Shunt 2. Fistula 3. Graft B. Peritoneal Dialysis C. Special Considerations for Hemodialysis Patients 1. Obtaining B/P D. Complications/Adverse Effects of Dialysis 1. Hypotension 2. Muscle cramps 3. Nausea/vomiting 4. Hemorrhage especially from access site 5. Infection at access site E. Missed Dialysis Treatment 1. Weakness 2. Pulmonary edema IV. Management for a Patient With a Dialysis Emergency A. ABCs, Support Ventilation B. Stop Bleeding From Shunt as Needed C. Position—Flat If Shocky, Upright If Pulmonary Edema V. Urinary Catheter Management file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 VI. Consider Age-Related Variations in Pediatric and Geriatric Patients VII. Communication and Documentation VIII. Transport Decisions Gynecology I. Introduction A. Female Reproductive System Anatomy and Physiology 1. External Genitalia 2. Internal Organs and Structures II. Assessment Findings A. Abdominal Pain or Vaginal Pain B. Vaginal Bleeding C. Vaginal Discharge D. Fever E. Nausea and Vomiting F. Syncope III. General Management A. Protect Privacy and Modesty B. Communication Techniques C. Consider Pregnancy and/or Sexually Transmitted Diseases IV. Specific Gynecological Emergencies—Definition, Causes, Risk Factors, Assessment Findings, Management A. Vaginal Bleeding B. Sexual Assault — Legal Issues C. Infections — Pelvic Inflammatory Disease D. Sexually Transmitted Diseases V. Age-Related Variations for Pediatric and Geriatric Assessment and Management A. Pediatrics -- Menarche could be cause of bleeding B. Geriatrics -- Menopausal women can get pregnant VI. Communication and Documentation VII. Transport Decisions Non-Traumatic Musculoskeletal Disorders I. Anatomy and physiology review A. Bones B. Muscles II. Pathophysiology A. Non-Traumatic Fractures (i.e. cancer or osteoporosis) III. Assessment A. Pain or Tenderness B. Swelling C. Abnormal or Loss of Movement D. Sensation Changes E. Circulatory Changes F. Deformity IV. Management A. Airway, Ventilation, and Circulation B. Splinting C. Transport Considerations D. Communications and Documentation V. Consider Age-Related Variations A. Pediatric B. Geriatric Diseases of the Eyes, Ears, Nose, and Throat I. Nosebleed A. Causes 1. Trauma 2. Medical a. Dryness file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 b. High blood pressure B. General Assessment Findings and Symptoms 1. Pain or tenderness 2. Bleeding from nose 3. Vomits swallowed blood 4. Can block airway if patient is unresponsive C. Techniques to Stop Bleeding in Conscious Patient If No Risk of Spine Injury 1. Sit patient up and lean forward 2. Pinch the nostrils together firmly 3. Tell patient not to sniffle or blow nose Shock and Resuscitation I. Ethical Issues in Resuscitation A. Withholding Resuscitation Attempts 1. Irreversible death 2. Do Not Resuscitate (DNR) orders B. Provide Emotional Support for Family II. Anatomy and Physiology Review A. Respiratory System 1. Passageway for fresh oxygen to enter the lungs and blood supply 2. Respiratory waste products to leave the blood and lungs B. Cardiovascular System 1. Heart a. Four chambers b. Pumps blood to the lungs to pick up oxygen c. Pumps blood around the body i. to deliver oxygen and nutrients to the tissues ii. to remove waste products from the tissues 2. Vascular System a. Arteries carry blood to tissues i. carotid pulse ii. femoral pulse iii. radial pulse iv. brachial pulse b. Veins carry blood to heart III. Respiratory Failure A. Pathophysiology 1. Constrictive 2. Obstructive 3. Destructive B. Assessment 1. Pulmonary symptoms 2. Cardiovascular symptoms 3. Neurological symptoms 4. Other symptoms C. Treatment 1. Oxygen therapy 2. Ventilatory support a. Carbon dioxide clearance b. Pharmacological therapy IV. Respiratory Arrest A. Assessment B. Treatment 1. Oxygen therapy 2. Ventilatory support a. Carbon dioxide clearance b. Advanced airways V. Cardiac Arrest A. Pathophysiology 1. If the heart stops contracting, no blood will flow 2. The body cannot survive when the heart stops a. Organ damage begins quickly after the heart stops b. Brain damage begins 4-6 minutes after the patient suffers cardiac arrest — damage becomes irreversible in 8-10 minutes 3. Cardio-pulmonary resuscitation (CPR) a. Artificial ventilation — oxygenates the blood file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 b. External chest compressions — pushing on the chest squeezes the heart and simulates a contraction c. Oxygenated blood is circulated to the brain and other vital organs B. General Reasons for the Heart to Stop Beating 1. Sudden death and heart disease 2. Breathing stops, especially in infants and children 3. Medical emergencies 4. Trauma VI. Resuscitation A. System Components to Maximize Survival 1. Early access a. Public education and awareness i. rapid recognition of a cardiac emergency ii. rapid notification before CPR starts — "phone first" b. 911-pre-arrival instructions and dispatcher directed CPR 2. Early CPR a. Lay public i. family ii. bystanders b. Emergency Medical Responders 3. Early Defibrillation 4. Early Advanced Care B. Basic Cardiac Life Support (Refer to the Current American Heart Association Guidelines) 1. Adult CPR and foreign body airway obstruction 2. Child CPR and foreign body airway obstruction 3. Infant CPR and foreign body airway obstruction C. Airway Control and Ventilation 1. Basic Airway adjuncts 2. Ventilation a. Delivery of excessive rate or depth of ventilation reduces blood return to the right side of the hear b. Reduces the overall blood flow that can be generated with CPR D. Chest Compressions 1. Factors which decrease effectiveness a. Compression that are too shallow b. Slow compression rate c. Sub-maximum recoil d. Frequent interruptions 2. Devices to assist circulation a. Impedance Threshold Device b. Mechanical Piston Device c. Load-Distributing Band or Vest CPR VII. Automated External Defibrillation (AED) (Refer to the current American Heart Association guidelines) A. Adult AED Use B. Child AED Use C. Infant AED Use D. Special AED situations 1. Pacemaker 2. Wet patients 3. Transdermal medication patches VIII. Shock (Poor Perfusion) A. Definition 1. Perfusion is the passage of blood and oxygen and other essential nutrients to the body’s cells 2. While delivering these essentials to the body’s cells, the circulatory system is also removing waste such as carbon dioxide from the cells 3. Shock is a state of hypoperfusion, or inadequate perfusion of blood through body tissues 4. Hypoperfusion can lead to death if not corrected B. Anatomy and Physiology Review 1. Heart/Blood vessels 2. Physiology of respiration a. Gas exchange i. alveolar level ii. tissue level file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 b. Circulation i. pulmonary ii. systemic 3. Essential components for normal perfusion a. Functioning pump/heart i. pump delivers blood to the tissue ii. pump collects blood from the body iii. controlled by the autonomic nervous system during shock b. Adequate volume i. blood contains formed elements a) RBCs transport oxygen b) WBCs fight infection c) platelets form blood clots d) clots are very unstable and prone to rupture ii. plasma is the fluid that transports the formed elements c. Intact container/vessels i. arteries surrounded by smooth muscle contract and dilate to deliver blood to tissue ii. capillary beds are the site where perfusion occurs iii. veins are low pressure vessels responsible for returning blood to the heart iv. smooth muscle and sphincters controlled by the autonomic nervous system to constrict or dilate v. blood flow controlled by cellular tissue demands C. Disruptions That Can Cause Shock 1. Inadequate fluid/blood – blood/water loss 2. Failing pump/heart a. Disease or injury to conduction system b. Damage to cardiac muscle 3. Leaky or dilated container/vessels a. Loss of nervous control b. Severe allergic reactions c. Massive infection d. Hypothermia D. Categories of Shock 1. Compensated shock 2. Decompensated shock 3. Irreversible shock E. Shock Due to Fluid Loss 1. Hypovolemic a. Examples b. Signs and symptoms F. Shock Due to Pump Failure 1. Cardiogenic a. Examples b. Signs and symptoms G. Shock Due to Container Failure 1. Anaphylaxis a. Examples b. Signs and symptoms 2. Neurogenic a. Examples b. Signs and symptoms 3. Sepsis a. Examples b. Signs and symptoms H. Patient Assessment 1. Complete a scene size-up 2. Perform a primary assessment 3. Obtains a relevant history 4. Perform secondary assessment 5. Perform a reassessment I. Management 1. Manual in-line spinal stabilization, as needed 2. Comfort, calm, and reassure the patient while awaiting additional EMS resources 3. Do not give food or drink 4. Airway control – adjuncts, as needed 5. Breathing a. Oxygen administration (high-flow/high-concentration) file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 b. Assist ventilation, as needed 6. Circulation a. Attempt to control obvious uncontrolled external bleeding b. Position patient appropriately for all ages c. Keep patient warm – attempt to maintain normal body temperature 7. Pneumatic anti-shock garment (PASG) application 8. Begin transport at the earliest possible moment 9. Treat any additional injuries that may be present J. Age-related variations 1. Pediatrics a. Common causes of shock i. trauma ii. fluid loss iii. infection iv. anaphylaxis v. congenital heart disease vi. chest wall injury b. Presentation of Shock i. cardiovascular ii. skin signs iii. CNS iv. decreased fluid output v. vital signs c. Management i. inline spinal stabilization, if indicated ii. suction, as needed iii. high oxygen concentration iv. control bleeding v. positioning vi. maintain body temperature vii. transport 2. Geriatrics a. Assessment i. body system changes affecting presentation of shock a) CNS b) cardiovascular c) respiratory d) skin e) renal f) GI ii. vital signs changes a) CNS b) hypoxia iii. airway a) decreased cough reflex b) cervical arthritis c) loose dentures iv. breathing a) higher resting respiratory rate b) lower tidal volume c) less elasticity/compliance of chest wall v. circulation a) higher resting heart rate b) irregular pulses vi. skin a) dry, less elastic b) cold c) fever, not common d) hot b. Management i. inline spinal stabilization, if indicated ii. suction, as needed iii. high oxygen concentration iv. control bleeding v. positioning vi. maintain body temperature vii. transport Trauma Overview I. Identification and Categorization of Trauma Patients file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 A. Entry-level students need to be familiar with the National Trauma Triage Protocol 1. Centers for Disease Control and Prevention. Guidelines for Field Triage of Injured Patients: Recommendations of the National Expert Panel on Field Triage. MMWR 2008:58 RR-1:1-35. 2. http://cdc.gov/fieldtriage contains the National Trauma Triage Protocols and additional instructional materials. II. Pathophysiology of the Trauma Patient A. Blunt Trauma 1. Non-bleeding 2. Multiple forces and conditions can cause blunt trauma B. Penetrating Trauma -- high, medium, and low velocity II. Assessment of the Trauma Patient A. Major Components of the Patient Assessment 1. Standard precautions 2. Scene size-up 3. General impression 4. Mechanism of injury 5. Primary assessment 6. Baseline vital signs 7. History 8. Secondary assessment 9. Re-assessment B. Mechanism of Injury (MOI) 1. Significant MOI (including, but not limited to) a. Multiple body systems injured b. Vehicle Crashes with intrusion c. Falls from heights d. Pedestrian versus vehicle collision e. Motorcycle crashes f. Death of a vehicle occupant in the same vehicle 2. Non-significant MOI (including, but not limited to) a. Isolated trauma to a body part b. Falls without loss of consciousness (adult and pediatric) 3. Pediatric considerations a. Falls >10 feet without loss of consciousness b. Falls <10 feet with loss of consciousness c. Bicycle collision d. Medium- to high-speed vehicle collision (>25 mph) 4. Re-evaluating the MOI 5. Special Considerations a. Spinal precautions must be initiated soon as practical based on the MOI b. When practical, roll the supine patient on their side to allow for an appropriate assessment of the posterior body c. Consider the need for ALS backup for all patients who have sustained a significant MOI C. Primary Survey 1. Airway a. Clear airway; jaw thrust, suction b. Protect airway 2. Breathing a. Assess ventilation b. Administer high concentration oxygen c. Check thorax and neck i. deviated trachea ii. tension pneumothorax iii. chest wounds and chest wall motion iv. sucking chest wound v. neck and chest crepitation vi. multiple broken ribs vii. fractured sternum d. Listen for breath sounds e. Circulation i. Apply pressure to sites of external bleeding ii. Radial and carotid pulse locations, B/P determination iii. Jugular venous distention f. Hypovolemia g. Disability i. brief neurological exam file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 ii. pupil size and reactivity iii. limb movement iv. Glasgow Coma Scale h. Exposure i. completely remove all clothes ii. logroll as part of inspection D. Secondary Assessment - Head-to-Toe Physical Exam 1. Described in detail in Patient Assessment: Secondary Survey E. Secondary Assessment 1. Rapid Method 2. Modified secondary assessment F. Trauma Scoring 1. Glasgow Coma Score 2. Revised Trauma Score III. Management of the Trauma Patient A. Rapid Transport and Destination Issues 1. Scene time 2. Air versus ground B. Destination Selection C. Trauma System Components 1. Hospital categorizations 2. Levels and qualifications D. Transport Considerations Bleeding I. Pathophysiology A. Type of Traumatic Bleeding 1. Internal 2. External 3. Arterial a. Bright red bleeding “spurting” b. Difficult to control, due to size of vessels, volume of blood, and pressure that blood is pushed through arteries c. As blood pressure drops, amount of spurting blood drops 4. Venous a. Darker red blood can vary from slow to severe stream, depending on size of vein b. Can be difficult to control, but easier to control than arterial bleeds c. Bleeding can be profuse and life-threatening 5. Capillary – blood oozes from wound a. Usually easy to control or stop without intervention b. Clots spontaneously B. Severity – Related to 1. Volume of blood loss 2. Rate of blood loss 3. Age and pre-existing health of patient C. Physiological Response to Bleeding 1. Clotting and clotting disorders 2. Factors that affect clotting a. Movement of injured area b. Body temperature c. Medications d. Removal of bandages 3. Localized vasoconstriction II. General Assessment A. Mechanism of Injury B. Primary Survey 1. Identify and manage life threats related to bleeding 2. Mental status C. Physical Exam 1. Blood pressure is not a reliable indicator of early shock 2. Lung sounds 3. Peripheral perfusion 4. Skin parameters D. History – Pre-Existing Illnesses E. Pediatric Considerations file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 1. Vital sign variations 2. Total fluid volume less than adults F. Geriatric Considerations III. Management Strategies A. Body Substance Isolation B. Airway Patency – May be obstructed if unconscious C. Oxygenation and Ventilation 1. Pulse oximetry 2. Apply oxygen D. Internal and External Bleeding Control 1. External bleeding a. Direct pressure i. application of even pressure to an open injury that includes the area just proximal and distal to the injury ii. using a gloved hand and dressings, the wound is covered and firm pressure applied until bleeding is controlled iii. usually effective in capillary and minor venous bleeding iv. in cases of heavier bleeding or major wounds, multiple dressings may be necessary; do not remove existing dressings but apply additional dressings on top of existing dressings in cases of continuing hemorrhage b. Splints i. soft ii. rigid iii. traction splint iv. pressure splints c. Tourniquet – if severe bleeding is not controlled by direct pressure d. Signs and symptoms – bleeding may not slow after much blood loss i. some patients may be quiet and calm due to excessive blood loss ii. the amount of blood at the scene does not always indicate the amount of blood loss; the patient may move iii. estimating the amount of blood loss by the size of a blood pool or the amount on clothing is not accurate iv. assess for signs and symptoms of shock 2. Internal bleeding a. Definition/description i. any bleeding in a cavity or space inside the body. ii. internal bleeding can be severe and life threatening. iii. may initially go undetected without proper assessment (mechanism of injury, signs, and symptoms) b. Signs and symptoms i. guarding, tenderness, deformity, discoloration of the affected area ii. coughing up blood, blood in urine, rectal bleeding iii. abdominal tenderness, guarding, rigidity, distention iv. bleeding from a body orifice. v. signs of shock E. Stabilize Body Temperature F. Psychological Support G. Transport Considerations 1. Trauma center 2. Aeromedical transport 3. ALS mutual aid Chest Trauma I. Incidence of Chest Trauma A. Morbidity B. Mortality II. Mechanism of Injury for Chest Trauma A. Blunt B. Penetrating C. Energy and Injury III. Anatomy of the Chest A. Skin file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 B. Muscles C. Bones D. Trachea E. Bronchi F. Lungs G. Vessels H. Heart I. Esophagus J. Mediastinum IV. Physiology A. Role of the Chest in Systemic Oxygenation 1. Musculoskeletal structure 2. Intercostal muscle 3. Diaphragm 4. Accessory muscle 5. Changes in intrathoracic pressure B. Ventilation 1. Gas exchange depends on a. Normal inspiration i. active process ii. normal chest rise iii. negative pressure in chest allows air to flow in b. Normal expiration – passive process 2. Chest wall movement – intact chest wall 3. Minute volume – volume of air exchanged between lungs and environment per minute V. Pathophysiology of Chest Trauma A. Impaired Cardiac Output Related to 1. Trauma that affects the heart a. Heart can’t refill with blood b. Blood return to the heart is blocked 2. Blood loss (external and internal) B. Impaired Ventilation 1. Collapse of lung 2. Multiple rib fractures C. Impaired Gas Exchange 1. Blood in lungs 2. Bruising of lung tissue VI. General Assessment Findings A. Vital Signs 1. Blood pressure 2. Pulse a. Increases initially if hypoxia or shock b. Decreases when patient near arrest from shock or hypoxia 3. Respiratory rate and effort – respiratory distress B. Skin – Color, Temperature, Moisture C. Head, Neck, Chest, and Abdomen 1. Jugular vein distension 2. Paradoxical movement D. Level of Consciousness E. Medical History 1. Medications 2. Respiratory/cardiovascular diseases F. Physical Exam 1. Inspection 2. Auscultation – breath sounds present or absent 3. Palpation G. Associated Injuries H. Blunt Injury I. Penetrating Injury VII. General Management A. Airway and Ventilation 1. Occlusion of open wounds 2. Positive pressure ventilation – to support flail chest B. Circulation VIII. Blunt Trauma or Closed Chest Injury A. Closed Chest Injury file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 1. Specific injuries a. Rib fractures b. Flail segment – stabilizing a flail is contraindicated c. Sternal fracture – consider underlying injury d. Clavicle fracture e. Commotio Cordis IX. Open Chest Injury A. Mechanism of Injury 1. Penetrating injury from weapons 2. Penetrating injury secondary to blunt chest wall trauma 3. Specific injuries a. Lung Injury b. Air in pleural space causes lung to collapse (pneumothorax) i. closed ii. open (sucking chest wound) c. Increasing amounts of air in space causing pressure on vessels and heart (tension pneumothorax) d. Blood in chest due to injury (hemothorax) e. Signs and symptoms of lung injury i. oxygenation changes due to open chest injuries ii. decreased or absent lung sounds due to open chest injuries f. Assessment of lung injury – presence or absence of lung sounds g. Management – apply non-porous (occlusive) dressing h. Myocardial injury i. Penetrating – effect on pumping action of the heart and blood loss with blood in the sac surrounding the heart restricting heart’s ability to pump (pericardial tamponade) j. Signs and symptoms of heart injury i. irregular pulse ii. chest pain iii. hypo-perfusion k. Assessment l. Management X. Age-Related Variations for Pediatric and Geriatric Assessment and Management A. Pediatric B. Geriatric Abdominal and Genitourinary Trauma I. Incidence A. Morbidity B. Mortality II. Anatomy A. Quadrants and Boundaries of the Abdomen B. Surface Anatomy of the Abdomen C. Intraperitoneal Structures D. Retroperitoneal Structures E. Reproductive Organs III. Physiology A. Solid Organs B. Hollow Organs C. Vascular Structures IV. Specific Injuries A. Closed Abdominal Trauma 1. Mechanism of Injury a. Compression b. Deceleration c. MVA d. Motorcycle collisions e. Pedestrian injuries f. Falls g. Assault h. Blast injuries 2. Signs and Symptoms a. Pain file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 b. Guarding c. Distention – rise in abdomen between pubis and xiphoid process d. Discoloration of abdominal wall e. Tenderness – on movement f. Lower rib fractures g. May be overlooked in multi-system injuries h. Suspicion based on mechanism of injury 3. Assessment a. Inspection b. Noting position of the patient c. Noting pain with movement d. Auscultation – little value e. Blood loss through rectum or vomit 4. Management a. Oxygen b. Transport in position of comfort if indicated c. Treat for shock – internal bleeding B. Penetrating/Open Abdominal Trauma 1. Low-velocity penetration – knife wound, tear of abdominal wall, consider injury to underlying organ 2. Medium velocity penetration – shot gun wound 3. High velocity penetration – gunshot wound 4. Signs and Symptoms of penetrating abdominal trauma a. Bleeding b. Puncture wounds – entrance and exits c. Many signs and symptoms of closed abdominal wounds could also be present along with a puncture wound 5. Assessment a. Clothing removal b. Inspection – look for exit wounds including posterior c. Noting position of patient 6. Management a. Cover wounds b. Use non-porous dressing if chest may be involved c. Treat for shock d. Oxygen e. Transport decision C. Considerations in Abdominal Trauma 1. Hollow organs injuries a. Stomach b. Small bowel c. Large bowel d. Gallbladders e. Urinary bladder f. Considerations of signs and symptoms of hollow organ injuries i. pain – may be intense with open wounds to the stomach or small bowel ii. infection – delayed complication which may be fatal iii. air in peritoneal cavity 2. Solid organ injuries a. Blood in the abdomen does not acutely produce abdominal pain b. Abdominal pain from solid organ penetration or rupture is of slow onset c. Liver i. largest organ ii. very vascular leading to hypo-perfusion iii. injured with lower right rib fractures or penetrating trauma d. Spleen i. injured in auto crashes, falls, bicycle accidents, motorcycles ii. injured with lower left rib fractures or penetrating trauma iii. left shoulder pain e. Pancreas – injury with penetrating trauma f. Kidney i. vascular ii. blood in urine g. Diaphragm i. abnormal respiratory sounds ii. shortness of breath h. Retroperitoneal structures – the abdomen can hold a large volume of blood due to injuries of solid organs and major blood vessels file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 V. General Assessment A. High Index of Suspicion B. Pain With Abdominal Trauma Is Often Masked Due to Other Injuries C. Airway Patency D. External and Internal Hemorrhage – Monitor Vital Signs Closely With Suspicion E. Identification and Management of Life Threats F. Spinal Immobilization G. Physical Exam 1. Inspection 2. Auscultation 3. Palpation H. Associated Trauma – Provide Emergency Staff With History of Events Causing Trauma I. Recognition and Prevention of Shock J. PASG for Pelvic Fracture Stabilization K. Transportation Decisions to Appropriate Facility VI. General Management A. Scene Safety / Standard Precautions B. Airway Management C. Oxygenation and Ventilation D. Spinal Immobilization Considerations E. Control External Hemorrhage F. Identification of Life-Threatening Injury G. Application and Inflation of PASG for Pelvic Fracture Stabilization H. Abdominal Trauma May Be Masked by Other Body System Trauma I. Transportation to Appropriate Facility 1. No transport decisions 2. Transport to acute care facility 3. Transport to trauma center 4. ALS mutual aid J. Communication and Documentation VII. Age-Related Variations for Pediatric and Geriatric Assessment and Management A. Pediatric 1. Mechanism of injury as pedestrian 2. Use of PASG (fracture stabilization) B. Geriatric VIII. Special Considerations of Abdominal Trauma A. Sexual Assault 1. Criminal implications and evidence management 2. Patient confidentiality 3. Treat wounds as other soft tissue injuries B. Vaginal Bleeding Due to Trauma 1. May be due to penetrating or blunt trauma 2. Assess to determine pregnancy 3. Apply sterile absorbent vaginal pad 4. Determine mechanism of injury 5. Do not insert gloved fingers for instruments in vagina Orthopedic Trauma I. Incidence A. Morbidity/Mortality 1. Upper extremity 2. Lower extremity B. Pediatric Considerations C. Geriatric Considerations D. Mechanism of Injury 1. Direct force 2. Indirect force 3. Twisting force II. Anatomy A. Skin Layers B. Subcutaneous Layers C. Extremity Structures 1. Vascular structure a. Venous b. Arterial file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 2. Muscles 3. Bony structure a. Scapula b. Clavicle c. Humerus d. Radius e. Ulna f. Carpals g. Metacarpals h. Phalanges i. Pelvis i. ileum ii. ischium iii. pubis iv. acetabulum j. Femur i. greater trochanter ii. lesser trochanter k. Tibia l. Fibula m. Talus n. Calcaneus o. Tarsals p. Metatarsals q. Phalanges D. Axial Structures 1. Skull 2. Vertebral column E. Components of a Long Bone 1. Head 2. Shaft III. Physiology A. Function of Musculoskeletal System 1. Support a. Ligaments b. Tendons c. Cartilage d. Joints 2. Flexion 3. Extension 4. Rotation IV. Mechanism of Injury A. Upper Extremity 1. Structures a. Humerus b. Radius c. Ulna d. Metacarpal e. Carpal f. Phalanges g. Clavicle h. Joints 2. Direct 3. Indirect 4. Open – hemorrhage significance 5. Closed – hemorrhage significance 6. Sprains/strains 7. Amputations B. Lower Extremity 1. Direct 2. Indirect 3. Open 4. Closed 5. Structures a. Pelvis b. Femur c. Tibia d. Fibula file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 e. Talus f. Calcaneus g. Tarsals h. Metatarsals i. Phalanges V. Complications A. Hemorrhage B. Instability C. Loss of Tissue D. Contamination E. Long-Term Disability F. Interruption of Blood Supply G. Pregnancy With Pelvic Fracture VI. Descriptions of Fractures A. Greenstick B. Oblique C. Transverse D. Comminuted E. Spiral VII. Dislocations A. Specific Injuries 1. Acromio-clavicular 2. Shoulder 3. Elbow 4. Wrist 5. Metacarpal-phalanx a. Hip b. Posterior c. Anterior d. Associated with fracture 6. Knee a. Posterior b. Anterior c. Patella 7. Foot 8. Hand 9. Ankle B. Management 1. Scene safety/standard precautions 2. Limb-threatening injury 3. Splinting VIII. Sprains/Strains A. Mechanism of Injury B. Assessment C. Management IX. Pelvic Fracture A. Incidence B. Mechanism of Injury C. Signs and Symptoms D. Assessment E. Management – PASG (Pelvic Stabilization) X. General Assessment A. Scene Safety/Standard Precautions B. Mechanism of Injury 1. Primary injury 2. Secondary injury C. Determine Life Threat 1. Life threatening 2. Limb threatening D. Six P’s of Assessment 1. Pain a. Palpation b. Movement 2. Pallor file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 3. Paresthesia 4. Pulses 5. Paralysis 6. Pressure E. Physical Exam F. Bleeding 1. External 2. Internal G. Guarding/Self-Splinting H. Associated Injuries XI. General Management A. Control Hemorrhage 1. Internal 2. External a. Direct pressure b. Tourniquet c. Traction splint with fracture B. General Considerations for Immobilization/Splinting 1. PASG for pelvic fracture 2. Traction for femur fracture 3. Neurologic exam before and after splinting 4. Bandage/dress wounds before immobilization 5. In position found 6. Remove jewelry 7. Above and below the joint for fractures 8. Bones above and below for joints 9. Complications of improper splinting 10. Equipment needed for splinting C. Neurologic/Circulatory Examination 1. Motor/sensory 2. Distal pulses 3. Capillary refill 4. Color, temperature D. Pain Management 1. Elevate 2. Cold 3. Immobilize injury E. Associated Injuries F. Transport to Appropriate Facility G. Appropriate Communication and Documentation XII. Specific Injuries A. Amputation 1. Control bleeding of stump a. Direct pressure b. Tourniquet 2. Locate and Transport Amputate; Management a. Clean b. Wrap in sterile, moist gauze and place in plastic bag c. Place bag on crushed ice (do not freeze) d. Transport with patient e. Transport to appropriate resource hospital B. Sprains/Strains 1. Description a. Sprain b. Strain 2. Difficult to differentiate from a fracture 3. Manage as fracture C. Pelvic 1. Shock 2. Immobilize on long spine board 3. Apply PASG (pelvic stabilization) D. Femur 1. Traction splinti a. types b. application 2. Long spine board 3. Assess for soft tissue, vascular, and nerve damage E. Tibia/Fibula file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 1. Pneumatic splint 2. Long spine board splint 3. Splint to opposite leg F. Shoulder 1. Sling 2. Swathe G. Knee 1. Vascular and nerve damage 2. No traction splint H. Clavicle – Sling I. Humerus 1. Sling 2. Swathe J. Forearm 1. Splint 2. Elevate XIII. Types of Splints A. Rigid B. Formable C. Traction D. Air E. Vacuum F. Pillow/Blanket G. Short Spine Board H. Long Spine Board XIV. Age-Related Variations for Pediatric and Geriatric Assessment and Management A. Pediatric B. Geriatric – Osteoporosis (Decreased Bone Density) Increases the Likelihood of Fractures With Minimal Trauma XV. Sprains/Strains A. Pathophysiology 1. Review previous knowledge 2. Strain – muscle pull a. Stretch, tear or rip of muscle itself b. Produced by abnormal contraction c. May range from minute separation to complete rupture 3. Sprain a. Tearing of stabilizing connective tissue b. Injury to ligaments, articular capsule, synovial membrane and tendons crossing the joint c. Most vulnerable – ankles, knees, shoulders B. Special Assessment Findings 1. Review previous knowledge 2. Strains a. Sound of a “snap” when muscle tears b. Severe weakness of the muscle c. Sharp pain immediately with occurrence d. Extreme point tenderness 3. Sprains a. Edema at joint b. Sound of a “snap” with injury c. Point tenderness C. Special Management Considerations 1. Review previous knowledge 2. Strains a. Apply cold and pressure b. Elastic wrap c. Pain relief d. Elevation of part 3. Sprains a. Apply cold and pressure b. Elevation c. Elastic wrap to control swelling d. Immobilization if needed e. Pain management Soft Tissue Trauma file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 I. Incidence of Soft Tissue Injury A. Mortality B. Morbidity II. Anatomy and Physiology of Soft Tissue Injury A. Layers of the Skin B. Function of the Skin III. Closed Soft Tissue Injury A. Type of Injuries 1. Contusion 2. Hematoma 3. Crush injuries B. Signs and Symptoms 1. Discoloration 2. Swelling 3. Pain C. Assessment 1. Mechanism of injury, suspect underlying organ trauma/injury 2. Diffuse or generalized soft tissue trauma can be critical 3. Pulse, movement, sensation distal to injury D. Management 1. Cold 2. Splinting if necessary IV. Open Soft Tissue Injury A. Type of Injuries 1. Abrasions 2. Lacerations and incisions 3. Avulsions 4. Bites 5. Impaled objects 6. Amputations 7. Blast injuries/High Pressure 8. Penetrating/Punctures B. Complications of Soft Tissue Injury 1. Bleeding – shock 2. Pain 3. Infection a. Mechanisms of infection b. Risk factors C. Signs and Symptoms of Open Soft Tissue Injuries 1. Bleeding 2. Shock 3. Pain 4. Hemorrhage 5. Contaminated wounds 6. Impaled objects 7. Loss of extremity 8. Entrance and exit wounds 9. Flap of skin attached V. General Assessment A. Safety of Environment / Standard Precautions B. Airway Patency C. Respiratory Distress D. Concepts of Open Wound Dressings/Bandaging 1. Sterile 2. Non-sterile 3. Occlusive 4. Non-occlusive 5. Wet 6. Dry 7. Tourniquet 8. Complications of dressings/bandages E. Hemorrhage Control 1. Pressure dressing 2. Tourniquets F. Associated Injuries file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 1. Airway 2. Face 3. Neck trauma – increased bleeding VI. Management A. Airway Management B. Control Hemorrhage – Dress/Bandage Open Wounds C. Prevention of Shock D. Prevent Infection E. Transport to the Appropriate Facility F. Bites 1. Control hemorrhage 2. Bites often lead to serious infection G. Avulsions 1. Never remove skin flap regardless of size 2. Complete avulsion often has serious infection concerns 3. Place skin in anatomic position if flat avulsion VII. Incidence of Burn Injury A. Morbidity/Mortality B. Risk Factors VIII. Anatomy and Physiology of Burns A. Types of Burns 1. Thermal a. Types b. Severity related to i. exposure time ii. temperature c. Enclosed space versus open d. Scalds with unusual history patterns may be abuse 2. Inhalation a. Airway obstruction due to swelling may be very rapid b. Carbon monoxide inhalation c. Enclosed space vs. open space 3. Chemical a. Severity related to i. type of chemical ii. concentration of chemical iii. duration of exposure b. Solutions and powders are different 4. Electrical a. External burns may not indicate seriousness of burn b. Entrance and exit wounds c. May cause cardiac arrest d. Lighting strikes may cause cardiac arrest 5. Radiation B. Depth Classification of Burns 1. Superficial 2. Partial-thickness 3. Full-thickness C. Body Surface Area of Burns 1. Rule of nines 2. Rule of ones (palm) D. Severity of Burns 1. Minor 2. Moderate 3. Severe IX. Complications of Burn Injuries A. Infection B. Shock C. Hypoxia D. Airway Obstruction E. Hypothermia F. Hypovolemia G. Complications of Circumferential Burns X. General Assessment of Burn Injuries A. Scene Safety/Standard Precautions file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 1. Identification of burn type 2. Possibility of inhalation injury B. Airway Patency C. Respiratory Distress D. Classification of Burn Depth E. Percentage of Body Surface Area Burned F. Severity XI. General Management A. Stop the Burning B. Airway Management C. Respiratory Distress 1. Administer high concentration oxygen 2. Assist ventilation if indicated 3. Position with head elevated if spine injury not suspected D. Circulatory E. Dry, Sterile, Non-Adherent Dressing 1. After initial cooling of burn 2. Moist dressing if burn less than ten percent body surface area F. Remove Jewelry and Clothing G. Treat Shock H. Prevent Hypothermia I. Transportation to Appropriate Facility 1. ALS mutual aid 2. Criteria for burn center J. Pediatric Considerations 1. Pediatric a. Rule of nines b. Increased risk of hypothermia 2. Abuse K. Geriatric Considerations XII. Specific Burn Injury Management Considerations A. Thermal 1. Complete general management 2. May be associated with an inhalation injury 3. Large burns may cause hypovolemia and hypothermia 4. Cool small burns or those remaining hot (patient who has just been rescued from fire) 5. Dry dressing help prevent infection and provide comfort 6. Time in contact with heat increases damage B. Inhalation 1. Complications are related to toxic chemicals within inhaled air a. Carbon monoxide b. Cyanide c. Other toxic gasses 2. Edema of mucosa of airway can be rapid -- consider ALS backup if signs and symptoms of edema are present, such as: a. Hoarseness b. Singed nasal or facial hair c. Burns of face d. Carbon in sputum 3. Burns in enclosed spaces without ventilation cause inhalation injuries C. Chemical 1. Liquid chemicals – flush with water 2. Dry powder chemicals and need brushed off to remove chemicals 3. Chemical burns treatments can be specific to the burning agent and labels should be read 4. Burns at industrial sites may have experts available on scene D. Electrical 1. The type of electric current, amperage and volts, have effect on seriousness of burns 2. No patient should be touched while in contact with current 3. Sometimes electric current crosses the chest and causes cardiac arrest or arrhythmias 4. Many underlying injuries to organs and the nervous system may be present E. Radiation – radiation burns require special rescue techniques XIII. Age-Related Variations file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 A. Pediatric 1. Percentage of surface area in a burn patient 2. Alteration in calculating the burned area B. Geriatrics Head, Facial, Neck, and Spine Trauma I. Introduction A. Incidence 1. Head/scalp 2. Face injury 3. Neck injury B. Mechanisms of Head, Face, and Neck (Non-Spine) Injury 1. Motor vehicle crashes 2. Sports 3. Falls 4. Penetrating trauma 5. Blunt trauma C. Morbidity and Mortality D. Associated Injuries 1. Airway compromise 2. Cervical spine injury II. Review of Anatomy and Physiology of the Head, Face, and Neck A. Arteries B. Veins C. Nerves D. Bones 1. Nasal 2. Zygoma/Zygomatic arch 3. Orbital 4. Maxilla 5. Mandible 6. Skull E. Scalp 1. Hair 2. Subcutaneous tissue 3. Muscle F. Mouth/Throat 1. Airway a. Oropharynx b. Larynx c. Trachea d. Tongue e. Teeth G. Neck 1. Blood vessels a. Carotid arteries b. Jugular veins 2. Airway – trachea 3. Gastrointestinal – esophagus H. Eye 1. Bony orbit 2. Sclera 3. Cornea 4. Iris 5. Pupil 6. Lens 7. Retina 8. Optic nerve III. General Patient Assessment A. Scene Size-Up B. Primary Survey 1. Airway 2. Ventilation and oxygenation 3. Circulation 4. Disability a. Level of consciousness b. Motor/sensory response file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 c. Pupils – anisocoria 5. Expose 6. Identify and manage life threats IV. Specific Injuries to Head, Face, and Neck A. Scalp 1. Assessment a. Open wounds b. Closed wounds c. Consider underlying injury 2. Signs and Symptoms a. Open wounds bleed heavily b. Direct pressure is complicated with underlying skull injury c. Injuries above the ears may be more serious d. Battle’s sign is a delayed finding of basal skull fracture 3. Management considerations a. Apply pressure to control bleeding b. Dressings and bandages should not close mouth B. Facial Injuries 1. Types a. Soft tissue injuries b. Fractures of facial bones c. Eye injuries d. Oral/dental injuries i. mandibular fractures ii. maxillar fractures iii. tooth avulsion 2. Signs/symptoms a. Soft tissue injuries are similar to others, but swelling may be more severe b. Facial bones may fracture causing airway and ventilation obstruction c. Eye injuries suffer soft tissue type injuries, abrasions, lacerations, punctures, chemical burns, etc. d. Eye injuries may cause vision disturbances e. Eyes injured with chemicals need flushing with copious amounts of water f. Excessive pressure on the eye may “blow out” bones in the orbit g. Nasal fractures may cause bleeding h. Oral injuries may cause airway management complications 3. Assessment considerations in facial and eye injuries a. Inspection i. open wounds ii. swelling iii. deformity of bones iv. eye clarity without foreign objects v. eye symmetry vi. bone alignment in anatomical position b. Palpation – facial bones c. Eye examination i. follows finger up, down, lateral ii. can read regular print iii. no blood visible in iris area 4. Management considerations in facial and eye injuries a. Maintain patent airway b. Nasopharyngeal airways are contraindicated c. May need frequent suctioning d. Bring broken teeth to hospital with patient e. Flush eyes contaminated with chemicals with copious amounts of water f. Control simple nose bleeds by pinching nostrils g. Eye injuries require patching of both eyes h. Stabilize impaled objects in the eye i. Impaled objects in cheeks may be removed if bleeding obstructs the airway j. Patients with these injuries may be more comfortable sitting up – if no risk of spinal injury k. Bandaging should not occlude the mouth C. Neck Injuries (Non-Spinal) 1. Types of Injuries file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 a. Open wounds b. Blunt trauma 2. Considerations in neck injuries a. May have underlying spinal injury b. Open wounds may bleed profusely and cause death c. Airway passages may be obstructed 3. Assessment considerations in neck injuries a. Monitor airway throughout care b. Patient may not be able to swallow with esophageal injury c. Swelling may be related to air escape under the skin which can “crackle” with digital pressure d. Larynx injuries will cause changes in voice sounds e. Air may enter the circulatory system if there is penetrating injury to a large blood vessel in the neck 4. Management considerations in neck injuries a. Single digital pressure (gloves on) to control bleeding of carotid artery or jugular veins may be necessary b. ALS intercept or air medical transport may be necessary in severe cases of airway compromise c. Occlusive dressing for large vessel wounds (after bleeding controlled) – to prevent air entry into circulatory system D. Nasal Fractures 1. Mechanism of Injury a. Blunt b. Penetrating 2. Assessment – epistaxis 3. Management E. Eye/Orbital 1. Types of Vision a. Central b. Peripheral 2. Types of Injury a. Penetrating i. abrasions – cornea ii. foreign body iii. lacerations – eyelid b. Blunt c. Burns to cornea i. acid ii. alkali iii. ultraviolet d. Blast e. Avulsions 3. Assessment 4. Management a. Airway b. Control bleeding i. blunt injury a) positioning b) bandage i) one/both ii) no pressure ii. penetrating a) positioning b) moist bandage c) stabilize impaled object d) patch both eyes iii. burns a) acid b) alkali c. Foreign Body F. Dental 1. Mechanism of Injury 2. Assessment 3. Management – bring tooth with patient G. Laryngeal Injuries 1. Definition 2. Mechanism of Injury a. Blunt b. Penetrating – do not remove file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 3. Signs/symptoms 4. Assessment a. Neck bruising, hematoma, or bleeding b. Cyanotic, pale skin c. Sputum in wound d. Subcutaneous air 5. Associated Injuries a. Soft tissue and fascia b. Cervical spine injury 6. Management a. Oxygenation and ventilation b. Cervical immobilization (avoid rigid collars) c. Stabilize impaled objects if not obstructing airway H. Head Injury 1. Definition 2. Mechanism of injury a. Penetrating b. Blunt c. Open d. Closed 3. Signs/symptoms of fractures and other injuries a. Cerebral spinal fluid – clear drainage from ears or nose b. Discoloration around eyes c. Discoloration around ears d. Skull deformity e. Decreased mentation f. Irregular breathing pattern g. Unequal pupils h. Nausea and/or vomiting i. Seizure activity j. Elevated blood pressure k. Slow heart rate 4. Assessment a. Airway patency b. Ventilation c. Vital signs d. Pupils e. Neurological exam 5. Associated injuries 6. Management a. Standard precautions b. Manage airway c. Administer oxygen d. Assist ventilation if indicated e. Immobilize spine f. Shock prevention i. control bleeding ii. body positioning I. Brain Injury 1. Definition 2. Signs/Symptoms 3. Mechanism of Injury a. Penetrating b. Blunt 4. Pathophysiology of head/brain injury a. Increased intracranial pressure (ICP) b. Direct or indirect injury i. edema ii. bleeding iii. hypotension 5. Types of Injury a. Intracranial hematoma i. epidural a) signs/symptoms b) assessment c) management ii. subdural a) signs/symptoms b) assessment c) management file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 iii. intracerebral a) signs/symptoms b) assessment c) management iv. subarachnoid a) signs/symptoms b) assessment c) management b. Concussion i. signs/symptoms a) delayed motor and verbal responses b) inability to focus attention c) lack of coordination d) disorientation e) inappropriate emotional responses f) memory deficit g) inability to recall simple concepts, words h) nausea/vomiting i) headache ii. assessment iii. management 6. Assessment a. Cerebral cortices b. Hypothalamus – vomiting c. Brain Stem i. vagus nerve pressure – bradycardia ii. respiratory centers iii. posturing iv. seizures d. Indicators of increasing ICP i. decreased level of consciousness ii. increased blood pressure and slowing pulse rate iii. pupils still reactive iv. Cheyne Stokes respirations v. initially localize to painful stimuli vi. all effects reversible at this stage vii. middle brain stem involved a) wide pulse pressure and bradycardia b) pupils nonreactive or sluggish c) central neurogenic hyperventilation d) extension viii. lower portion of brain stem involved/medulla a) pupil blown – same side as injury b) ataxic respirations c) flaccid response to painful stimuli d) pulse rate e) diminished blood pressure ix. Cushing’s phenomenon e. Glasgow coma scale i. head injury classified according to score a) mild – 13-15 b) moderate – 8-12 c) severe – <8 f. Vital signs g. Bilateral pupil size and reaction – fixed and dilated h. History of unconsciousness or amnesia of event i. Hypotension j. Hypoxemia k. Pediatric considerations – pre-verbal Glasgow coma scale l. Geriatric considerations 7. Management a. Suspect cervical spine injury based on mechanism of injury at scene assessment i. management of a patient wearing a helmet – consideration for removal of helmet ii. types of helmets b. Secure airway if patient cannot maintain an adequate airway c. Administer oxygen d. Assist ventilation if indicated e. Control external bleeding f. Disability – repeated assessment crucial file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 g. Position – elevate head of backboard 30 degrees h. Transport considerations i. identify need for rapid intervention and transportation ii. trauma center iii. use of lights and sirens i. Psychological support j. Effective communication and appropriate documentation V. Age-Related Variations A. Pediatric -- modifications for Glasgow coma scale B. Geriatric Nervous System Trauma I. Incidence A. Morbidity B. Mortality II. Anatomy and Physiology of the Brain and Spine A. Spine 1. Spinous process 2. Cervical 3. Thoracic 4. Lumbar 5. Spinal Fluid B. Spinal Cord C. Brain 1. Skull 2. Meninges a. Dura mater b. Arachnoid mater c. Pia mater 3. Gray matter – composed of nerve cells 4. White matter – covered nerve pathways that conduct messages of the brain 5. Brain stem – center for involuntary functions, temperature regulation, respiratory and heart rate, nerve function transmissions 6. Cerebrum – main part of brain, divided into two hemispheres, with four lobes 7. Cerebellum – center for equilibrium and coordination 8. Meninges – coverings of the brain 9. Cerebral spinal fluid D. Types of Skull Fractures 1. Basal 2. Compressed 3. Open 4. Linear E. Types of Brain injuries 1. Concussion – temporary disruption to brain without injury due to closed trauma 2. Contusion – bruise of brain matter, may be diffuse or localized to one area 3. Cerebral laceration 4. Space occupying lesions a. Epidural bleed – typically arterial with high emergent risk b. Subdural – typically venous, may be acute or chronic 5. Penetrating wounds III. General Assessment Considerations for Brain Trauma Patients A. Airway and Ventilation 1. Maintain airway 2. Assess for adequate ventilation B. Mechanism of Injury 1. Consider the potential for blunt head trauma based on mechanism of injury 2. Assess the need to remove the helmet with proper spinal considerations if airway compromise or bleeding under the helmet is present C. Spinal Immobilization 1. In patients with head injuries with altered mental status 2. Mechanism of injury that suggests the possibility of trauma to the spine D. Respiratory Status -- brain injuries can cause irregular breathing patterns due to injuries affecting the brain stem file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 E. Complete a Neurological Exam 1. Appearance and behavior a. Alert b. Responds to verbal stimuli c. Responds to painful stimuli d. Unresponsive 2. Observe posture and motor behavior – appropriate movement 3. Facial expression 4. Speech and language 5. Thoughts and perceptions a. Logical b. Ability to make decisions 6. Memory and attention a. Assess orientation i. person ii. place iii. time iv. purpose b. Knowledge of recent events 7. Pupils a. Equal b. React to light 8. Vital signs a. Blood pressure i. systolic pressure increase ii. hypotension is associated with poorer outcomes in head injured patients b. Pulse rate – may be slower than normal if severe head injury F. Management Considerations With Brain Trauma 1. Maintain airway throughout care 2. Administer oxygen by non-rebreather mask – maintain oxygen saturation >90 percent at all times 3. Nasopharyngeal airways should not be used 4. Assist ventilation if indicated – avoid hyperventilation; except in specific circumstances G. Transport Considerations 1. Head trauma patients with impaired airway or ventilation, open wounds, abnormal vital signs, or who do not respond to painful stimuli may need rapid extrication 2. Head trauma patients must be transported to appropriate trauma centers 3. Head trauma patients may deteriorate rapidly and may need air medical transport 4. Adequate airway, ventilation, and oxygenation are critical to the outcome of head trauma patients 5. Head trauma patients frequently vomit – keep suction available 6. Head trauma patient frequently have seizures H. Refer to Brain Injury Foundation Guidelines IV. Age-Related Variations for Pediatric and Geriatric Assessment and Management of Brain Injury A. Pediatric B. Geriatric V. Spinal Cord Injuries A. Types of Associated Spinal Injuries 1. Fractures 2. Dislocations 3. Open wounds 4. Flexion 5. Extension B. General Assessment Considerations in Spinal Trauma 1. Often present with other injuries a. Head trauma b. Penetrating trauma i. anterior ii. posterior c. Direct blunt trauma d. Falls or diving injuries e. Car crashes and multi-system trauma f. Rapid deceleration injuries file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 2. Neurological examination considerations a. Movement of extremities i. absent or weak ii. note level of impairment b. Respiratory ability i. chest wall movement ii. abdominal Excursion c. Sensation i. present throughout body ii. absent – note the specific level of impairment iii. altered sensation distal to injury – jingling, numbness, “electric shocks” d. Pain and tenderness present at site e. Vital signs i. Hypotension may be present with cervical or high thoracic spine injuries; ii. Heart rate may be slow or fail to increase in response to hypotension f. Other signs or symptoms associated with spinal cord trauma i. priapism ii. inability to maintain body temperature iii. loss of bowel or bladder control 3. History for patient with suspected spinal trauma C. General Management Considerations With Spinal Trauma 1. Manual immobilization of spine when airway opened 2. Immobilization principles 3. Log-roll patient with suspected spinal trauma to move or examine back 4. Cervical collars a. Rigid b. Proper size 5. Seated patient spinal immobilization 6. Standing patient spinal immobilization 7. Lifting and moving patient with suspected spinal injury 8. Rapid moves for patient with suspected spinal injury 9. Helmet removal if present with airway complications 10. Consideration for pneumatic antishock garment use VI. Age-Related Variations for Pediatric and Geriatric Assessment and Management of Spinal Injury A. Pediatric 1. Head size and anatomical positioning during immobilization 2. Use of child safety seats B. Geriatric 1. Unusual spinal anatomy due to aging 2. Special modifications of spinal immobilization techniques Special Considerations in Trauma I. Trauma in Pregnancy A. Special Unique Considerations for Pregnant Patient Involved in Trauma 1. Mechanism of injury a. Pregnant patients can sustain all types of trauma b. Susceptible to falls and physical abuse 2. Fetal considerations – trauma to an expectant mother can have effects on fetal health B. Special Anatomy, Physiology, and Pathophysiology Considerations 1. Cardiovascular a. Increase to total vascular volume b. Increase in maternal heart rate in third trimester c. Shock in a third trimester patient may be difficult to detect d. Third trimester fetus size can affect venous return in patients lying flat on their backs e. Decreased gastrointestinal motility increases risk of vomiting and aspiration after trauma C. Unique Types of Injuries and Conditions of Concern for Pregnant Patients Involved in Trauma 1. Fetal distress due to hypoxia or hypovolemia/shock 2. Separation of the placenta from the uterine wall a. Abdominal pain b. Vaginal bleeding often present c. High risk of fetal death file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 3. Fetal injury from penetrating trauma 4. Seat belts 5. Cardiac arrest due to trauma D. Unique Assessment Considerations for Pregnant Patients Involved in Trauma 1. Two patients to consider a. Mother i. immobilize and tilt the long spine board to the left if spinal injury is suspected ii. internal blood loss is difficult to assess as signs of shock are masked iii. vaginal exam may be present iv. increased risk of aspiration from decreased gastrointestinal motility b. Fetus i. size of fetus is important (number of weeks pregnant) ii. difficult to assess so treat mother aggressively if severe trauma E. Unique Management Considerations for the Pregnant Patients Involved in Trauma 1. Airway, ventilation, and oxygenation a. Anticipate vomiting – have suction available b. Assure bilateral breath sounds are present c. Keep oxygenation levels high (100%) – administer oxygen by nonrebreather mask d. Assist ventilation if inadequate 2. Circulation 3. Transport considerations a. Transport on left side b. Major trauma may need ALS intercept or air medical resources c. Trauma centers – inform them that pregnant patient is involved in the trauma II. Trauma in the Pediatric Patient A. Special Unique Considerations for Pediatric Patient Involved in Trauma 1. Vehicle crashes 2. Pedestrian versus vehicle collisions 3. Drowning 4. Burns 5. Falls 6. Penetrating trauma B. Unique Anatomy, Physiology, and Pathophysiology Considerations of Injured Pediatric Patients 1. Heavy head with weak neck muscles in children increases risk of cervical spine injury 2. Chest wall flexibility produces flail chest C. Unique Assessment Considerations for a Pediatric Patient Who Has Sustained Trauma 1. Pediatric assessment triangle a. Appearance b. Work of breathing c. Circulation 2. Airway, ventilation, oxygenation a. Respiratory rates vary by age b. Accessory muscle use more prominent during respiratory distress 3. Vital signs a. Assess brachial pulse in infants b. Pulse rates vary by age c. Slow pulse rate indicates hypoxia d. Blood pressure for age 3 or younger unreliable e. Blood pressure varies by age f. Normal blood pressure may be present in compensated shock D. Unique Management Considerations for Pediatric Patients Involved in Trauma 1. Manage hypovolemia and shock as for adults 2. Shaken baby syndrome may cause brain trauma 3. Prevent hypothermia in shock 4. Transport to appropriate facility 5. Pad beneath child from shoulders to hips during cervical immobilization to prevent flexion of the neck 6. Ventilate bradycardic pediatric patient III. Trauma in the Elderly Patient file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 A. Special Considerations for Geriatric Patients Involved in Trauma 1. Vehicle crashes 2. Pedestrian versus vehicle collisions 3. Fall 4. Burns 5. Penetrating trauma 6. Elder abuse B. Unique Anatomy, Physiology, and Pathophysiology Considerations of Injured Geriatric Patients 1. Changes in pulmonary, cardiovascular, neurologic, and musculoskeletal systems make older patients susceptible to trauma 2. Circulation changes lead to inability to maintain normal vital signs during hemorrhage, blood pressure drops sooner 3. Multiple medications are more common and may affect a. Assessment, especially vital signs b. Blood clotting 4. Brain shrinks leading to higher risk of cerebral bleeding following head trauma 5. Skeletal changes cause curvature of the upper spine that may require padding during spinal immobilization 6. Loss of strength, sensory impairment, and medical illness increase risk of falls C. Unique Assessment Considerations for Injured Geriatric Patients 1. Airway a. Dentures may cause airway obstruction b. May have decrease in cough reflex so suctioning is important c. Curvature of the spine may require padding to keep patient supine 2. Breathing a. Use pulse oximetry to monitor oxygenation b. Minor chest trauma can cause lung injury 3. Circulation D. Unique Management Considerations for Injured Geriatric Patients 1. Suctioning is important in elderly due to decrease cough reflex 2. Decrease muscle size in the abdomen may mask abdominal trauma 3. Prevent hypothermia 4. Broken bones are common – traction splints are not used to treat hip fractures 5. Falls leading to trauma must be investigated as to the reason for the fall IV. Trauma in the Cognitively Impaired Patient A. Unique Considerations for Injured Cognitively Impaired Patients 1. Types of cognitive impairment a. Alzheimer’s disease b. Vascular dementia c. Down’s syndrome d. Autistic disorders e. Brain injury f. Stroke 2. Mechanism of injury – cognitively impaired patients are more susceptible to trauma B. Unique Anatomy, Physiology, and Pathophysiology Considerations for Injured Cognitively Impaired Patients 1. Sensory loss related to aging and disease may increase risk of injury and alter the patient’s response to injury 2. Musculoskeletal strength due to aging or impairment 3. Memory loss with Alzheimer’s disease will alter patient assessment 4. Cardiovascular changes with dementia C. Unique Assessment Consideration for Cognitive Impaired Patients Involved in Trauma 1. Poor historians of past medical history or events of trauma 2. Pain perception may be altered 3. Psychological implications of trauma may be different 4. Patient may be bed ridden or under nursing home care D. Unique Management Consideration for Cognitively Impaired Patients Involved in Trauma 1. Cognitively impaired patient special care 2. Involve usual care givers in emergency treatment Environmental Emergencies file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 I. Submersion Incidents A. Drowning 1. Definition 2. Incidence 3. Predictors of morbidity and mortality B. Types 1. Fresh water 2. Salt water C. Pathophysiology 1. Little difference in patient lungs regardless of what type of water submersion occurred 2. Submersion in cold water results in better survival than warm water 3. Age is a factor due to cardiovascular health 4. Duration under water effects outcome 5. Submersion in very cold water can produce cardiac disturbances 6. Hypoxia from submersion is major factor in death 7. Diving in shallow water can cause spinal trauma 8. Prolonged hypoxia causes death of brain tissue D. Unique Signs and Symptoms 1. Airway – obstructed with water immediately after rescue 2. Breathing a. May be coughing if early rescue b. Agonal breaths if prolonged submersion c. Respiratory arrest if very prolonged submersion 3. Circulation a. May be in cardiac arrest b. Skin is cyanotic c. Skin may be cold E. Assessment Considerations 1. Airway, ventilation, and oxygenation a. Oxygen saturation may be difficult to obtain if patient is cold b. Use spinal precautions when opening airway to assess if risk of spinal trauma is possible c. Auscultate breath sounds 2. Assess for presence of other injuries 3. Obtain past medical history F. Management Considerations 1. Airway, ventilation, and oxygenation a. Suction and maintain open airway i. anticipate vomiting ii. position lateral recumbent if no risk of spinal injury b. Ventilate with bag-mask if impaired ventilation or respiratory arrest c. Administer oxygen by non-rebreather mask if breathing is adequate 2. Circulation a. If cardiac arrest is present, refer to current American Heart Association guidelines b. Defibrillate with AED if indicated (refer to current American Heart Association guidelines) 3. Transport Considerations a. Transport to appropriate facility b. All patients who had submersion injury with any report of signs and symptoms during or after submersion need transport to the hospital II. Temperature-Related Illness A. Incidents 1. Temperature-related illness a. Cold-related illness b. Heat-related illness 2. How the body loses heat a. Conduction b. Convection c. Radiation d. Evaporation e. Respiration 3. Type of temperature-related illness a. Generalized cold injury (hypothermia) b. Localized cold injury file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 c. Generalized heat injury – may affect full body or muscle groups B. Pathophysiology 1. Cold-related injuries a. Low environmental temperatures generalized exposure i. factors that contribute to risk of cold injury a) clothing of the patient b) age c) time of exposure d) alcohol or other medication ingestion e) suicide f) activity level of the victim g) pre-existing injury or illness ii. environment factors that contribute to risk of cold injury a) ambient temperature b) wind speed c) moisture b. Local cold exposure i. local exposure of body appendage to cold – ears, fingers, and toes very susceptible ii. ice crystals form iii. impairs local blood flow iv. temporary or permanent tissue damage – may lead to amputation 2. Heat-related illness a. Environmental factors that contribute to risk of heat-related illness i. ambient temperature ii. humidity b. Patient factors that contribute to risk of heat injury i. no acclimation to heat ii. medical illness or injury iii. age iv. exertion v. alcohol or other medication use c. Patient with moist, pale, cool skin – excessive fluid and salt loss d. Patient with hot, dry skin i. true emergency ii. seen on hot, humid days in patients with fluid and salt loss iii. body unable to regulate temperature e. Patient with hot, moist skin i. true emergency ii. seen when extreme exertion exceeds the body’s ability to regulate temperature C. Signs and Symptoms 1. Cold-related illness – (generalized) hypothermia a. Decreased level of consciousness b. Impaired motor function i. rigidity ii. altered balance c. Shivering i. muscle contractions help to increase body temperature ii. temperature will drop quickly when shivering stops d. Slow pulse and breathing in later stages e. Cool abdominal skin below clothing f. Extreme hypothermia i. cardiac insufficiency ii. may have no palpable pulse iii. cardiac arrest 2. Cold-related illness (localized) a. Frozen extremity b. Loss of color c. Loss of movement d. Pain 3. Heat-related illness (moist, pale skin) a. Muscle cramps b. Change in level of consciousness, dizziness c. Weakness d. Weak, rapid pulse e. Nausea and vomiting f. Apply pulse oximetry 4. Heat-related illness (hot skin) a. Little or no perspiration – in exertional heat stroke the skin may be file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 sweaty and hot b. Loss of consciousness c. Rapid breathing d. Rapid pulse e. Seizures D. Management Considerations 1. Cold-related illness – (generalized) hypothermia a. Move the patient from the cold environment b. Remove any wet clothing c. Administer oxygen – warmed and humidified if available d. Cover with warm blankets e. Rewarm with hot packs in groin, arm pits – use caution to avoid burns f. Provide warm clear liquids if conscious and not vomiting g. Rewarm slowly h. Transport i. Passive rewarming is best delivered at the appropriate facility j. Handle gently to decrease risk of ventricular fibrillation k. If unconscious and in cardiac arrest follow AHA recommendations for CPR 2. Cold-related illness (localized) a. Move patient out of cold environment b. Administer oxygen c. Consider active rewarming if no chance of re-injury i. immerse part in tepid (100 – 105 degrees Farenheit) water ii. after rewarming, apply sterile dressings iii. keep patient warm iv. transport as soon as possible 3. Heat-related illness, with moist, pale, cool skin a. Remove from hot environment b. Administer oxygen c. Remove clothing d. Splash the patient with cool water 4. Heat-related illness with hot skin a. Remove patient from hot environment b. Administer high concentration oxygen c. Assist ventilation if inadequate d. Cool packs to armpits, groin, neck e. Transport immediately f. This is true emergency III. Bites and Envenomations A. Injuries of Concern 1. Spider bites 2. Snake bites 3. Hymenoptera (bees, wasps, ants, yellow jackets) B. Pathophysiology of Bites and Envenomations 1. Spider bites (black widow) -- inject neurotoxins 2. Snake bites -- rattlesnake is most common in United States a. toxins affect blood and nervous system both at the bite site and systemically b. patient age and size cause different effects c. amount of toxin injected is related to toxicity (often none at all) d. initial 6-8 hours of care is essential 3. Hymenoptera a. Cause allergic reactions in sensitized (allergic) people b. May lead to anaphylactic response C. Signs and Symptoms 1. Spider bite (black widow) a. Localized swelling initially b. Chest or abdominal pain depending on bite site c. Dangerous in children, may be fatal 2. Rattlesnake bite a. Time of bite to care is important b. Pain at site c. Progressive weakness d. Nausea and vomiting e. Seizures f. Vision problems g. Changes in level of consciousness file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 3. Bee, wasp, and other stings a. Pain at site b. Swelling c. Signs of allergic reaction d. Signs of anaphylaxis D. Unique Management Considers of Bites and Stings 1. Spider bite (black widow) a. Ice pack to area of bite b. Clean wound with soap and water c. Transport immediately with supportive care 2. Rattlesnake bite a. Note time of bite to transport b. Slow venous return c. Keep patient calm d. Immobilize extremity e. Position extremity f. Clean bite site with soap and water g. Identify snake if possible 3. Bees, wasps, and other stings a. Remove stinger or venom sac b. If anaphylaxis develops follow protocol IV. Diving Emergencies (Dysbarism) A. Mechanism of Injury 1. SCUBA diving at greater depths for long periods of time 2. Repeated dives at depth on the same day B. Pathophysiology 1. Diver remains at depth too long 2. Compressed air in blood at depth expands upon ascent, turning into bubbles in blood which obstruct blood flow C. Signs and Symptoms 1. Occur after the patient raises to the surface too fast following dive at depths 2. Cyanosis 3. Cough 4. Respiratory distress 5. Pain in joints D. Unique Management Considerations 1. Administer high-concentration oxygen 2. Transport rapidly for recompression therapy at the appropriate facility V. Electrical A. Electrical 1. Skin wounds may not indicate seriousness of burn 2. Entrance and exit wounds 3. May cause cardiac arrest 4. Lighting strikes may cause cardiac arrest VI. Radiation VII. Age-Related Variations for Pediatric and Geriatric Assessment and Management Trauma Multi-System Trauma I. Kinematics of Trauma A. Definition 1. Looking at a trauma scene and attempting to predict what injuries might have resulted based on an evaluation of the motion involved 2. Kinetic energy – function of weight of an item and its speed – speed is the most import variable 3. Blunt trauma a. Objects collide during crashes i. car with object ii. patient with part of car iii. organs collide inside body b. Unbelted drivers and front seat passengers suffer multi-system trauma due to multiple collisions of the body and organs c. Direction of the force has impact on type of injury i. frontal impacts file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 ii. rear impacts iii. side impacts iv. rotational impacts v. rollovers 4. Deceleration Injuries 5. Penetrating Trauma a. Damage is influenced by i. distance from shooter ii. size of bullet iii. fragmentation iv. cavitation v. velocity of weapon b. Energy levels have effect i. low energy (stabbings) ii. medium energy (handguns, some rifles) iii. high energy (military weapons) c. Signs and symptoms will vary according to the organ struck i. head ii. chest iii. abdomen iv. extremities II. Multi-System Trauma A. Definition 1. Almost all trauma affects more than one system 2. Typically a patient considered to have “multi-system trauma” has more than one major system or organ involved a. Head and spinal trauma b. Chest and abdominal trauma c. Chest and multiple extremity trauma 3. Multi-system trauma treatment involves a team of physicians to treat the patient. This may include specialists such as neurosurgeons, thoracic surgeons, and orthopedic surgeons 4. Multi-system trauma has a high level of morbidity and mortality B. The Golden Principles of Out-of-Hospital Trauma Care 1. Safety of rescue personnel and patient 2. Determination of additional resources 3. Kinematics a. Mechanism of injury b. High index of suspicion 4. Identify and manage life threats 5. Airway management while maintaining cervical spinal immobilization 6. Support ventilation and oxygenation – oxygen saturation greater than 95 percent 7. Control external hemorrhage 8. Basic shock therapy a. Maintain normal body temperature b. Splint musculoskeletal injuries 9. Maintain spinal immobilization on long spine board a. Standing patients b. Sitting patients c. Rapid transport considerations d. Prone patients e. Supine patients 10. Transportation considerations a. Golden period b. Closest appropriate facility c. ‘Platinum 10 Minutes’ 11. Obtain medical history 12. Secondary survey after treatment of life threats C. Critical Thinking in Multi-System Trauma Care 1. Airway, ventilation, and oxygenation are key elements to success a. Airway must be opened and clear throughout care b. Adequate ventilation must occur – patients with low minute volume need assisted ventilation c. Administration of high concentrations of oxygen 2. Oxygenation cannot occur when patients are bleeding profusely a. Stop arterial bleeding rapidly b. Consider use of tourniquets if severe extremity bleeding cannot be controlled with direct pressure file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 3. Sequence of treating patients a. Not all treatments are linear. At times care must be adjusted depending on the needs of the patient. b. Example: i. control arterial bleeding in an awake patient first ii. much care can be done en route 4. Rapid transport is essential a. The definitive care for multi-system trauma may be surgery which cannot be done in the field b. On scene time is critical and should not be delayed c. Rapid extrication should be considered for critically injured patients d. Use of advanced life support intercept and air medical resources in a multi-trauma patient should be highly considered e. Early notification of hospital resources is essential f. Transport to the appropriate facility is critical – know your local trauma system capabilities 5. Backboards – serve as entire body splints when patients are appropriately secure in unstable patients 6. Personal safety a. Most important when arriving on scene, and throughout care, an injured EMT can not provide care b. Be sure to assess your environment i. passing automobiles ii. hazardous situation iii. hostile environments iv. unsecured crime scenes v. suicide patients who may become homicidal 7. Experience a. Do not develop “tunnel” vision by focusing on patients who complain of pain and are screaming for your help while other quiet patients who may be hypoxic or bleeding internally can not call out for help because of decreases in level of consciousness b. Sometimes an obvious injury does not have the most potential for harm c. Trauma care is a leading cause of death of young people. It is essential to keep important care principles in mind during management III. Specific Injuries Related to Multi-System Trauma A. Blast Injuries 1. Types of Blast Injuries (explosions) a. Release i. blast waves ii. blast winds iii. ground shock iv. heat 2. Pathophysiology a. Blast waves cause disruption of major blood vessels, rupture of major organs, and lethal cardiac disturbances when the victim is close to the blast b. Blast winds and ground shock can collapse buildings and cause trauma 3. Signs/symptoms a. Hollow organs are injured first i. respiratory distress ii. hearing impaired b. Multi-system injury sign and symptom patterns i. lungs ii. heart iii. major blood vessels 4. Management considerations in blast injuries a. Multi-system trauma care b. Immediate transport to appropriate facility c. Multi-casualty care Special Patient Populations Obstetrics I. Introduction file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 A. Anatomy and Physiology Review of the Female Reproductive System 1. Uterus 2. Cervix 3. Ovaries 4. Vagina 5. Breasts B. Female Reproductive Cycle C. Cultural Values Affecting Pregnancy D. Special Considerations of Adolescent Pregnancy II. Physiology A. Normal Anatomical, Physiological, and Psychological Changes in Pregnancy 1. Reproductive system 2. Respiratory system 3. Cardiovascular system 4. Musculoskeletal system B. Identify Normal Events of Pregnancy C. Conception and Fetal Development 1. Ovulation 2. Fertilization 3. Implantation 4. Embryonic stage 5. Fetal stage D. Functions of the Placenta III. General System Physiology, Assessment, and Management A. Premonitory Signs of Labor 1. Lightening 2. Braxton Hicks 3. Cervical changes 4. Bloody show 5. Rupture membranes 6. Other B. Stages of Labor and Delivery 1. First stage 2. Second stage a. Spontaneous birth b. Positional changes of the fetus 3. Third stage a. Placental separation b. Placental delivery C. Antepartum and Intrapartal Assessment Findings 1. Airway, breathing, circulation 2. Initial assessment 3. SAMPLE history 4. Vital signs 5. Obstetrical history 6. Physical examination a. Fetal movement b. Inspect for crowning D. Management of a Normal Delivery Obstetrical Patient 1. Treatment modalities a. Oxygen b. Non-pharmacological intervention – positioning E. Postpartum Care 1. Fundal massage 2. Signs of hemorrhage IV. Complications of Pregnancy A. Abuse B. Substance Abuse C. Diabetes Mellitus D. Bleeding: Pathophysiology, Assessment, Complications, and Management 1. Abortion a. Elective abortion b. Spontaneous abortion 2. Ectopic pregnancy E. Placental Problems: Pathophysiology, Assessment, Complications, and Management 1. Abruption placenta file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 2. Placenta previa F. Hypertensive Disorders: Pathophysiology, Assessment, Complications, and Management 1. Pregnancy-induced hypertension 2. Preeclampsia 3. Eclampsia V. High-Risk Pregnancy: Pathophysiology, Assessment, Complications, and Management A. Precipitous Labor and Birth B. Post-Term Pregnancy C. Meconium Staining D. Multiple Gestation E. Intrauterine Fetal Death VI. Complications of Labor: Pathophysiology, Assessment, Complications, and Management A. Premature Rupture of Membranes B. Preterm Labor VII. Complications of Delivery: Pathophysiology, Assessment, Complications, and Management A. Cephalic Presentation B. Breech C. Nuchal Cord D. Prolapse of Cord VIII. Postpartum Complications: Pathophysiology, Assessment, Complications, and Management A. Hemorrhage 1. Early 2. Late B. Increase Risk of Embolism Special Patient Populations Neonatal Care I. Initial Care of the Neonate A. Physiologic Response to Birth 1. Respiratory adaptations 2. Cardiovascular adaptations 3. Temperature regulation B. Routine care 1. Support 2. Dry 3. Warm 4. Position 5. Airway 6. Stimulation C. Assessment Special Patient Populations Pediatrics I. Anatomy and Physiology A. Pediatric Head versus Adult’s B. Head is Proportionally Larger to Body Size C. Implications for Health Care Provider 1. Increased incidence of blunt head trauma 2. Excessive heat loss may occur from head 3. Securing the airway may be difficult; to open the airway and obtain “sniffing” position may require a towel or roll under the shoulders D. Examine Fontanelles in Infants 1. Bulging fontanelle in an ill-appearing non-crying infant suggests increased intracranial pressure 2. Sunken fontanelle in an ill-appearing infant suggests dehydration II. Airway Compared to an Adult’s A. Smaller in Diameter and Shorter in Length B. Jaw Smaller With Infant’s Tongue Taking Up More Room in the Oropharynx C. Infants are Nasal Breathers D. Tracheal Cartilage is Softer and More Collapsible file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 E. Epiglottis of Infants and Toddlers Long, Floppy, Narrow and Extends at a 45Degree Angle Into Airway F. Implications for the Health Care Provider 1. Essential to suction the nares of infants in respiratory distress 2. Posterior displacement of the tongue may cause airway obstruction 3. Smaller airways more easily obstructed by a. Flexion or hyperextension b. Particulate matter (including mucus) c. Soft tissue swelling (injury, inflammation) can cause obstruction III. Chest and Lungs Compared to an Adult’s A. Ribs More Cartilaginous and Pliable B. Less Overlying Muscle and Fat to Protect Ribs and Vital Organs C. Young Children Breathe Primarily With Their Diaphragms D. Thin Chest Wall Easily Transmits Breath Sounds E. Implications for the Health Care Provider 1. Effective diaphragmatic excursion essential for adequate ventilation 2. Rib fractures less common due to pliability; when present represent significant energy transmission accompanied by multi-system injury (e.g., pulmonary contusion) 3. Lungs prone to pneumothorax from excessive pressures while bag-mask ventilating IV. Abdominal Difference A. Less-Developed Abdominal Muscles and Organs Situated More Anteriorly, Therefore Less Protection of Rib Cage B. Liver and Spleen Proportionally Larger C. Implications for the Health Care Provider 1. Seemingly insignificant forces can cause serious internal injury 2. Liver, spleen, and kidneys are more frequently injured 3. Multiple organ injury common V. Extremities Compared to Adult’s A. Bones Softer B. Open Growth Plates Are Weaker Than Ligaments and Tendons, So Injury to Growth Plate Can Result in Length Discrepancies C. Implications for the Health Care Provider VI. Integumentary Differences A. Larger Surface Area to Body Mass Ratio B. Implications for the Health Care Provider 1. Skin more easily, quickly, and deeply burned 2. Larger surface can lead to large fluid and heat losses 3. Hypothermia can complicate resuscitative efforts VII. Respiratory System Compared to an Adult’s A. Higher Oxygen Demand per Kilogram of Body Weight (Twice That of an Adult’s) B. Smaller Lung Oxygen Reserves C. Implications for the Healthcare Provider 1. Higher oxygen demand with less reserve increases risk of hypoxia with apnea or ineffective bagging 2. Err on using a larger bag for ventilating the pediatric patient (regardless of the size of the bag used for ventilation, use only enough force to make the chest rise slightly) VIII. Nervous System and Spinal Column Compared to an Adult’s A. Continually B. Brain Tissue and Vascular System More Fragile and Prone to Bleeding From Injury C. Subarachnoid Space Is Relatively Smaller, With Less Cushioning Effect for Brain D. Pediatric Brain Requires Nearly Twice the Cerebral Blood Flow As Does an Adult’s E. Brain and Spinal Cord Less Well Protected F. Implications for the Health Care Provider 1. The large cerebral blood flow requirement increases risk of hypoxia; hypoxia and hypotension in a child with a head injury can cause ongoing damage 2. Head momentum may result in bruising and damage to the brain 3. Spinal cord injuries less common file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 4. Cervical spine injuries more commonly ligamentous injuries IX. Metabolic Differences Compared to an Adult A. Limited Glucose Stores B. Newborns and Infants Less Than One Month Most Susceptible to Hypothermia C. Implications for the Health Care Provider 1. Keep the infant or child warm during treatment and transport 2. Cover the head (not the face, though) to minimize heat loss 3. Newborns should not be overwarmed, as this can worsen their neurologic outcomes X. Growth and Development A. Infancy 1. Birth to two months a. Physical development i. control gazing at faces, turning their heads, and sucking ii. sleep accounts for up to 16 hours a day iii. infants have a relatively large surface area which predisposes them to hypothermia b. Cognitive development i. crying form of communication ii. infants cry for obvious reasons such as hunger and needing to be changed iii. when obvious reasons for crying have been addressed, persistent crying can be a sign of significant illness c. Implications for the health care provider i. persistent crying or irritability in a 0- to 2-month-old can be a symptom of serious illness ii. infants sleep a lot, however should arouse easily; inability to arouse a baby should be considered an emergency iii. head control is limited 2. Two to six months a. Physical development i. voluntarily smile and increasing eye contact ii. uses both hands to examine objects iii. 70 percent of babies sleep through the night by six months iv. intentional rolling over begins v. begin to hold their heads up b. Cognitive development i. increased awareness of surroundings ii. explore bodies c. Implications for the health care provider i. persistent crying or irritability can be a symptom of serious illness ii. by six months, babies should make eye contact; lack of eye contact in a sick infant could be a sign of significant illness or depressed mental status or delayed development 3. Six to 12 months a. Physical development i. sit without support ii. develop a pincer grasp; everything goes to the mouth iii. begin to crawl iv. begin getting teeth and eating soft foods b. Cognitive development i. begin babbling and by 12 months learn their first word ii. develop “separation anxiety” from parents c. Implications for the health care provider i. persistent crying or irritability can be a symptom of serious illness ii. at-risk for foreign body aspiration and poisoning due to exploration of environment with their mouths iii. reduce separation anxiety by keeping the child and parent together during evaluation and involving the parent in the treatment if appropriate iv. crawling and walking increase exposure to physical dangers B. Toddler Years 1. Twelve to 18 months a. Physical development – begin to walk and explore their environments file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 b. Cognitive development i. imitate older children and parents ii. know major body parts iii. know four to six words c. Implications for the health care provider i. persistent crying or irritability can be a symptom of serious illness ii. children may not be able to grind up food before swallowing, due to lack of molars, increasing risk of food aspiration iii. increased mobility increases exposure to physical dangers and injury iv. distracting a child with a flashlight or toy may aid in physical exam 2. Eighteen to 24 months a. Physical development i. improved gait and balance ii. begin to run and climb b. Cognitive development i. begin to understand cause and effect ii. begin to label objects iii. ten to 15 words becomes 100 by 24 months c. Emotional development i. clinginess with parents ii. attachment to a special object, like a blanket d. Implications for the health care provider i. persistent crying or irritability can be a symptom of serious illness ii. allow a child to hold objects of importance to them (e.g., blanket) iii. children no longer require shoulder rolls to limit flexion of the neck when bag-valve-mask ventilating or intubating iv. painful procedures make lasting impressions C. Preschool Years (2-5 Years) 1. Physical development a. Perfectly normal walking and running b. Begin throwing, catching, kicking c. Toilet training 2. Cognitive development a. Most rapid increase in language b. Magical thinking c. Rules tend to be absolute d. Irrational fears 3. Emotional development a. Learn acceptable behaviors b. Tantrums around control issues c. Modesty developing 4. Implications for the health care provider a. Rapid increase in language enhances ability to understand care explanations b. Respect modesty c. Foreign body airway obstruction risk continues to be high d. Appealing to their magical thinking may allow you to do more (e.g., this magic smoke will help you breathe better [nebulizer]) D. Middle Childhood Years (6-12 Years) 1. Physical development a. Loss of baby teeth; permanent teeth come in 2. Cognitive development a. Think logically b. School important 3. Emotional development a. Popularity and peer pressure important b. Children with chronic illness or disabilities very self-conscious c. Begin to understand that death is final 4. Implications for health care provider a. Provide simple explanations for illness and treatments b. Provide sense of control by giving choices if possible c. Respect patient’s modesty and cover after the physical exam d. Asking about school will often allow patients to warm up to you faster file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 E. Adolescence (12-20 Years) 1. Physical development – puberty begins 2. Cognitive development a. Ability to reason b. Do not see possibilities as real things which could happen to them c. Develop morals 3. Emotional development a. Self-conscious about body image b. Begin to understand who they are and begin to be comfortable with that c. Relationships generally transition to those of the opposite sex 4. Implications for the health care provider a. Explain things clearly and honestly as you would to an adult b. Give choices when appropriate c. Respect modesty and cover after the physical exam d. Be honest about procedures which will cause discomfort e. Address concerns and fears about the lasting effects of their injuries (especially cosmetic) and if appropriate, reassure f. Adolescence time of hormonal surges, emotions, and peer pressure; increases risk for substance abuse, self-endangerment, pregnancy, and dangerous sexual practices XI. Assessment A. General Considerations 1. Many components of the initial evaluation can be done by careful observation without touching the patient 2. When appropriate, utilize the parent/guardian to help the infant or child be more comfortable with your exam and therapies 3. Communicating with scared, concerned parents and family is an important aspect of one’s responsibilities at the scene of an ill infant or child 4. Assessment is an ongoing process continuing until care is transferred to the receiving facility B. Assessment Process 1. Preparing for arrival a. Assembling age-appropriate equipment b. Reviewing age-appropriate vital signs and anticipated development 2. Scene survey a. Evaluate the scene for safety threats to patient and health care providers b. Evaluate the scene for clues related to the chief complaint i. ingestions or toxic exposures: pills, medicine bottles, chemicals, alcohol, drug paraphernalia, etc. ii. child abuse: injury must be consistent with history given and physical/developmental capabilities of the patient iii. note position and location in which patient is found c. Observe and note parents’/guardians’/caregivers’ interactions with the child i. are they appropriately concerned, angry, or indifferent? ii. does the child seem comforted by them or scared by them? 3. Patient assessment a. Pediatric assessment triangle i. general a) Provides a 15- to 30-second assessment of the severity of the patient’s illness or injury b) Use prior to addressing “the ABCs” c) Does not require touching the patient, just looking and listening ii. components a) appearance i) muscle tone ii) interactiveness iii) consolability iv) eye contact v) speech or cry b) work of breathing i) abnormal airway noise (i.e., wheeze, stridor, grunting) ii) abnormal positioning (i.e., tripoding) iii) retractions (i.e., chest wall, nasal flaring) file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 c) Circulation to the skin i) pallor ii) mottling iii) cyanosis iii. possible physiologic states based upon the above three components a) respiratory distress or failure b) cardiovascular shock c) cardiopulmonary failure or arrest d) isolated head injury, ingestion, or other primary CNS abnormality e) stable patient iv. initial triage and transport decision based on physiologic state a) urgent—begin rapid ABCs assessment and treatment; transport once treatment has begun b) stable patient—proceed with ABCs assessment followed by focused history and complete physical exam; begin transport starting potential therapies en route 4. Hands-on ABCs a. Airway i. open and remove if possible, secretions, blood, or foreign body(ies) ii. maintainable on its own, with help (jaw thrust, chin lift, oral or nasal airway), or unmaintainable (in need of advanced airway care) b. Breathing/oxygenation i. respiratory rate and effort ii. auscultation for wheezes, crackles, etc. iii. oxygen saturation c. Circulation i. heart rate ii. central and peripheral pulse quality: strong or weak iii. extremity skin temperature, assess capillary refill time, and active bleeding iv. blood pressure d. Disability i. determine level of consciousness ii. AVPU scale iii. assess pupils: dilated, constricted, reactive, or fixed iv. neurological motor deficit or moving all extremities equally v. pain assessment using standardized pain scale e. Exposure i. examine for additional injuries and rashes ii. promptly cover to prevent hypothermia 5. Additional assessment a. Focused history i. symptoms and duration a) fever b) activity level c) recent eating, drinking, and urine output history d) history of vomiting, diarrhea, or abdominal pain e) note any rashes ii. medications taking and medication allergies iii. past medical problems or chronic illnesses iv. key events leading to the injury or illness b. Detailed physical exam—“Head to Toe” i. head: bruising, swelling, quality of fontanelles, if present ii. nose: drainage obstructing ability to breathe through nose iii. ears: drainage suggestive of trauma or infection iv. mouth: loose teeth, identifiable odors, bleeding v. neck: abnormal bruising or swelling, inability to move neck if febrile vi. chest and back: bruises, injuries, or rashes vii. abdomen: distention, tenderness, seat belt abrasions or bruising viii. extremities: deformities, swellings, or pain on movement XII. Specific Pathophysiology, Assessment, and Management file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 A. Respiratory Distress 1. Introduction a. Epidemiology b. Anatomic and physiologic differences in children 2. Pathophysiology a. Respiratory distress b. Respiratory failure c. Respiratory arrest 3. Assessment a. History b. Physical findings 4. Upper airway obstruction a. Croup b. Foreign body aspiration c. Bacterial tracheitis d. Epiglottitis e. Tracheostomy dysfunction 5. Lower airway disease and reactive airway disease a. Asthma b. Bronchiolitis c. Pneumonia d. Foreign body lower airway obstruction e. Pertussis 6. Management a. Airway positioning (chin lift, jaw thrust) b. Age and situation appropriate airway clearance measures (finger sweep, back blows, abdominal thrusts, suctioning) c. Airway adjuncts (nasopharyngeal and oropharyngeal airways) d. Oxygen e. Inhaled medications (albuterol) f. Assisted ventilation (bag mask) B. Shock 1. Introduction a. Anatomic differences b. Physiologic differences 2. Pathophysiology a. Shock shock b. Decompensated shock 3. Assessment a. History b. Physical findings 4. Management C. Neurology 1. Introduction a. Anatomic differences b. Physiologic differences 2. Pathophysiology a. Causes of altered mental status in children b. Causes of seizures i. febrile ii. afebrile 3. Assessment a. History b. Physical findings 4. Specific Conditions a. Meningitis b. Seizures i. febrile/afebrile ii. status epilepticus c. Altered mental status d. Closed head injury i. bleeding inside skull ii. fractures 5. Management a. Seizures b. Altered mental status i. assess for need to protect airway ii. assess and intervene for increased intracranial 6. Management D. Gastrointestinal file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 1. Introduction – anatomic and physiologic differences in children 2. Pathophysiology a. Vomiting b. Diarrhea 3. Assessment a. History b. Physical findings 4. Vomiting and diarrhea E. Toxicology 1. Introduction 2. Assessment a. History b. Physical findings c. Ingestion d. Inhalation F. Sudden Infant Death Syndrome (SIDS) 1. Introduction a. Definition of SIDS b. Risk factors 2. Assessment a. Cardiopulmonary status b. Clinical signs of death c. Evaluation for signs of abuse 3. Management a. Local EMS criteria for death in the field b. Notification of appropriate authorities c. Caregiver support G. Pediatric Trauma Special Patient Populations Geriatrics I. Cardiovascular System Anatomical and Physiological Changes, and Pathophysiology A. Cardiovascular Changes in the Elderly 1. Degeneration of valves 2. Degeneration of conduction system 3. Vascular changes 4. Muscular changes 5. Stroke volume 6. Cardiac output 7. Dysrhythmias B. Myocardial Infarction 1. Associated signs and symptoms a. Recognition of the types of chest pain that occur in the elderly i. Typical ii. atypical b. Dyspnea c. Epigastric and abdominal pain d. Nausea and vomiting e. Fatigue f. Dizziness, lightheaded, syncope g. Confusion 2. Possible changes in physical assessment a. Changes in circulation b. Diaphoresis, pale, cyanotic mottled skin c. Adventitious or decrease breath sounds d. Increased peripheral edema 3. Assessment tools 4. Treatment a. Airway, ventilatory, and circulatory support b. Oxygen with adjuncts appropriate to patient condition c. Evaluation of patient treatment through reassessment C. Heart Failure – A Condition Caused by Left and Right Ventricular Failure With Accompanying Pulmonary Edema 1. Associated signs and symptoms a. Dyspnea – on exertion and paroxysmal nocturnal dyspnea b. Orthopnea c. Tachypnea d. Pulmonary edema e. Accessory muscle use to breath file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 f. Chest Pain g. Anxiety h. Fatigue 2. Possible changes in physical assessment a. Changes in circulation b. Diaphoresis and Cyanosis c. Adventitious breath sounds to include crackles, wheezing, and rales d. Tachycardia e. Hypertension early and hypotension as a late sign 3. Assessment tools – blood pressures 4. Treatment a. Airway, ventilatory, and circulatory support b. Oxygen with adjuncts appropriate to patient condition II. Respiratory System Anatomical and Physiological Changes, and Pathophysiology A. Respiratory Changes in the Elderly 1. Loss of elastic recoil in the chest wall resulting in air trapping and increase in lung capacity and residual volume 2. Loss of alveoli 3. Reduction in oxygen and carbon dioxide exchange 4. Inability to increase rate of respiratory effort 5. Decreased cough reflex 6. Decreased ability of cilia to move mucus upward B. Pneumonia – Infection of the Lung From Bacterial Viral or Fungal Causes 1. Evaluation of pathophysiology through history and possible risk factors a. Institutionalized b. Chronic disease processes c. Immune system compromise d. Chronic Obstructive Pulmonary Disease e. Cancer f. Inhaled toxins g. Aspiration 2. Associated signs and symptoms a. Exertional dyspnea b. Productive cough c. Chest discomfort and pain d. Wheezing e. Headache f. Nausea and vomiting g. Musculoskeletal pain h. Weight loss i. Confusion 3. Possible changes in physical assessment a. Changes in circulation b. Cyanosis and pallor, dry skin, possible fever c. Increased skin turgor, pale, dry mucosa, and furrowed tongue d. Tachycardia e. Diminished breath sounds with adventitious noises of wheezing, rales, or rhonchi; percussion will produce a dull sound; increased vocal f. Hypotension 4. Assessment a. Wheezing, rales, and rhonchi b. Temperature: oral or core c. Orthostatic pressures d. Pulse oximetry 5. Treatment a. Airway, ventilatory, and circulatory support b. Oxygen with appropriate adjuncts c. Supportive measures d. Evaluation of patient treatment through reassessment C. Pulmonary Embolism – Sudden Blockage of the Pulmonary Artery by a Venous Clot 1. Associated signs and symptoms a. Sudden onset of dyspnea b. Shoulder/back/chest pain c. Syncope d. Anxiety/apprehension e. Fever file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 f. Leg pain/redness/unilateral pedal edema g. Fatigue h. Cardiac arrest 2. Possible changes in physical assessment a. Changes in circulation b. Tachycardia c. Adventitious noises such as wheezing, rales or decrease breath sounds d. Decreased pulse oximetry reading of 70 percent or lower e. Hypotension 3. Assessment tools a. Blood pressure b. Pulse oximetry 4. Treatment a. Airway, ventilatory, and circulatory support b. Oxygen with appropriate adjunct; events may necessitate aggressive management c. Respiratory and cardiac arrest management according to current ACLS standards or area protocol d. Evaluation of patient treatment through reassessment III. Neurovascular System Anatomical and Physiological Changes, and Pathophysiology A. Neurovascular Changes in the Elderly 1. Atrophy of the brain tissue a. Cognitive and short-term memory effects b. Delayed verbal response 2. Deterioration of the nervous system function in controlling a. Rate and depth of breathing b. Heart rate c. Blood pressure d. Hunger and thirst e. Temperature f. Sensory perception – including audio, visual, olfactory, touch, and pain 3. Neuropathy B. Dementia – A Chronic, Generally Irreversible Condition That Causes a Progressive Loss of Cognitive Abilities, Psychomotor Skills, and Social Skills 1. Demographics 2. Evaluation of pathophysiology through history, and risk factors and current medications a. Cerebrovascular accidents b. Alzheimer’s disease c. Various forms of encephalitis d. Alcohol e. Work history with metals or organic or airborne toxins 3. Known reversible causes of dementia a. Drug overdose b. Emotional disorders c. Metabolic and endocrine disorders d. Eye and ear problems e. Tumors f. Trauma g. Infections h. Parkinson’s disease i. Huntington’s chorea 4. Associated signs and symptoms a. Progressive loss of cognitive function; short- and long-term memory problems, decreased attention span b. Inability to perform daily routines with decreased ability to communicate and confusion over environment c. Mood often angry 5. Problems associated with management of patient with dementia a. Poor historian; impaired judgment b. Inability to vocalize areas of pain and current symptoms c. Unable to follow commands d. Anxiety over movement out of home or current establishment e. Anxiety and fear of treatment of current medical problems C. Delirium – A Sudden Change in Behavior, Consciousness, or Cognitive Processes Generally Due to a Reversible Physical Ailment 1. Mortality rates file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 2. Evaluation of pathophysiology through history, possible risk factors, and current medications a. Intoxication or withdrawal from alcohol b. Withdrawal from sedatives c. Medical conditions as urinary tract infections/ Bowel obstructions d. dehydration, cardiovascular disease, febrile episodes may increase risk e. Hyper/hypoglycemia f. Psychiatric disorders (i.e., depression) g. Malnutrition/vitamin deficiencies h. Environmental emergencies 3. Associated signs and symptoms a. Onset of minutes, hours, days b. Disorganized thoughts: inattention, memory loss, disorientation c. Hallucinations d. Delusions e. Reduced level of consciousness 4. Possible changes in physical assessment a. Changes in circulation b. Changes in response of pupils c. Changes in response to motor tests d. Adventitious breath sounds 5. Assessment tools a. Blood pressures b. Auscultation of breath sounds to detect adventitious noises 6. Treatment a. Airway, ventilatory, and circulatory support b. Oxygen with adjuncts appropriate to patient condition c. Venous access IV. Gastrointestinal System Anatomical and Physiological Changes, and Pathophysiology A. Gastrointestinal (GI) Changes in the Elderly 1. Dental problems 2. Decrease in saliva 3. Poor muscle tone of smooth muscle sphincter between esophagus and stomach can cause regurgitation leading to heartburn, and acid reflux 4. Decrease in hydrochloric acid in the stomach 5. Alterations in absorption of nutrients 6. Slowing peristalsis causing constipation 7. Rectal sphincter may become weak resulting in fecal incontinence 8. Liver shrinks 9. Blood flow to the liver declines 10. Decrease metabolism in the liver B. Gastrointestinal Bleeding Caused by Disease Processes, Inflammation, Infection and Obstruction of the Upper and Lower Gastrointestinal Tract 1. Associated signs and symptoms a. Hematamesis b. Hemetemesis c. Melena d. Dyspepsia e. Hepatomegaly f. Jaundice g. Constipation, diarrhea h. Agitation, inability to find a comfortable position i. Dizziness 2. Possible changes in physical assessment a. Changes in circulation b. Pale or yellow, thin skin, frail musculoskeletal system c. Peripheral, sacral, and periorbital edema d. Hypertension e. Fever f. Tachycardia g. Dyspnea 3. Assessment tools – blood pressure 4. Treatment: a. Airway, ventilatory, and circulatory support b. Oxygen with adjuncts appropriate to patient condition 5. Assessment tools a. Blood pressures, lying, sitting, and standing noting any change of 10 mm/Hg or more lower as the patient moves to an upright file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 position b. Pulses, lying, sitting, and standing noting any change of 10 beats per minute more higher as the patient moves to an upright position c. Auscultation of breath sounds to detect adventitious noises, or foreign bodies 6. Treatment: a. Airway, ventilatory and circulatory support b. Oxygen with adjuncts appropriate to patient condition V. Genitourinary System Anatomical and Physiological Changes, and Pathophysiology A. Genitourinary Changes in the Elderly 1. Reduction in renal function 2. 50 percent reduction in renal blood flow 3. Tubule degeneration 4. Decreased bladder capacity 5. Decline in sphincter muscle control 6. Decline in voiding senses 7. Increase in nocturnal voiding 8. In males benign prostatic hypertrophy VI. Endocrine System Anatomical and Physiological Changes, and Pathophysiology A. Endocrine Changes in the Elderly 1. Decreased metabolism of thyroxine 2. Decreased conversion of thyroxine to triiodothyronine 3. Reduction in pancreatic beta cell secretion causing hyperglycemia 4. Reduction of the hormones secreted by the hypothalamus and pituitary gland 5. Increase in secretion of antidiuretic hormone and atrial natriuretic hormone causing fluid imbalance 6. Increase in levels of norepinephrine B. Hyperosmolar Hyperglycemic (Nonketotic Coma) Is a Diabetic Complication of Type 2 (Formerly NIDDM of Type II) in the Elderly; Unlike DKA the Resulting High Blood Glucose Levels Do Not Cause Ketosis, but Rather Lead to Osmotic Diuresis, and Shift of Fluid to the Intravascular Space, Resulting in Dehydration 1. Associated signs and symptoms a. Hyperglycemia b. Polydipsia c. Dizziness d. Confusion e. Altered mental status f. Seizures 2. Possible changes in physical assessment a. Changes in circulation b. Warm, flushed skin, poor skin turgor; pale, dry, oral mucosa, furrowed tongue c. Hypotension and shock d. Tachycardia e. Blood glucose levels greater than 500 mg/dL 3. Assessment tools a. Blood pressures b. Distal pulses c. Auscultation of breath sounds to detect adventitious noises d. Temperature 4. Treatment a. Airway, ventilatory, and circulatory support b. Oxygen with adjuncts appropriate to patient condition VII. Musculoskeletal System Anatomical and Physiological Changes, and Pathophsysiology A. Musculoskeletal Changes in the Elderly 1. Atrophy of muscles and muscle wasting 2. Degenerative changes and loss of bone 3. Loss of strength 4. Degenerative changes in joints 5. Loss of elasticity in ligaments and tendons 6. Thinning of cartilage and thickening of synovial fluid B. Osteoporosis Is a Bone Disease That Decreases Bone Density VIII. Toxicological Emergencies A. Pathophysiological Changes That Cause the Elderly to Be Susceptible to Toxicity 1. Decreased kidney function file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 2. Altered gastrointestinal absorption 3. Decrease vascular flow in the liver altering metabolism and excretion B. Non-Compliance of Medication Can Occur From Financial Inability, a Motor Inability to Open Caps, Impaired Cognitive, Vision and Hearing Ability; Medics Should Check Prescription Dates and Number of Pills Available to Access Compliance of Medication Use C. Polypharmacy is the Use of Multiple Medications, Often Prescribed by Different Doctors That Can Cause Adverse Reactions in the Patient D. Adverse Reactions Occur When a Drug or Drugs Taken Together Change the Pharmacokinetics or Pharmacodynamics in the Body IX. Sensory Changes in the Elderly A. Vision 1. Decreased visual acuity – inability to accommodate 2. Inability to differentiate colors 3. Decreased night vision 4. Decreased tear production 5. Development of cataracts 6. Disease processes a. Glaucoma b. Macular degeneration c. Retinal detachment B. Hearing 1. Presbycusis 2. Inability to hear high frequency sounds 3. Use of hearing aids C. Pain Perception 1. Alteration of pain perception 2. Inability to differentiate hot from cold Special Patient Populations Patients With Special Challenges I. Abuse and Neglect A. Child Abuse 1. Types of abuse a. Neglect b. Physical abuse c. Sexual abuse d. Emotional abuse 2. Assessment a. History or scene findings to concern for abuse or neglect b. Caregiver’s behavior c. Physical findings 3. Management a. Reporting b. Safely transporting c. Role of child/adult protective services 4. Legal aspects 5. Documentation B. Elder Abuse 1. Types of abuse a. Neglect b. Physical abuse c. Sexual abuse d. Emotional abuse e. Financial abuse 2. Epidemiology 3. Assessment 4. Management 5. Legal aspects 6. Documentation II. Homelessness/Poverty A. Advocate for Patient Rights and Appropriate Care B. Identify Facilities That Will Treat Regardless of Payment C. Prevention Strategies Will Likely Be Absent, Increasing the Probability of Disease D. Familiarity With Assistance Resources Offered in Community file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 III. Bariatric Patients A. Increased Risk for 1. Diabetes 2. Hypertension 3. Heart disease 4. stroke B. Patient Handling Issues to 1. Prevent back injuries 2. Position the patient to breathe IV. Technology Assisted/Dependent A. Ventilation Devices B. Apnea Monitoring/Pulse Oximetry C. Long-Term Vascular Access Devices D. Dialysis Shunts E. Nutritional Support (i.e. gastric tubes) F. Colostomy or Ileostomy V. Hospice Care and Terminally Ill A. What is Hospice? 1. Comfort care versus curative care 2. Terminally ill as verified by physician 3. Typically cancer, heart failure, Alzheimer’s disease, AIDS B. EMS Intervention C. DNR (Do Not Resuscitate) Orders VI. Tracheostomy Care A. Tracheostomy: Surgical Opening From the Anterior Neck Into the Trachea B. Consists of 1. Stoma 2. Outer cannula 3. Inner cannula C. Routine Care 1. Keep stoma clean and dry 2. Suction as needed D. Acute Care VII. Sensory Deficits A. Sight 1. Service dogs 2. Allow patient to take your arm 3. Other B. Hearing Impaired 1. Hearing aid issues 2. Communication a. Face patient (so he can lip read) b. Lighted area c. Communicate by writing d. Obtain sign language interpreter VIII. Homecare A. Common for Patients Over Age 65 B. Various Reasons for Calls IX. Patient With Developmental Disability A. Respect as With Any Other Patient B. Family or Friends May Supply Additional Information C. Take Special Care to Provide Explanations EMS Operations Principles of Safely Operating a Ground Ambulance I. Risks and Responsibilities of Emergency Response A. Safety Issues During Transport 1. All personnel and others riding in or on apparatus are properly seated and secured with safety belts. 2. All patients are properly secured and all stretcher straps are appropriately in place and tightened. 3. All equipment is appropriately secured a. Cab areas file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 b. Rear of ambulances c. Compartments 4. Consideration of use of lights and sirens a. Risk/benefit analysis i. status of patient interventions ii. patient condition b. Audible warning devices i. asking for right of way of others ii. not to be used to clear traffic 5. Transport with due regard 6. High-risk situations a. Intersections b. Highway access c. Speeding d. Driver Distractions i. mobile computer ii. global Positioning Systems iii. using mobile radio iv. operating visual and audible devices v. vehicle stereo vi. wireless devices vii. eating/drinking e. Inclement weather f. Aggressive drivers g. Unpaved roadways (see Federal Highway Administration definition) h. Driving alone i. Fatigue EMS Operations Incident Management I. Establish and Work Within the Incident Management System A. Entry-Level Students Need to Be Certified in 1. ICS-100: Introduction to ICS, or equivalent 2. FEMA IS-700: NIMS, An Introduction B. This Can Be Done as a Co requisite or Prerequisite or as Part of the Entry-Level Course EMS Operations Multiple Casualty Incidents I. Multiple Casualty Incidents (MCI) -- An Event That Places a Great Demand on Resources, Be It Equipment or Personnel II. Triage A. Performing 1. Primary versus secondary a. Primary triage used on scene to rapidly categorize patient’s condition i. document location of patient and transport needs ii. triage tape or labels used iii. focus on speed to sort patients quickly b. Secondary triage used at treatment area i. re-triage of patients ii. paper tags usually used iii. not always necessary 2. Techniques of Triage a. Center for Disease Control (CDC) Guidelines b. START c. Other B. Re-Triage C. Destination Decisions 1. Patient distribution 2. Hospital surge capacity 3. Specialty patient needs (burn, pediatric, etc.) 4. Ongoing coordination and communication D. Post-Traumatic and Cumulative Stress 1. Should be part of post-incident SOP 2. Access to defusing during the MCI file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 3. Roles of debriefing for an MCI 1. Access to debriefing EMS Operations Air Medical I. Safe Air Medical Operations A. Types 1. Rotorcraft 2. Fixed wing B. Advantages 1. Specialized care – skills, supplies, equipment 2. Rapid transport 3. Access to remote areas 4. Helicopter hospital helipads C. Disadvantages 1. Weather/environmental 2. Altitude limitations 3. Airspeed limitations 4. Aircraft cabin size 5. Terrain 6. Cost D. Patient Transfer 1. Interacting with flight personnel 2. Patient preparation 3. Scene safety a. Securing loose objects b. Approaching the aircraft c. Landing zone E. Landing Zone Selection and Preparation F. Approaching the Aircraft G. Communication Issues II. Criteria for Utilizing Air Medical Response A. Indications for Patient Transport 1. Medical 2. Trauma 3. Search and rescue B. Activation 1. Local guidelines 2. State guidelines a. State statutes b. Administrative rules c. City/county/district ordinance standards EMS Operations Vehicle Extrication I. Safe Vehicle Extrication A. Role of EMS in Vehicle Extrication 1. Provide patient care 2. Perform simple extrication B. Personal Safety 1. First priority for all EMS personnel 2. Appropriate personal protective equipment for conditions 3. Scene size-up C. Patient Safety 1. Keep them informed of your actions 2. Protect from further harm D. Situational Safety 1. Control traffic flow a. Proper positioning of emergency vehicles i. upwind/uphill ii. protect scene b. Use of lights and other warning devices c. Setting up protective barrier d. Designate a traffic control person 2. 360-degree assessment a. Downed electrical lines b. Leaking fuels or fluids file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 c. Smoke or fire d. Broken glass e. Trapped or ejected patients f. Mechanism of injury 3. Vehicle stabilization a. Put vehicle in “park” or in gear b. Set parking brake c. Turn off vehicle ignition d. Cribbing/Chocking e. Move seats back and roll down windows f. Disconnect battery or power source g. Identify and avoid hazardous vehicle safety components i. seat belt pretensioners ii. undeployed air bags iii. other 4. Unique hazards a. Alternative-fuel vehicles b. Undeployed vehicle safety devices c. HAZMAT 5. Evaluate the need for additional resources a. Extrication equipment b. Fire suppression c. Law enforcement d. HAZMAT e. Utility companies f. Air medical g. Others 6. Extrication considerations a. Disentanglement of vehicle from patient b. Multi-step process c. Rescuer-intensive d. Equipment-intensive e. Time-intensive f. Access to patient i. simple a) try to open doors b) ask patient to unlock doors c) ask patient to lower windows ii. complex iii. tools a) hand b) pneumatic c) hydraulic d) other E. Determine Number of Patients (implement local multiple casualty incident protocols if necessary) II. Use of Simple Hand Tools A. Hammer B. Center Punch C. Pry Bar D. Hack Saw E. Come-Along III. Special Considerations for Patient Care A. Removing Patient 1. Maintain manual cervical spine stabilization 2. Complete primary assessment 3. Provide critical interventions B. Assist With Rapid Extrication C. Move Patient, Not Device D. Use Sufficient Personnel E. Use Path of Least Resistance EMS Operations Hazardous Materials Awareness I. Risks and Responsibilities of Operating in a Cold Zone at a Hazardous Material or Other Special Incident A. Entry-Level Students Need to Be Certified in: Hazardous Waste Operations and file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 Emergency Response (HAZWOPER) standard, 29 CFR 1910.120 (q)(6)(i) -First Responder Awareness Level B. This Can Be Done as a Co requisite or Prerequisite or as Part of the Entry-Level Course EMS Operations Mass Casualty Incidents Due to Terrorism and Disaster I. Risks and Responsibilities of Operating on the Scene of a Natural or Man-Made Disaster A. Role of EMS 1. Personal safety 2. Provide patient care 3. Initiate/operate in an incident command system (ICS) 4. Assist with operations B. Safety 1. Personal a. First priority for all EMS personnel b. Appropriate personnel protective equipment for conditions c. Scene size-up d. Time, distance, and shielding for self-protection e. Emergency responders are targets f. Dangers of the secondary attack 2. Patient a. Keep them informed of your actions b. Protect from further harm c. Signs and symptoms of biological, nuclear, incendiary, chemical and explosive (B-NICE) substances d. Concept of “greater good” as it relates to any delay e. Treating terrorists/criminals 3. 360-degree assessment and scene size-up a. Outward signs and characteristics of terrorist incidents b. Outward signs of a weapons of mass destruction (WMD) incident c. Outward signs and protective actions of biological, nuclear, incendiary, chemical, and explosive (B-NICE) weapons 4. Determine number of patients (implement local multiple-casualty incident (MCI) protocols as necessary) 5. Evaluate need for additional resources 6. EMS operations during terrorist, weapons of mass destruction, disaster events a. All hazards safety approach b. Initially distance from scene and approach when safe c. Ongoing scene assessment for potential secondary events d. Communicate with law enforcement at the scene of an armed attack e. Initiate or expand incident command system as needed f. Perimeter use to protect rescuers and public from injury g. Escape plan and a mobilization point at a terrorist incident 7. Care of emergency responders on scene a. Safe use of an auto injector for self and peers b. Safe disposal of auto injector devices after activation Lab: Practical skills lab includes demonstration and practice of basic emergency care techniques required of the EMT. Primary areas of practrical skills are listed below but are not inclusive of all practrical application check off sheets mandate by the national standard. AIRWAY, OXYGEN AND VENTILATION SKILLS UPPER AIRWAY ADJUNCTS AND SUCTION Start Time: Stop Time: Date: Candidate's Name: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 Evaluator's Name: OROPHARYNGEAL AIRWAY Points Points Possible Awarded Takes, or verbalizes, body substance isolation precautions 1 Selects appropriately sized airway 1 Measures airway 1 Inserts airway without pushing the tongue posteriorly 1 Note: The examiner must advise the candidate that the patient is gagging and becoming conscious Removes the oropharyngeal airway 1 SUCTION Note: The examiner must advise the candidate to suction the patient's airway Turns on/prepares suction device Assures presence of mechanical suction Inserts the suction tip without suction Applies suction to the oropharynx/nasopharynx 1 1 1 1 NASOPHARYNGEAL AIRWAY Note: The examiner must advise the candidate to insert a nasopharyngeal airway Selects appropriately sized airway 1 Measures airway 1 Verbalizes lubrication of the nasal airway 1 Fully inserts the airway with the bevel facing toward the septum 1 Total: 13 Critical Criteria Did not take, or verbalize, body substance isolation precautions Did not obtain a patent airway with the oropharyngeal airway Did not obtain a patent airway with the nasopharyngeal airway Did not demonstrate an acceptable suction technique Inserted any adjunct in a manner dangerous to the patient BAG-VALVE-MASK APNEIC PATIENT Start Time: Stop Time: Date: Candidate's Name: Evaluator's Name: Takes, or verbalizes, body substance isolation precautions Voices opening the airway Voices inserting an airway adjunct Points Possible 1 1 1 Points Awarded file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 Selects appropriately sized mask 1 Creates a proper mask-to-face seal 1 Ventilates patient at proper rate and adequate volume (The examiner must 1 witness for at least 30 seconds) Connects reservoir and oxygen 1 Adjusts liter flow to 15 liters/minute or greater 1 The examiner indicates arrival of a second EMT. The second EMT is instructed to ventilate the patient while the candidate controls the mask and the airway Voices re-opening the airway 1 Creates a proper mask-to-face seal 1 Instructs assistant to resume ventilation at proper rate and adequate volume 1 (The examiner must witness for at least 30 seconds) Total: 11 Critical Criteria Did not take, or verbalize, body substance isolation precautions Did not immediately ventilate the patient Interrupted ventilations for more than 20 seconds Did not provide high concentration of oxygen Did not provide, or direct assistant to provide proper volume/breath or rate (more than 2 ventilation errors per minute) Did not allow adequate exhalation BLEEDING CONTROL/SHOCK MANAGEMENT Start Time: Stop Time: Date: Candidate's Name: Evaluator's Name: Points Points Possible Awarded Takes, or verbalizes, body substance isolation precautions 1 Applies direct pressure to the wound 1 Note: The examiner must now inform the candidate that the wound continues to bleed. Applies tourniquet 1 Note: The examiner must now inform the candidate the patient is now showing signs and symptoms indicative of hypoperfusion Properly positions the patient 1 Administers high concentration oxygen 1 file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 Initiates steps to prevent heat loss from the patient Indicates the need for immediate transportation Total: 1 1 7 Critical Criteria Did not take, or verbalize, body substance isolation precautions Did not apply high concentration oxygen Did not control hemorrhage using correct procedures in a timely manner Did not indicate a need for immediate transportation CARDIAC ARREST MANAGEMENT/AEDWITH BYSTANDER CPR IN PROGRESS Start Time: Stop Time: Date: Candidate's Name: Evaluator's Name: ASSESSMENT Takes, or verbalizes, body substance isolation precautions Briefly questions the rescuer about arrest events Turns on AED power Attaches AED to the patient Directs rescuer to stop CPR and ensures all individuals are clear of the patient Initiates analysis of the rhythm Delivers shock Directs resumption of CPR TRANSITION Gathers additional information about the arrest event Confirms effectiveness of CPR (ventilation and compressions) INTEGRATION Verbalizes or directs insertion of a simple airway adjunct (oral/nasal airway) Ventilates, or directs ventilation of the patient Assures high concentration of oxygen is delivered to the patient Points Possible Points Awarded 1 1 1 1 1 1 1 1 1 1 1 1 1 file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 Assures adequate CPR continues without unnecessary/prolonged interruption Continues CPR for 2 minutes Directs rescuer to stop CPR and ensures all individuals are clear of the patient Initiates analysis of the rhythm Delivers shock Directs resumption of CPR TRANSPORTATION Verbalizes transportation of the patient Total: 1 1 1 1 1 1 1 20 Critical Criteria Did not take, or verbalize, body substance isolation precautions Did not evaluate the need for immediate use of the AED Did not immediately direct initiation/resumption of CPR at appropriate times Did not assure all individuals were clear of patient before delivering a shock Did not operate the AED properly or safely (inability to deliver shock) Prevented the defibrillator from delivering any shock IMMOBILIZATION SKILLS JOINT INJURY Start Time: Stop Time: Date: Candidate's Name: Evaluator's Name: Points Possible Takes, or verbalizes, body substance isolation precautions 1 Directs application of manual stabilization of the shoulder injury 1 Points Awarded Assesses motor, sensory and circulatory function in the injured extremity 1 Note: The examiner acknowledges "motor, sensory and circulatory function are presentand normal." Selects the proper splinting material 1 Immobilizes the site of the injury 1 Immobilizes the bone above the injured joint 1 Immobilizes the bone below the injured joint 1 Reassesses motor, sensory and circulatory function in the injured extremity 1 Note: The examiner acknowledges "motor, sensory and circulatory function are presentand normal." Total: 8 Critical Criteria Did not support the joint so that the joint did not bear distal weight Did not immobilize the bone above and below the injured site Did not reassess motor, sensory and circulatory function in the injured extremity before and after splinting file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 IMMOBILIZATION SKILLS LONG BONE INJURY Start Time: Stop Time: Date: Candidate's Name: Evaluator's Name: Points Points Possible Awarded Takes, or verbalizes, body substance isolation precautions 1 Directs application of manual stabilization of the injury 1 Assesses motor, sensory and circulatory function in the injured extremity 1 Note: The examiner acknowledges "motor, sensory and circulatory function are present and normal" Measures the splint 1 Applies the splint 1 Immobilizes the joint above the injury site 1 Immobilizes the joint below the injury site 1 Secures the entire injured extremity 1 Immobilizes the hand/foot in the position of function 1 Reassesses motor, sensory and circulatory function in the injured extremity 1 Note: The examiner acknowledges "motor, sensory and circulatory function are present and normal" Total 10 Critical Criteria Grossly moves the injured extremity Did not immobilize the joint above and the joint below the injury site Did not reassess motor, sensory and circulatory function in the injured extremity before and after splinting IMMOBILIZATION SKILLS TRACTION SPLINTING file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 Start Time: Date: Stop Time: Candidate's Name: Evaluator's Name: Points Possible Takes, or verbalizes, body substance isolation precautions 1 Directs application of manual stabilization of the injured leg 1 Directs the application of manual traction 1 Assesses motor, sensory and circulatory function in the injured extremity 1 Note: The examiner acknowledges "motor, sensory and circulatory function arepresent and normal" Prepares/adjusts splint to the proper length 1 Positions the splint next to the injured leg 1 Applies the proximal securing device (e.g..ischial strap) 1 Applies the distal securing device (e.g..ankle hitch) 1 Applies mechanical traction 1 Positions/secures the support straps 1 Re-evaluates the proximal/distal securing devices 1 Reassesses motor, sensory and circulatory function in the injured extremity 1 Note: The examiner acknowledges "motor, sensory and circulatory function arepresent and normal" Note: The examiner must ask the candidate how he/she would prepare thepatient for transportation Verbalizes securing the torso to the long board to immobilize the hip 1 Verbalizes securing the splint to the long board to prevent movement of the splint 1 Total: 14 Points Awarded Critical Criteria Loss of traction at any point after it was applied Did not reassess motor, sensory and circulatory function in the injured extremity before and after splinting The foot was excessively rotated or extended after splint was applied Did not secure the ischial strap before taking traction Final immobilization failed to support the femur or prevent rotation of the injured leg Secured the leg to the splint before applying mechanical traction Note: If the Sagar splint or the Kendricks Traction Device is used without elevating the patient's leg, application of manual traction is not necessary. The candidate should be awarded one (1) point as if manual traction were applied. Note: If the leg is elevated at all, manual traction must be applied before elevating the leg. The ankle hitch maybe applied before elevating the leg and used to provide manual traction. MOUTH TO MASK WITH SUPPLEMENTAL OXYGEN Start Time: Stop Time: Date: Candidate's Name: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 Evaluator's Name: Takes, or verbalizes, body substance isolation precautions Connects one-way valve to mask Opens patient's airway or confirms patient's airway is open (manually or with adjunct) Establishes and maintains a proper mask to face seal Ventilates the patient at the proper volume and rate Connects the mask to high concentration or oxygen Adjusts flow rate to at least 15 liters per minute Continues ventilation of the patient at the proper volume and rate Note: The examiner must witness ventilations for at least 30 seconds Total: Points Possible 1 1 1 1 1 1 1 1 8 Points Awarded Critical Criteria Did not take, or verbalize, body substance isolation precautions Did not adjust liter flow to at least 15 liters per minute Did not provide proper volume per breath (more than 2 ventiliation errors per minute) Did not ventilate the patient at a rate of 10-12 breaths per minute Did not allow for complete exhalation OXYGEN ADMINISTRATION Start Time: Stop Time: Date: Candidate's Name: Evaluator's Name: Takes, or verbalizes, body substance isolation precautions Assembles the regulator to the tank Opens the tank Checks for leaks Checks tank pressure Points Possible 1 1 1 1 1 Points Awarded file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 Attaches non-rebreather mask to oxygen 1 Prefills reservoir 1 Adjusts liter flow to 12 liters per minute or greater 1 Applies and adjusts the mask to the patient's face 1 Note: The examiner must advise the candidate that the patient is not tolerating thenon-rebreather mask. The medical director has ordered you to apply a nasal cannula to the patient. 1 1 1 1 15 Attaches nasal cannula to oxygen Adjusts liter flow to 6 liters per minute or less 1 1 Applies nasal cannula to the patient Note: The examiner must advise the candidate to discontinue oxygen therapy Removes the nasal cannula from the patient Shuts off the regulator Relieves the pressure within the regulator Total: Critical Criteria Did not take, or verbalize, body substance isolation precautions Did not assemble the tank and regulator without leaks Did not prefill the reservoir bag Did not adjust the device to the correct liter flow for the non-rebreather mask (12 liters per minute or greater) Did not adjust the device to the correct liter flow for the nasal cannula (6 liters per minute or less) Patient Assessment/Management - Medical Start Time: Stop Time: Date: Candidate's Name: Evaluator's Name: Points Possible Takes, or verbalizes, body substance isolation precautions 1 SCENE SIZE-UP Determines the scene is safe 1 Determines the mechanism of injury/nature of illness 1 Determines the number of patients 1 Requests additional help if necessary 1 Considers stabilization of spine 1 INITIAL ASSESSMENT Verbalizes general impression of the patient 1 Determines responsiveness/level of consciousness 1 Determines chief complaint/apparent life threats Assesses airway and breathing Assesses circulation Identifies priority patients/makes transport decisions 1 Assessment Indicates appropriate oxygen therapy Assures adequate ventilation 111 Assesses/controls major bleeding Assesses pulse Assesses skin (color, temperature and condition) 111 Points Awarded 1 file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 FOCUSED HISTORY AND PHYSICAL EXAMINATION/RAPID ASSESSMENT Signs and symptoms (Assess history of present illness) 1 Respiratory *Onset? *Provokes? *Quality? *Radiates? *Severity? *Time? *Interventions? Cardiac Altered Mental Status AllergicReaction Poisoning/Overdose Environmental Emergency Obstetrics *Onset? *Provokes? *Quality? *Radiates? *Severity? *Time? *Interventions? *Description of the episode. *Onset? *Duration? *Associated Symptoms? *Evidence of Trauma? *Interventions? *Seizures? *Fever? *History of allergies? *What were you exposed to ? *How were you exposed? *Effects? *Progression? *Interventions? *Substance? When did you ingest/become exposed? *How much did you ingest? *Over what time period? *Interventions? *Estimated weight? *Source? *Environment? *Duration? *Loss of consciousness? *Effectsgeneral or local? *Are you pregnant? *How long have you been pregnant? *Pain or contractions? *Bleeding or discharge? *Do you feel the need to push ? *Last menstrual period? Allergies 1 Medications 1 Past pertinent history 1 Last oral intake 1 Event leading to present illness (rule out trauma) 1 Performs focused physical examination (assesses affected body part/system or, if indicated, completes rapid assessment) 1 Vitals (obtains baseline vital signs) 1 Interventions (obtains medical direction or verbalizes standing order for medication interventions and verbalizes proper additional intervention/treatment) 1 Transport (re-evaluates the transport decision) 1 Verbalizes the consideration for completing a detailed physical examination 1 ONGOING ASSESSMENT (verbalized) Repeats initial assessment 1 Repeats vital signs 1 Repeats focused assessment regarding patient complaint or injuries 1 Critical Criteria Total: 30 Behavioral *How do you feel? *Determine suicidal tendencies. *Is the patient a threat to self or others? Is there a medical problem? Interventions? Did not take, or verbalize, body substance isolation precautions when necessary Did not determine scene safety Did not obtain medical direction or verbalize standing orders for medical interventions Did not provide high concentration of oxygen Did not find or manage problems associated with airway, breathing, hemorrhage or shock (hypoperfusion) Did not differentiate patient's need for transportation versus continued assessment at the scene Did detailed or focused history/physical examination before assessing the airway, breathing and circulation Did not ask questions about the present illness Administered a dangerous or inappropriate intervention file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 Patient Assessment/Management -Trauma Start Time: Stop Time: Date: Candidate's Name: Evaluator's Name: Points Points Possible Awarded Takes, or verbalizes, body substance isolation precautions 1 SCENE SIZE-UP Determines the scene is safe 1 Determines the mechanism of injury 1 Determines the number of patients 1 Requests additional help if necessary 1 Considers stabilization of spine 1 INITIAL ASSESSMENT Verbalizes general impression of the patient 1 Determines responsiveness/level of consciousness 1 Determines chief complaint/apparent life threats 1 Assessment 1 Assesses airway and breathing Initiates appropriate oxygen therapy 1 Assures adequate ventilation 1 Injury management 1 Assesses/controls major bleeding 1 Assesses circulation Assesses pulse 1 Assesses skin (color, temperature and conditions) 1 Identifies priority patients/makes transport decision 1 FOCUSED HISTORY AND PHYSICAL EXAMINATION/RAPID TRAUMA ASSESSMENT Selects appropriate assessment (focused or rapid assessment) 1 Obtains, or directs assistance to obtain, baseline vital signs file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 1 Obtains S.A.M.P.L.E. history 1 DETAILED PHYSICAL EXAMINATION Inspects and palpates the scalp and ears 1 Assesses the head Assesses the eyes 1 Assesses the facial areas including oral and 1 nasal areas Inspects and palpates the neck 1 Assesses the neck Assesses for JVD 1 Assesses for tracheal deviation 1 Inspects 1 Assesses the chest Palpates 1 Auscultates 1 Assesses the abdomen 1 Assesses the abdomen/pelvis Assesses the pelvis 1 Verbalizes assessment of genitalia/perineum 1 as needed 1 point for each extremity 4 Assesses the extremities includes inspection, palpation, and assessment of motor, sensory and circulatory function Assesses the posterior Assesses thorax 1 Assesses lumbar 1 Manages secondary injuries and wounds appropriately 1 1 point for appropriate management of the secondary injury/wound Verbalizes re-assessment of the vital signs 1 Total: 40 Critical Criteria Did not take, or verbalize, body substance isolation precautions Did not determine scene safety Did not assess for spinal protection Did not provide for spinal protection when indicated Did not provide high concentration of oxygen Did not find, or manage, problems associated with airway, breathing, hemorrhage or shock (hypoperfusion) Did not differentiate patient's need for transportation versus continued assessment at the scene Did other detailed physical examination before assessing the airway, breathing and circulation Did not transport patient within (10) minute time limit SPINAL IMMOBILIZATION SEATED PATIENT Start Time: Stop Time: Date: Candidate's Name: Evaluator's Name: Takes, or verbalizes, body substance isolation precautions Directs assistant to place/maintain head in the neutral in-line position Directs assistant to maintain manual immobilization of the head Reassesses motor, sensory and circulatory function in each extremity Applies appropriately sized extrication collar Positions the immobilization device behind the patient Points Possible 1 1 1 1 1 1 Points Awarded file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 Secures the device to the patient's torso Evaluates torso fixation and adjusts as necessary Evaluates and pads behind the patient's head as necessary Secure the patient's head to the device Verbalizes moving the patient to a long board Reassesses motor, sensory and circulatory function in each extremity Total: 1 1 1 1 1 1 12 Critical Criteria Did not immediately direct, or take, manual immobilization of the head Released, or ordered release of, manual immobilization before it was maintained mechanically Patient manipulated, or moved excessively, causing potential spinal compromise Device moved excessively up, down, left or right on the patient's torso Head immobilization allows for excessive movement Torso fixation inhibits chest rise, resulting in respiratory compromise Upon completion of immobilization, head is not in the neutral position Did not assess motor, sensory and circulatory function in each extremity after voicing immobilization to the long board Immobilized head to the board before securing the torso SPINAL IMMOBILIZATION SUPINE PATIENT Start Time: Stop Time: Date: Candidate's Name: Evaluator's Name: Points Possible Takes, or verbalizes, body substance isolation precautions 1 Directs assistant to place/maintain head in the neutral in-line position 1 Directs assistant to maintain manual immobilization of the head 1 Reassesses motor, sensory and circulatory function in each extremity 1 Applies appropriately sized extrication collar 1 Positions the immobilization device appropriately Directs movement of the patient onto the device without compromising the integrity of the spine 1 1 Applies padding to voids between the torso and the board as necessary 1 Immobilizes the patient's torso to the device 1 Evaluates and pads behind the patient's head as necessary 1 Immobilizes the patient's head to the device 1 Secures the patient's legs to the device 1 Secures the patient's arms to the device 1 Reassesses motor, sensory and circulatory function in each extremity 1 Total: 14 Points Awarded Critical Criteria file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 Did not immediately direct, or take, manual immobilization of the head Released, or ordered release of, manual immobilization before it was maintained mechanically Patient manipulated, or moved excessively, causing potential spinal compromise Patient moves excessively up, down, left or right on the device Head immobilization allows for excessive movement Upon completion of immobilization, head is not in the neutral position Did not assess motor, sensory and circulatory function in each extremity after immobilization to the device Immobilized head to the board before securing the torso VENTILATORY MANAGEMENT DUAL LUMEN DEVICE INSERTION FOLLOWING AN UNSUCCESSFUL ENDOTRACHEAL INTUBATION ATTEMPT Start Time: Stop Time: Date: Candidate's Name: Evaluator's Name: Continues body substance isolation precautions Confirms the patient is being properly ventilated with high percentage oxygen Directs the assistant to pre-oxygenate the patient Checks/prepares the airway device Points Possible 1 1 1 1 1 Points Awarded 1 1 Lubricates the distal tip of the device (may be verbalized) Note: The examiner should remove the OPA and move out of the way when the candidate is prepared to insert the device Positions the patient's head properly Performs a tongue-jaw lift USES COMBITUBE Inserts device in the mid-line and to the depth so that the printed ring is at the level of the teeth Inflates the pharyngeal cuff with the proper volume and removes the syringe Inflates the distal cuff with the proper volume and removes the syringe USES THE PTL Inserts the device in the mid-line until the bite block flange is at the level of the teeth 1 Secures the strap 1 Blows into tube #1 to adequately inflate both cuffs 1 Attaches/directs attachment of BVM to the first (esophageal placement) lumen and ventilates Confirms placement and ventilation through the correct lumen by observing chest rise, auscultation over the epigastrium and bilaterally over each lung Note: The examiner states, "You do not see rise and fall of the chest and hear sounds only over epigastrium" 1 1 Attaches/directs attachment of BVM to the second (endotracheal placement) lumen and ventilates 1 Confirms placement and ventilation through the correct lumen by observing chest rise, auscultation over the 1 epigastrium and bilaterally over each lung Note: The examiner states, "You see rise and fall off the chest, there are no sounds over the epigastrium and breath sounds are equal over each lung" Secures device or confirms that the device remains properly secured 1 15 Total: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 Critical Criteria Did not take or verbalize body substance isolation precautions Did not initiate ventilations within 30 seconds Interrupted ventilations for more than 30 seconds at any time Did not pre-oxygenate the patient prior to placement of the dual lumen airway device Did not provide adequate volume per breath (maximum 2 errors/minute permissable) Did not ventilate the patient at a rate of 10-12 breaths per minute Did not insert the dual lumen airway device at a proper depth or at the proper place within 3 attempts Did not inflate both cuffs properly Combitube – Did not remove the syringe immediately following inflation of each cuff PTL - Did not secure the strap prior to cuff inflation Did not confirm, by observing chest rise and auscultation over the epigastrium and bilaterally over each lung that the proper lumen of the device was being used to ventilate the patient Inserted any adjunct in a manner that was dangerous to the patient VENTILATORY MANAGEMENT ENDOTRACHEAL INTUBATION Start Time: Stop Time: Date: Candidate's Name: Evaluator's Name: Note: If a candidate elects to initially ventilate the patient with a BVM attached to a reservoir and oxygen, full credit must be awarded for steps denoted by "**" provided first ventilation is delivered within the initial 30 seconds Takes, or verbalizes, body substance isolation precautions Opens the airway manually Points Possible 1 1 1 Points Awarded 1 1 1 1 1 1 1 Elevates the patient's tongue and inserts a simple airway adjunct (oropharyngeal/nasopharyngeal airway) Note: The examiner must now inform the candidate, "No gag reflex is present and the patient accepts the airwayadjunct." **Ventilates the patient immediately using a BVM device unattached to oxygen **Ventilates the patient with room air Note: The examiner must now inform the candidate that ventilation is being properly performed without difficulty Attaches the oxygen reservoir to the BVM Attaches the BVM to high flow oxygen (15 liter per minute) Ventilates the patient at the proper volume and rate of 10-12 breaths per minute Note: After 30 seconds, the examiner must auscultate the patient's chest and inform the candidate that breathsounds are present and equal bilaterally and medical direction has ordered endotracheal intubation. The examiner must now take over ventilation of the patient. Directs assistant to pre-oxygenate the patient Identifies/selects the proper equipment for endotracheal intubation Checks equipment Checks for cuff leaks Checks laryngoscope operation and bulb tightness 1 1 Note: The examiner must remove the OPA and move out of the way when the candidate is prepared to intubate thepatient. Positions the patient's head properly Inserts the laryngoscope blade into the patient's mouth while displacing the patient's tongue laterally Elevates the patient's mandible with the laryngoscope Introduces the endotracheal tube and advances the tube to the proper depth Inflates the cuff to the proper pressure Disconnects the syringe from the cuff inlet port Directs assistant to ventilate the patient Confirms proper placement of the endotracheal tube by auscultation bilaterally and over the epigastrium Note: The examiner must ask, "If you had proper placement, what would you expect to hear?" Secures the endotracheal tube (may be verbalized) Total: 1 1 1 1 1 1 1 1 1 21 Critical Criteria Did not take or verbalize body substance isolation precautions when necessary Did not initiate ventilation within 30 seconds after applying gloves or interrupts ventilations for greater than 30 seconds at a time Did not voice or provide high oxygen concentrations (15 liter/minute or greater) Did not ventilate the patient at a rate of 10-12 breaths per minute Did not provide adequate volume per breath (maximum of 2 errors per minute permissible) Did not pre-oxygenate the patient prior to intubation Did not successfully intubate the patient within 3 attempts Used the patient's teeth as a fulcrum Did not assure proper tube placement by auscultation bilaterally over each lung and over the epigastrium The stylette (if used) extended beyond the end of the endotracheal tube Inserted any adjunct in a manner that was dangerous to the patient Did not immediately disconnect the syringe from the inlet port after inflating the cuff file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Audiovisual; 2. Case Study; 3. Demonstration; 4. Discussion; 5. Group Work; 6. Informational Interviews; 7. Instruction through examination or quizzing; 8. Job Shadowing; 9. Laboratory; 10. Lecture; 11. Outside reading; 12. Peer analysis, critique & feedback; 13. Performance; 14. Problem Solving; 15. Skills Development and Performance; 16. Written work; 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to Textbook reading. Workbook completion. Online proctored exams. A minimum of 16 clinical experience hours is required in the emergency room, ambulance or at another clinical provider. Students perform basic evaluations in a controlled environment under the direct supervision of licensed preceptors. One to three essays may be required by students completing research, analysis and writing papers relating to the evaluation, management and treatment of medical and trauma patients. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to Students are assessed using performance based exams complying with the standards established by the National Highway Traffic Safety Administration's National Standard Curriculum for the EMT. Students are assessed with problem solving activities and/or exercises related to patient assessment and treatment. Students are assessed using skill practical application of mandated techniques in the Emergency Medical Technician scope of practice. Students are assessed by a cognitive national exam administered by the NREMT. Students are assessed by exams. 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks American Academy of Orthopedic Surgeons. (2010) Emergency Care and Transportation of the Sick and Injured textbook , 10th, Jones and Bartlett This is mandated. American Academy of Orthopedic Surgeons. (2010) Emergency Care and Transportation of the Sick and Injured workbook , 10th, Jones and Bartlett This is mandated. Manuals Periodicals Software Other Computer access with internet connection is mandated for this course, to access the latest national standards and the online class testing site. 29. METHOD OF DELIVERY: Online with some required face-to-face meetings (â€œHybridâ€);Face to face; 30. MINIMUM QUALIFICATIONS: Emergency Medical Technologies; 31. APPROVALS: Origination Date 10/13/2011 Last Outline Revision 01/27/2012 01/27/2012 file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] EMTC C105 Curriculum Committee Approval 03/08/2012 Board of Trustees 03/13/2012 State Approval UC Approval CSU Approval UC Approval Status 50 = Summer 2000 IGETC Approval CSU GE Approval CSU Approval Status Approved IGETC Approval Status CSU GE Approval Status Data Element Changes CB06 â€“ Maximum Units Data Justification Additional hour and curriculum requirements will require additional unit maximum. Course Element Changes Title Change Change in units Change in hours Change/Update Course Outline Proposal of new Distance Education indication Add/Update course content Course Change Justification State law (Title 22) has created changes to: the EMT designator from EMT-I; added hours to the course thus creating a change in the unit value for the course; and added content and modified the course content and objectives. Course ID (CB00) CCC000320703 TOP Code (CB03) 1250.00 - Emergency Medical Service; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 6.5 Course Units of Credit Minimum Low (CB07): 6.5 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): B = Advance Occupational; Cooperative Education Course Status (CB10): Not part of Coop Work Exp; Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): CAN-Code Seq (CB15): Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/EMTC%20C105.htm[4/8/2013 1:25:45 PM] HCRS C130 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE HCRS C130 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: HCRS C130 2. COURSE TITLE: Communication in Healthcare 3. SHORT BANWEB TITLE: Comm in Healthcare 4. COURSE AUTHOR: Gates, Cheryl G. 5. COURSE SEATS: 6. COURSE TERMS: 70 = Fall; 30 = Spring; 50 = Summer 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC New Course 9. START TERM: 70 = Fall, 2012 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This course is designed to prepare the student to recognize human behaviors and communicate effectively with clients and other healthcare providers in the workplace. Topics include verbal, nonverbal communication techniques, listening skills, therapeutic communication skills and communicating with other healthcare providers. This course meets the competency standards for CAAHEP and CCBMA certification. 12. GRADING METHOD S = Standard Letter Grade Default: Optional: 13. TOTAL UNITS: 2 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 2 Lab 0 Min Hours 36 0 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: HCRS Administrative Medical Assisting- (Certificate of Achievement) HCRS Clinical Medical Assisting- (Certificate of Achievement) HCRS Medical Assisting (AS Degree Program) Elective: 21. GENERAL EDUCATION APPLICABILITY file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C130.htm[4/8/2013 1:25:48 PM] HCRS C130 Local: IGETC: CSU: UC Transfer Course: CSU Transfer Course: California State University, San Bernardino = HSCI 273: Software Applications in the Health Sciences 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Compare styles and types of verbal communication. 2. Analyze nonverbal communication techniques. 3. Evaluate different types of communication barriers. 4. Differentiate between subjective and objective information. 5. Recognize elements of fundamental writing skills. 6. Identify resources and adaptations that are required based on individual needs. 23. REQUISITES Advisory: Advisory Reading Level I skills prepare the students to succeed in HCRS C130 by ensuring they have the skills to read college textbooks, journal articles, and assigned readings. Student should be able to make connections between regulations, theory, and health care practice. Reading - 1 Level Prior to Transfer and Advisory In HCRS C130 students are expected to write summaries of journal articles and assigned readings. ENG C070 skills prepare the students to succeed in HCRS C130 by ensuring they are able to write short essays and communications that are free from major spelling and grammatical errors. Writing 1 Level Prior to Transfer 24. DETAILED TOPICAL OUTLINE: Lecture: A. Elements of Communication I. Message II. Source III. Sender B. Understanding Human Behavior I. Maslow’s Hierarchy of Needs II. Life Span Development C. Types of Communication I. Positive Verbal II. Negative Verbal III. Nonverbal D. Improving Communication Skills I. Listening Skills II. Interpersonal Skills III. Therapeutic Communication Skills IV. Assertiveness Skills V. Special Circumstances E. Communicating with Coworkers I. Positive communication with coworkers II. Communicating with management III. Dealing with conflict F. Written Communication Tools and Community Resources I. Policy and Procedure Manual file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C130.htm[4/8/2013 1:25:48 PM] HCRS C130 II. Community Resources G. Stress I. Causes of stress II. Reduce stress III. Prevent Burnout 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Case Study; 2. Discussion; 3. Instruction through examination or quizzing; 4. Lecture; 5. Outside reading; 6. Problem Solving; 7. Written work; 8. Other Methods: PowerPoint Presentations, video 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to 1. Assign a short 3 page paper on communication topics, e.g., describe how the affects of body posture on oral communication. 2. Assigned readings, example: Read Chapter 1 and outline prior to lecture. 3. Discussion of Case Studies Example: Case Study Mary is 23 years old and has been a medical assistant for 6 months. She is currently working in a walk-in clinic in a large urban city. She has interviewed three patients this morning. One patient is a homeless transient male who appears to have some type of mental incapacity; the second is a teenage girl who suspects she might be pregnant; and the third is a well dressed professional male who complains of a sore throat. 1. How will Mary adapt her communication style to communicate with each patient? 2. What types of communication roadblocks will she encounter with each one? 3. What types of communication techniques will she use for each patient? 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to 1. Discussions 2. Chapter Quizzes, short answer, multiple choice, or true-false: Question Example: Short Answer: Name 3 things that can affect oral communication. 3. Midterm and/or Final, short answer, multiple choice, or true-false: Question Example: The first impression of an office is often the result of A. A phone call B. An insurance referral C. The first visit D. rumors 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks No Author. (2000) No Textbook Is Required , , No Publisher This is for no textbook option No Author. (2000) No Textbook Is Required , , No Publisher This is for no textbook option Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online (purely online no face-to-face contact) ;iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality ;Face to face; 30. MINIMUM QUALIFICATIONS: Health Care Ancillaries; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C130.htm[4/8/2013 1:25:48 PM] HCRS C130 31. APPROVALS: Origination Date 02/29/2012 Last Outline Revision 05/04/2012 Curriculum Committee Approval 05/04/2012 06/14/2012 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 70 = Fall 2012 IGETC Approval CSU Approval Status Approved IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification This is a new course being offered for the new/revised Medical Assisting Program. This course meets the competency standards for CAAHEP and CCBMA certification for Medical Assistants. Course Element Changes Course Change Justification Course ID (CB00) CCC000532306 TOP Code (CB03) 1208.00 - Medical Assisting*; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 2 Course Units of Credit Minimum Low (CB07): 2 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Not part of Coop Work Exp; Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): CAN-Code Seq (CB15): Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C130.htm[4/8/2013 1:25:48 PM] HCRS C131 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE HCRS C131 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: HCRS C131 2. COURSE TITLE: Medical Law and Ethics for Medical Assistants 3. SHORT BANWEB TITLE: Med Law/Ethics for Med Assts 4. COURSE AUTHOR: Hodgins, Annette 5. COURSE SEATS: 6. COURSE TERMS: 70 = Fall 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC New Course 9. START TERM: 70 = Fall, 2012 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This course is designed to explore the theories, models and principles that serve as guides for ethical behavior within the medical assistant context. The student explores the complexities of the ethical and legal aspects of patient care related to the medical assistantâ€™s practice, all the while emphasizing the importance of principled behavior in personal and professional situations. 12. GRADING METHOD S = Standard Letter Grade Default: Optional: 13. TOTAL UNITS: 1.5 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 1.5 Lab 0 Min Hours 27 0 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: HCRS Administrative Medical Assisting- (Certificate of Achievement) HCRS Clinical Medical Assisting- (Certificate of Achievement) HCRS Medical Assisting (AS Degree Program) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C131.htm[4/8/2013 1:25:49 PM] HCRS C131 IGETC: CSU: UC Transfer Course: CSU Transfer Course: California State University, Bakersfield = PPA 325: Ethics in Public Administration/Health and Human Services 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Discuss the legal and ethical role of the medical assistant. 2. Compare medial law, ethics, and bioethics. 3. Compare and contrast physician and medical assistant roles in terms of standard of care. 4. Discuss all levels of governmental legislation and regulation as they apply to medical assisting practice, including FDA and DEA regulations. 5. Analyze the ethical implications of life and death decisions. 23. REQUISITES Advisory: Advisory The students are required to read a college level textbooks; perform research on the internet regarding the health care field; and relate ethical issues to the practice of medical assisting. Reading - 1 Level Prior to Transfer and Advisory ENG C070 skills prepare the students to succeed in HCRS C131 by ensuring they are able to write short essays and communications that are free from major spelling and grammatical errors. The students are required to perform research on the internet regarding the health care field and apply medical theory to the clinical setting. Writing - 1 Level Prior to Transfer 24. DETAILED TOPICAL OUTLINE: Lecture: A. The Basics 1. Legal scope of practice for medical assistants a. Licensure and certification as it applies to healthcare providers b. Code of ethics 2. Legal and Ethical Considerations a. Integrity b. Confidentiality c. Responsibility d. Regulating and accreditation policies and procedures 3. Medical law, Ethics, & Bioethics a. Patient Bill of Rights b. Privacy 4. Health-care team B. Law & liability 1. Implications of HIPAA for the medical assistant in various medical settings 2. OSHA Guidelines 3. FDA and DEA regulations 4. Americans with Disabilities Act (ADA) 5. Tort Law 6. Civil law as it applies to the practicing medical assistant. a. Negligence b. Malpractice c. Statute of Limitations d. Good Samaritan Act(s) e. Uniform Anatomical Gift Act f. Living will/Advanced directives g. Medical durable power of attorney C. Workplaces Issues 1. Medical Record 2. Cultural Perspective D. Bioethics 1. Genetic Engineering 2. End of life file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C131.htm[4/8/2013 1:25:49 PM] HCRS C131 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Audiovisual; 2. Case Study; 3. Discussion; 4. Group Work; 5. Lecture; 6. Outside reading; 7. Peer-to-peer instruction; 8. Performance; 9. Presentations (by students); 10. Problem Solving; 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Required Readings: weekly outline chapter prior to lecture. B. Weekly Homework Assignments: complete end of chapter questions; internet research on ethical issues with presentation to class; and group discussion. C. One Five page research paper on a topic assigned such as: ethical issues with genetic engineering; HIPAA in the workplace; and the effects of end-of-life issues on the healthcare provider. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to A. Weekly Quizzes using multiple choice, true-false, or short answer questions. Example of questions: A Fax is 1. A legal document 2. Covered by HIPAA 3. Considered a permanent part of the patient chart 4. Used only for billing purposes B. Mid-Term and Final Exams using multiple choice, true-false, or short answer questions. Example of questions: Define and explain tort law. C. Class discussion, e.g., students discuss case studies related to workplace ethical issues. 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Lewis, A.L., Tamparo, C.D., Tatro, B.M.. (2012) Medical Law, Ethics, & Bioethics for the Health Professions , 7th, F.A.Davis Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online with some required face-to-face meetings (â€œHybridâ€);iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality ;Online course with on ground testing;Face to face; 30. MINIMUM QUALIFICATIONS: Health Care Ancillaries; 31. APPROVALS: Origination Date 04/06/2012 Last Outline Revision 05/04/2012 Curriculum Committee Approval Board of Trustees 05/04/2012 06/14/2012 State Approval UC Approval CSU Approval UC Approval Status 70 = Fall 2012 IGETC Approval CSU GE Approval CSU Approval Status Approved IGETC Approval Status CSU GE Approval Status file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C131.htm[4/8/2013 1:25:49 PM] HCRS C131 Data Element Changes Data Justification This is a new course being offered for the new/revised Medical Assisting Program. This course meets the competency standards for CAAHEP and CCBMA certification for Medical Assistants. Medical Assisting program is pending and will be sent forward when all courses are completed. Course Element Changes Course Change Justification Course ID (CB00) CCC000532248 TOP Code (CB03) 1208.00 - Medical Assisting*; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1.5 Course Units of Credit Minimum Low (CB07): 1.5 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Not part of Coop Work Exp; Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): CAN-Code Seq (CB15): Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C131.htm[4/8/2013 1:25:49 PM] HCRS C132 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE HCRS C132 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: HCRS C132 2. COURSE TITLE: Electronic Health Record 3. SHORT BANWEB TITLE: Electronic Health Record 4. COURSE AUTHOR: Hodgins, Annette 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC Course Update 9. START TERM: 30 = Spring, 2013 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This course covers concepts and techniques for managing and maintaining manual and electronic health records (EHR). Topics include structure and use of health information including data collection and analysis, data sources/sets, archival systems, and quality and integrity of health care data. The focus of this course is system-wide clinical documentation guidelines and regulatory standards. 12. GRADING METHOD S = Standard Letter Grade Default: Optional: 13. TOTAL UNITS: 1.5 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 1.5 Lab 0 Min Hours 27 0 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: HCRS Administrative Medical Assisting- (Certificate of Achievement) HCRS Clinical Medical Assisting- (Certificate of Achievement) HCRS Medical Assisting (AS Degree Program) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C132.htm[4/8/2013 1:25:49 PM] HCRS C132 IGETC: CSU: UC Transfer Course: CSU Transfer Course: California State University, Fresno = INTD 164: Electronic Health Records IS 142: Health Records/Information Services California State University, Monterey Bay = CHHS 305: Electronic Health Records 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Describe the functions of electronic health records and explain the advantages they offer over paper-based records. 2. Demonstrate how paper records are converted to an electronic health record system. 3. Evaluate and demonsrate how electronic health records are used in physician practices and other outpatient settings. 4. Describe the different types of personal health records and explain how personal health records differ from electronic health records. 5. Analyze the challenges that electronic health informatiomn poses to the privacy and security of patient's health information. 6. Assess the HIPPA privacy and security rules and apply them to privacy protection in today's health care environment. 23. REQUISITES Advisory: Advisory The students are required to read a college level textbooks; perform research on the internet regarding the documentation in the electronic health record; and relate ethical issues to the practice of medical assisting. Reading - 1 Level Prior to Transfer and Advisory ENG C070 skills prepare the students to succeed in HCRS C132 by ensuring they are able to write short essays and communications that are free from major spelling and grammatical errors. The students are required to write a 5 page paper on the electronic health record from research completed on the internet regarding documentation in the health care field. Writing - 1 Level Prior to Transfer 24. DETAILED TOPICAL OUTLINE: Lecture: 1. Introduction to Electronic Medical Record a. Administrative b. Clinical 2. Functions of the Health Record 3. Contents and Structure of the Health Record a. Paper-based health records b. Computerized patient records c. Electronic medical records 4. Documentation Guidelines 5. Data and Information Management 6. Health Care Data Sets 7. Health Care Delivery Systems 8. Legal and Ethical Issues in Health Information Management 9. Regulatory Legislation 10. Regulatory and Compliance Issues a. Joint Commission on Accreditation of HealthCare Organizations b. Centers for Medicare and Medicaid Services c. Occupational Safety and Health Administration d. Food and Drug Administration e. Centers for Disease Control 11. HIPAA and Compliance 12. Evaluation of Health Care Services 13. Reimbursement Methodologies 14. Nomenclature and Classifications Systems 15. Information Systems and Security 16. Emerging Information Technologies 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Audiovisual; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C132.htm[4/8/2013 1:25:49 PM] HCRS C132 2. Demonstration; 3. Discussion; 4. Group Work; 5. Instruction through examination or quizzing; 6. Lecture; 7. Problem Solving; 8. Written work; 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to 1. The student will read the assigned text chapters prior lecture 2. The student will outline the chapters and incorporate lecture notes with chapter outlines 3. The student will answer assigned questions from homework assignments 4. The student will write a 5 page research paper discussing the importance of HIPPA in reference to the electronic Health Record 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to Demonstration Quizzes/Tests Research Paper Discussion 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks DeVore, Amy. (2012) The Electronic Health Record for the Physician's Office with MED TRAK Systems , , Elsevier/ Saunders Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online with some required face-to-face meetings (â€œHybridâ€);iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality ;Online (purely online no face-to-face contact) ;Face to face; 30. MINIMUM QUALIFICATIONS: Health Care Ancillaries; 31. APPROVALS: Origination Date 04/06/2012 Last Outline Revision 05/04/2012 Curriculum Committee Approval 06/14/2012 Board of Trustees 07/23/2012 State Approval UC Approval 05/04/2012 UC Approval Status CSU Approval 70 = Fall 2012 IGETC Approval CSU Approval Status Approved IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification This is a new course being offered for the revised Medical Assisting Program. This course meets the competency standards for CAAHEP & CCBMA certification for Medical Assistants. Course Element Changes Course Change Justification Course ID (CB00) CCC000532291 file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C132.htm[4/8/2013 1:25:49 PM] HCRS C132 TOP Code (CB03) 1208.00 - Medical Assisting*; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1.5 Course Units of Credit Minimum Low (CB07): 1.5 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Not part of Coop Work Exp; Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): CAN-Code Seq (CB15): Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C132.htm[4/8/2013 1:25:49 PM] HCRS C133 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE HCRS C133 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: HCRS C133 2. COURSE TITLE: Medical Office Procedures 3. SHORT BANWEB TITLE: Medical Office Procedures 4. COURSE AUTHOR: Hodgins, Annette 5. COURSE SEATS: 6. COURSE TERMS: 70 = Fall 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC New Course 9. START TERM: 70 = Fall, 2012 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This course enables the student to gain a wide range of skills that may be required in a medical front office which is an area that is constantly changing. It covers basic office procedures, which include receptionist, appointments, scheduling, telephone techniques, interpersonal relations, computer data entry, oral communication, and medico-legal doctrines. 12. GRADING METHOD S = Standard Letter Grade Default: Optional: 13. TOTAL UNITS: 3 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 3 Lab 0 Min Hours 54 0 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: HCRS Administrative Medical Assisting- (Certificate of Achievement) HCRS Medical Assisting (AS Degree Program) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C133.htm[4/8/2013 1:25:49 PM] HCRS C133 IGETC: CSU: UC Transfer Course: CSU Transfer Course: California State Polytechnic University, Pomona = HRT 275: Medical Assisting Office Procedures California State University, Dominguez Hills = HSC 201: Office Technology/Medical Offices 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Analyze environmental safety hazards and state techniques used to maintain a safe environment for clients and staff. 2. Differentiate between administrative (front office)and clinical (back office) roles, responsibilities, and functions. 3. Discuss verbal and nonverbal communication skills and techniques for the medical office. 4. Discuss and identify the electronic technologies used as part of the business of a medical office. 5. Identify systems used in medical office settings for filing, maintaining and utilized medical records. 6. Differentiate between medical and surgical aseptic techniques. 23. REQUISITES Prerequisite: HCRS C150 and HCRS C130 and HCRS C131 and HCRS C132 24. DETAILED TOPICAL OUTLINE: Lecture: A. Public and Interpersonal Relations 1. Professional conduct 2. Professional appearance 3. Working with the public 4. Office stress management B. Reception room and greeting patients C. Terminology D. Appointments/Scheduling 1. Time management 2. Office hours 3. Scheduling appointments 4. Cancellations/delays 5. Scheduling outside appointments for patients E. Telephone Techniques 1. Answering calls/inquiries 2. Taking messages 3. Organizing phone directory 4. Emergency calls 5. Answering service 6. Specialty Call a) Long Distance b) Conference Call file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C133.htm[4/8/2013 1:25:49 PM] HCRS C133 c) Skyping d) Other technology COMMUNICATION A. Oral Communication 1. Attitudes 2. Defense mechanisms 3. Cultural diversities 4. Cultural influences 5. Recognizing discrimination 6. Sexual harassment 7. Body language B. Communication Techniques 1. Patients 2. Physicians/Providers 3. Peers 4. Patient education C. Written Communication 1. Typing 2. Transcription and dictation 3. Letters and correspondence 4. Types of letters 5. Composing a letter 6. Responding to letters 7. Processing mail 8. Records 9. Managing records 10. Contents of records 11. Styles and forms of records D. Electronic Health Records (EHR)/Medical Records 1. Patient histories 2. Types of Medical Records and Charting systems 3. Medical abbreviations/symbols F. Filing Systems 1. Alphabetic 2. Numeric 3. Color coding 4. Organization 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Audiovisual; 2. Case Study; 3. Computational Work; 4. Demonstration; 5. Discussion; 6. Lecture; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C133.htm[4/8/2013 1:25:49 PM] HCRS C133 7. Outside reading; 8. Problem Solving; 9. Skills Development and Performance; 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Required Readings: outline chapter prior to lecture. B. Homework Assignments: complete end-of-chapter questions/assignments. C. Five page research paper on an assigned topic such as the past history and current issues affecting the practice of medicine. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to A. The student will demonstrate scenario-based medical front office procedures. B. Weekly examinations. Examination may include multiple-choice, true-false, or short answer questions. EXAMPLE QUESTION: A marketing plan for a physicianâ€™s office may include A. Radio advertisements B. Participation in a health fair C. Newsletters D. All of the above C. Mid-term and Final examinations. Examination may include multiple-choice, true-false, or short answer questions. EXAMPLE QUESTION: When scheduling patients you should A. Approximate how late the patient might be B. Allow the patient to determine the length of the appointment C. Assume the patient has insurance D. Work within an established appointment matrix 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Booth, K.A. . (2011) Administrative Procedures for Medical Assisting Workbook, 4th, McGraw Hill-Higher Education Booth, K.A. . (2011) Administrative Procedures for Medical Assisting , 4th, McGraw Hill-Higher Education. Manuals Periodicals Software Other 29. METHOD OF DELIVERY: iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality ;Online (purely online no face-to-face contact) ;Face to face;Online course with on ground testing; 30. MINIMUM QUALIFICATIONS: Health Care Ancillaries; 31. APPROVALS: Origination Date 04/06/2012 Last Outline Revision 05/04/2012 Curriculum Committee Approval Board of Trustees 05/04/2012 06/14/2012 State Approval UC Approval CSU Approval UC Approval Status 70 = Fall 2012 IGETC Approval CSU GE Approval CSU Approval Status Approved IGETC Approval Status CSU GE Approval Status Data Element Changes Data Justification This is a new course being offered for the new/revised Medical Assisting Program. This course meets the competency standards for CAAHEP and CCBMA certification for Medical Assistants. Medical Assisting program is pending and will be sent forward when all courses are completed. file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C133.htm[4/8/2013 1:25:49 PM] HCRS C133 Course Element Changes Course Change Justification Course ID (CB00) CCC000532218 TOP Code (CB03) 1208.20 - Administrative Medical As; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 3 Course Units of Credit Minimum Low (CB07): 3 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Not part of Coop Work Exp; Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): CAN-Code Seq (CB15): Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C133.htm[4/8/2013 1:25:49 PM] HCRS C134 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE HCRS C134 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: HCRS C134 2. COURSE TITLE: Medical Insurance and Billing 3. SHORT BANWEB TITLE: Med. Ins. & Billing 4. COURSE AUTHOR: Hodgins, Annette 5. COURSE SEATS: 6. COURSE TERMS: 70 = Fall 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC New Course 9. START TERM: 70 = Fall, 2012 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This course presents a thorough discussion of office finance management and insurance. Insurance coding and billing prepares the student to undertake the details necessary for implementing the specialized insurance forms utilized in the modern healthcare system. Included in the course insurance exercises are Blue Cross and Blue Shield, Medicaid-MediCal, CHAMPUS, Unemployment and Worker's Compensation, and Health Maintenance Organizations. 12. GRADING METHOD S = Standard Letter Grade Default: Optional: 13. TOTAL UNITS: 3 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 3 Lab 0 Min Hours 54 0 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: HCRS Administrative Medical Assisting- (Certificate of Achievement) HCRS Medical Assisting (AS Degree Program) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C134.htm[4/8/2013 1:25:50 PM] HCRS C134 IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Analyze the basics of medical insurance including multipurpose billing, primary coverage, health programs, health maintenance organizations (HMO), and preferred provider organizations (PPO). 2. Consider the methods of establishing professional fees, customer credit, and identify the laws and regulations that affect follow-up and collection procedures. 3. Discuss the skills necessary to perform bookkeeping, accounting, and payroll. 4. Accurately complete all forms of insurance, disability and workers compensation claim forms. 5. Compare at least 4 issues related to legal issues of insurance billing and medical records 6. Explain basic banking procedures including types of banking, credit cards, checks, and petty cash. 23. REQUISITES Prerequisite: HCRS C150 and HCRS C130 and HCRS C131 and HCRS C132 24. DETAILED TOPICAL OUTLINE: Lecture: I. To prepare the learner with basic knowledge of medical insurance A. Spell and define the key terms. B. Discuss the function of the multipurpose billing form (super bill). i. Combination bill, insurance form and routing document which may be given to the patient at the time of the office visit ii. Super bills (fee tickets, charge tickets, encounter form, patient service slip, routing form, transaction slip) are preprinted patient statements that can be used in a manual (peg-board charge-slip system) or computerized office bookkeeping system iii. Contains the patients name, date, services rendered, procedure codes (list codes for basic office charges), diagnostic codes, the physician’s identifying data and a section to indicate the patient’s next appointment. iv. Super bill form may have two or three copies v. Clipped to the front of the patient’s charts on their arrival at the office 1. Physician checks off procedures that are performed 2. Applicable diagnoses 3. Return appointment time frame if needed 4. May be used as a receipt for the patient 5. May be submitted to the billing department 6. Should be updated to include new or revised procedures and diagnostic codes at the beginning of each year C. Discuss determination of primary coverage. i. If the individual has only one policy, it is primary ii. If the person has coverage under two plans: 1. Insurance for the longest period of time is primary person 2. If active employee has a plan with a present employer and is still covered by a former employer’s plan as a retiree or a laid-off employee. The current employer’s plan is primary. iii. If the individual is also covered as a dependent under another insurance policy, the patient’s plan is primary. iv. If an employed person has coverage under the employer’s plan and additional coverage under a governmental sponsored plan, the employer’s plan is primary. Example – person is enrolled in a PPO through employment who is also on Medicare. v. If a retired individual is covered by the plan of the spouse’s employer and the spouse is still employed, the spouse’s plan is primary, even if he is retired person has Medicare. vi. The birthday rule: If the person is a dependent child covered by both parents’ plans and the parents are neither separated nor divorced (or have joint custody of the child), the primary plan is determined by which parent has the first birth date in the calendar year. vii. If two or more plans cover the dependent children of separated or divorced parents who do not have joint custody of their children, the children’s primary plan is determined in this order: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C134.htm[4/8/2013 1:25:50 PM] HCRS C134 1. The plan of the custodial parent 2. The plan of the spouse of the custodial parent (if the parent has remarried). 3. The plan of the parent without custody. D. Describe group, individual, and government sponsored health programs. i. Group insurance a. Group health benefits are sponsored by an organization such as an employer, a union or an association. b. A person covered by group health benefits is either an employee or a group member, who by virtue of employment or membership in an organization may participate in and receive benefits from a health plan. c. If an individual under group coverage leaves the employer or organization the insured may continue the same or lesser coverage under an individual policy d. COBRA ii. Individual health benefits a. Individual health benefits policies are purchased by an individual from an insurance company. b. Premiums are submitted by the individual directly to the insurance company. c. Company then reimburses the covered individual eligible medical expenses. d. Medi-Gap plans iii. Government sponsored health benefits a. Government sponsored benefits programs are funded and regulated by the federal or state government. b. Government programs have been developed over the years to assist persons who might otherwise have health benefits such as the elderly, the indigent, and others unable to obtain benefits. c. Government programs include Medicare, Medicaid (MediCal is the Medicaid program in California), CHAMPVA/TRICARE, and Worker’s Compensation (State program). i. Medicare 1. Medicare was designed to provide medical care and benefits for the elderly population. 2. Medicare has since been expanded to provide benefits for blind individuals, disabled individuals who are eligible for social security benefits and meet certain criteria, children and adults with end-stage renal disease, and kidney donors. 3. Medicare advantage plans 4. Part A hospital insurance a. Provides inpatient up to 90 days for each benefit period. (begins the day a patient goes into the hospital and ends the day patient has not been hospitalized for 60 days). b. Patient who has been an inpatient in a skilled nursing facility (SNF) for no more then100 days in each benefit period (one calendar year). c. A patient who is receiving medical care at home. d. A patient who has been diagnosed as terminally ill and needs hospice care (6 months to live). e. Patient who requires psychiatric treatment, covering 190 days of psychiatric hospitalization in a patient’s lifetimes. f. Patient who requires respite care (short break for caregivers), those who care for the terminally ill. 5. Part B – pays for procedures physician’s services) and supplies. 6. Part D – prescription coverage a. Covers 99% of top 100 drugs (covers 5000 drugs) b. $7.00 co-payment for generic drugs c. Total payment for the year - $2510.00) 7. Donut hole coverage – insurance that covers missing coverage. ii. Medicaid or MediCal 1. Government sponsored programs provide health benefits to low income or indigent persons. 2. Eligibility for Medicaid is based on a patient’s eligibility for other state programs such as welfare assistance. 3. Medicaid eligibility and benefits vary from state to state. 4. Federal government contributes partial funding to each state for Medicaid costs. 5. Medicaid provides coverage for the following: a. Inpatient hospital care b. Outpatient treatment and services c. Diagnostic services d. Family planning services e. Skilled nursing facilities f. Diagnostic screening for children. iii. CHAMPVA/TRICARE 1. CHAPVA: The civilian health and medical program of veterans’ administration covers dependents of veterans who have total and permanent service connected disabilities. The CHAMPVA program is administered by the area veterans’ administration program. 2. TRICARE Manager Care Programs are offered to control escalating medical costs and to standardize benefits for active-duty families, military retirees, and their dependents. Eligible individuals have three options from which to choose: a. TRICARE Prime (HMO) b. TRICARE Extra (PPO) c. TRICARE Standard d. Tricare for Life supplementary payer to Medicare iv. Workers’ Compensation a. Employers in every state are covered by a Workers’ Compensation program administered by the state or private insurers. file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C134.htm[4/8/2013 1:25:50 PM] HCRS C134 b. Worker’s Compensation benefits were developed to cover the expenses resulting from a work related illness or injury. E. Explain the differences between health maintenance organizations (HMO) and preferred provider organizations (PPO). i. HMO 1. Unlike the traditional insurance system, HMO promises to provide covered services rather than pay for them. 2. HMO acts both as an insurer and a provider of service medical services are rendered by participating providers. 3. HMO policy lists the medical services the member is entitled to receive and the physicians and hospitals that provide these services. 4. HMO has a contract with both the patient and the provider. 5. HMO, rather than the patient, is responsible for the cost of medical services. Providers bill the HMO rather than the patient if a reimbursable service has been rendered to an HMO member. 6. Physician typically paid by capitation 7. Patient’s pay a co-payment for services rendered 8. Three types of HMO plans a. Group practice model (independent physicians) b. Staff model (Kaiser) c. Network model (group practices) 9. Patient selects a primary care physician whose name and phone number appear on the insurance card ii. PPO 1. While an HMO promises to provide services and have a financial risk in their relationships with subscribers, a PPO is an organization whose purpose is simply to contract with providers, then lease this network of contracted providers to health care plans. a. Participating Physicians accept assignment b. Nonparticipating physicians does not accept assignment 2. PPO network is not risk bearing and does not have any financial involvement in the health plan. 3. A PPO is typically developed by hospitals and physicians as vehicle to attract patients. Some are developed and managed by insurance companies. 4. A PPO contracts with participating providers including hospital and physicians. These contracts allow the PPO to contract with insurers and other purchasers of health care services on behalf of the participating providers who accept less than normal charges and agree to follow the utilization management and other administrative protocols. 5. Subscriber has more freedom of choice than does an HMO patient iii. Point of Service (POS) plan 1. A managed care organization that combines elements of an HMO and a PPO iv. Basically an HMO with the flexibility to go out of network but receive benefits at a greater level of flexibility II. To prepare the learner with basic knowledge and skills to use methods of establishing professional fees, customer credit, and identify the laws and regulations that affect follow-up and collection procedures. A. Spell and define key terms. B. Identify methods of establishing professional fees. i. Fee-for-service is the most traditional method. ii. Physicians use their sense of values and judgments. iii. Identify fees appropriate for similar specialist in the community. iv. Determine the actual cost plus the physician time involved. v. Obtain usual and customary fee schedules for the local medical society from medical insurance corporations. vi. Must consider the complexity of the diagnosis and treatment. vii. For private patients, there are no limitations to fees charged. C. Explain a physician’s fee schedule. i. A physician may have multiple fee schedules. 1. Fee schedule set by government sponsored insurance programs such as: a. Medicare b. Medicaid or medical in California c. Champus, Champva, Tricare 2. One fee is set by the physician for their private paying patients or cash patients. 3. Fees schedule set by companies that physicians have contracted with: a. Health Maintenance Organizations (HMO) b. Preferred provider organizations (PPO), and related organizations c. State regulated agencies such as: i. County programs which may or may not be affiliated with medical ii. Workers’ compensation ii. The fee schedule should be discussed with the patient (depending on their status) prior to their visit. This avoids misunderstanding between the patient and the physician office. iii. Insurance companies set a physician’s fee profile based on the billing history established by the file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C134.htm[4/8/2013 1:25:50 PM] HCRS C134 physician and the usual customary fess of similar physicians with the same specialty in the same zip code. D. Distinguish different fee policies and contracts. i. A fee policy is an understanding of what a basic fee will be and how it will be paid or collected. ii. A contract is established with a third-party payer and without prior knowledge of the patient. In the contract the physician agrees to accept a set fee per patient with the addition of the patient’s co-payment or deductible. The fees to be paid vary with the contract. E. Identify areas on the patient registration form necessary for collection. i. The patient registration form serves many purposes. ii. Patients are required to give this information. A patient does not have a right to refuse. iii. Registration form should be updated on a yearly basis or if information has changed. iv. The registration form gives the patient’s demographic information. 1. Patients full name, correctly spelled 2. Date of birth 3. Marital status 4. Current address and length at that address 5. Telephone numbers at home and at work or cell phone 6. Name of person legally responsible for charges 7. Patient occupation and phone number of work 8. Name of person referring patient to facility v. If the patient has insurance 1. The insurance card and sometimes a second form of identification (driver’s license) are photocopied. 2. An insurance ID card will have valuable information which must be copied. 3. Information should be verified immediately. 4. A copy is kept in the patient chart and updated on a regular basis. vi. If a third party is involved, such as in an auto accident or workers’ compensation claim, the office personnel must establish who is responsible, where can they be reached, and verify financial responsibility. vii. Updates should be required of each patient every 6-12 months. F. Identify the need for payment arrangements. i. Establish immediately what the expectations for payment will be in your facility. 1. This can be done in the form of a letter to a new patient. 2. Each new patient may be asked to sign an agreement stating this payment information which often is included on the registration form. ii. Lessen the patient’s anxiety regarding insurance billing or personal responsibility. 1. Your patient is aware of where the initial responsibility rests. 2. Encourage your patient to be involved if insurance companies require additional information or request patient input. iii. Ideally the office will run smoothly on a budget, based on past cash receipts. 1. Without an established policy, patient may not feel any responsibility to become involved in the collection of funds owing on their account. 2. It has become necessary to involve patients in all areas of their care. 3. Better, more efficient care can be given if small details do not hamper the relationship you have established with your patients. iv. Discuss fees, arrange payments, and be sure they have been established and agreed upon in writing. v. By law, the facility must have the established fee schedule available. G. List various methods of payment. i. Cash 1. Keep change on hand. 2. Always give a written receipt for cash received. ii. Checks 1. This is the most common method of payment. 2. Patients have an automatic receipt with a cancelled check. 3. Checks should be verified based upon office or facility policies. 4. Checks help safeguard the office from accumulating a large amount of cash. a. Be sure the message line does not contain false information (paid in full). b. Be sure to endorse the check immediately with the facility's bank stamp. 5. Some patients will still expect a receipt. iii. Credit card payments 1. Credit cards are fast becoming a common method of payment. 2. Allow your customers to keep the account paid in full. 3. Credit cards acceptance must be set up with your bank or financial service company. a. A percentage fee will be charged. b. Credit card receipts are deposited in a similar manner to cash and checks. c. Credit cards may be taken over the phone. d. Be sure to get an imprint if the card is presented at the time of the visit. A stolen credit card may not be accepted by the financial institution if an imprint was not made. file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C134.htm[4/8/2013 1:25:50 PM] HCRS C134 iv. Debit card acceptance must be set up with your bank or financial service company, patients may expect a receipt. v. All co-pays are to be paid prior to the examination per the contract physician’s sign with the HMO insurance company. H. Apply current credit laws and regulations to compose collection letters. i. A patient should be advised of the office payment or collection policy at the onset of the contract or the first visit. ii. Confidentiality is extremely important. iii. Office personnel should compose a letter with all the necessary information the patient will need so it will be clearly understood by the patient. Be firm and concise. iv. Avoid words such as, neglected, ignored and failure that might offend the patient. Instead use words like missed, overlooked and forgotten. v. Contact should be made with the patient at their home. vi. Check the current collection laws and regulations to avoid accusations of harassment. I. Recognize legal limitations in methods of collection. i. Federal laws dictate limits in methods of collection. 1. Phone calls should be made during regular office ours. Do not call after 9pm or before 8am. 2. No more than one phone call per week allowed if contact has been made, failure to reach the party does not allow for daily callbacks. 3. If an employer requests that calls not be made to the place of employment, calling must be stopped. 4. Make no threats that you do not intend to carry out. 5. It may be difficult to locate a patient who has moved from the area, and almost impossible to collect from one who has left the state. 6. An attorney or reputable collection agency should be contacted for difficult cases or large sums of money. a. Collection agency will keep its share per an arranged percentage (50-60%) and will forward the remaining amount to the physician's office on a contracted basis. b. If a debtor contacts the office they must be instructed to contact the collection agency. ii. Remember all information is confidential. Contact of any type should only be made with the patient or responsible party. iii. Check for current state laws regarding limitations and changes in the law. III. To prepare the learner with basic knowledge and skills necessary to perform bookkeeping, accounting, and payroll A. Spell and define key terms. B. Describe the various accounting systems and supplies available for use in the medical office. i. Bookkeeping systems 1. Definitions a. Organized and accurate record-keeping system of financial transactions for a business b. Accounts receivable is money owed to the practice. c. Accounts payable is money owed by the practice. 2. Single-entry bookkeeping, books are not balanced a. Uses a day-sheet or general ledger to record fees and payments for the services rendered. b. An accounts receivable ledger card shows the amounts owed by each patient for services performed. c. A check register records the checks written and details the expense category where office expenditures were made. d. A payroll register may be kept separately or on the check register, recording the checks written to employees for wages earned and deductions from gross earnings. 3. Double entry bookkeeping, books are balanced a. This system uses assets, capital (or owner’s equity) and liabilities. The assets minus the liabilities are equal to the capital. i. Assets are all items owned by the business. ii. Capital (or owner’s equity), is the original investment and property that is owned. iii. Liabilities are the monies that are owed by the business. b. This system is more complicated, requires more training and is commonly used by corporations. 4. Pegboard bookkeeping a. The most commonly used bookkeeping method in a small physician’s office. It is a very accurate system. b. Requires some training and is easy to learn. c. This system uses multiple layers atop one another so that all pieces of information are recorded at one time. i. All are preprinted and arranged to be held in place by pegs at one side of the board. ii. Forms are NCR paper, where no carbon paper is required and the pressure of a pen will write through multiple layers. d. Forms used i. The day-sheet records all charges to accounts, such as payments/adjustments, directly to the patient receipt and ledger card. This prevents multiple entries and the possibility of errors. ii. The patient ledger card keeps record of all charges and file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C134.htm[4/8/2013 1:25:50 PM] HCRS C134 payments per individual or family, as required. iii. Super bills, encounter forms or transaction slips to record details of the charges and credits on a given day for each patient. 1. These serve as a patient receipt. 2. It is also an insurance billing request, and a reminder of a claim. 3. Copies of these are kept in the patient chart for record of transactions and charges. iv. Deposit slips are recorded simultaneously, checked and balanced at the end of the day, and taken or sent to the bank. v. Negotiable funds 1. Personal check is considered a negotiable instrument. a. Written and signed by a maker; contains a promise or order to pay a sum of money. b. Payable on demand c. Payable to order or bearer 2. Bank draft 3. Cashier's check 4. Certified check 5. Money order 6. Travelers check vi. Bank Codes 1. American Bankers Association (ABA)number 2. Magnetic Ink Character recognition a. Found at the bottom of check b. Represents a common machine language readable by machine and humans vii. Accounts payable journals have check registers available to record information from the payables in the same manner as receivables. ii. Computerized bookkeeping or accounting 1. This system seems easier but much training is needed to use the system to the fullest benefit or extent. 2. Data entry is the primary area for concern. This must be absolutely correct. 3. Many computerized systems are available. 4. Passwords or key operators are used to insure the integrity of the operators and equipment. 5. Many computer software programs are available with multiple capabilities. a. Appointment scheduling b. Tracking daily charges and credits. c. Identifying at risk patients. i. Preparing monthly billing ii. Insurance billing iii. Patient billing d. Computer programs work as expanded calculators and perform the arithmetic functions. e. May write checks. f. Manage electronic banking between the facility and the bank (e-banking). g. Generate office reports, daily, monthly, and yearly. h. Essential that data be backed up in a reliable way. iii. Monthly statements for accounting are available. 1. Aging analysis notes the delinquency of each account in terms of days. 2. Practice income analysis indicates where income is being generated. C. Illustrate the use of an accounts receivable aging analysis sheet. i. Construct an aging analysis sheet. 1. Outline categories for 30, 60, 90, and 120 day accounts. 2. Identify necessary information to contact patients. 3. Set priorities of who to contact first. 4. Discuss methods of contact. D. Discuss payroll forms. i. Payroll is a very important part of the accounting process. ii. Taxes must be taken out of the earnings, recorded, paid to the appropriate agencies every quarter by the 15 th of the month April, June, September, and December or weekly depending on office policy and reconciled. iii. Annual reports are required and W-2 forms distributed to employees at the beginning of the following year, in order to report earnings for tax purposes, must be prepared for each employee by January 31 of each year. iv. Have employees update W-4 forms each year in case they want to adjust their deductions or make other changes. E. Explain the multiple taxes and deductions withheld from a paycheck. i. California has state income tax deductions. ii. Federal income tax deductions use Circular E tables provided by the IRS. iii. Social Security tax deductions. iv. State Disability Insurance deductions and others 1. Any personal insurance is also deducted. 2. Other deductions approved by the employer and employee are also withheld. v. Each employee must have a record of their earnings and deductions from each pay period. vi. At the end of each year, taxes are paid according to wages earned and taxes withheld. file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C134.htm[4/8/2013 1:25:50 PM] HCRS C134 F. Demonstrate the use of machinery and equipment necessary to function as a bookkeeper in a medical facility. i. A ten key adding machine ii. A calculator with appropriate functions iii. A computer with appropriate software G. Cite the law relating to length of time records must be kept. i. Accounting and bookkeeping records must be kept for a minimum of seven years. Some facilities keep records of the financial activity indefinitely. ii. Liability and malpractice records must be kept permanently. IV. To prepare the learner with basic knowledge and skills necessary to perform banking procedures A. Spell and define key terms. B. Identify common types of banking accounts. i. Selection of a bank in a medical practice has usually been completed. ii. Many banks compete for business by offering a variety of services. iii. Banking transactions involve privileged information and the medical assistant must be aware of confidentiality. iv. Features that may differ from bank to bank 1. Fees for checks 2. Cashier checks 3. Travelers checks 4. Per check fees 5. Interest 6. Monthly fees 7. Notary 8. Safe deposit box v. Checking accounts 1. Regular checking accounts a. Money readily accessible b. Checks provide legal documentation of practice expenses c. Monthly service charge may be assessed and money does not increase in value. 2. Interest bearing checking or money market accounts a. Guidelines need to be followed or account will not earn interest. b. This type of account may be used to pay insurance premiums or quarterly taxes. 3. Savings account a. Used for money that is not needed for current expenses b. Earns interest at a prevailing rate C. Describe various types of checks encountered. i. Certified check 1. Has been authorized by a bank official and funds have been set aside to cover the check and verified by a stamped certification. 2. This type of check is not used very often. ii. Cashier’s check 1. Is purchased from a bank and is guaranteed. 2. It is written on the bank’s own checking account. iii. Money order: 1. Is a check purchased for a fee and used when personal checks are not accepted or available. 2. Patients may use this form of payment. iv. Travelers check 1. Is used for traveling or when personal checks are not accepted. 2. Printed in denominations of $10, $20, $50, or $100, checks are signed at the financial institution by the payer. 3. Upon presentation, the check is signed again by payer. Thus, two signatures of the payer are required. v. Warrant 1. Shows that a debit is due because services have been rendered. 2. Issued by government and civic agencies. vi. Voucher check: 1. Used to itemize or specify purpose for which check is drawn. 2. Convenience for payer 3. Voucher portion is removed before presenting check. D. Identify common types of credit cards used for payment of services. i. The use of credit cards has become common for payments. ii. Patients appreciate the convenience iii. The voucher is deposited to a bank credit card account. iv. Credit card companies charge a monthly fee for the collection service (1% to 5 %). v. MasterCard 1. Verification by phone 2. Credit card verification device vi. Visa 1. Verification by phone file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C134.htm[4/8/2013 1:25:50 PM] HCRS C134 2. Credit card verification device vii. Discover Card: 1. Verification by phone 2. Credit card verification device viii. ATM/Debit cards use direct withdrawals from accounts and may use the same machine as credit cards. ix. Other credit and debit cards have their own regulations. E. State the purpose of petty cash. i. Established by a check written payable to “cash” or “petty cash” ii. Provides cash for small purchases such as toilet paper, light bulbs and cleaning supplies iii. Revolving fund for continuous use iv. Petty cash voucher form used as a receipt of petty cash issued v. Replenished when balance reaches a designated amount for practical needs vi. It should not be used to make change for patients. F. Discuss precautions in writing and accepting checks. i. Written legibly and in ink ii. May be computer generated iii. Facility may use a check writer for printing the amount 1. Endorses the paper 2. Prevents forgery 3. Uses colored inks iv. The first step is to fill in information on voucher: 1. Date 2. Payee name 3. Amount 4. Check number 5. Purpose v. Write the name of payee at area designated “Pay to the order of” 1. Do not use title of persons 2. If it is an officer of an organization, add title at end such as John Smith, President. 3. Start at the extreme left of the line vi. Write amount of check in words on line below or above payee’s name, depending on print of check. 1. Draw line to extreme right to the word dollars, so no additional words can be inserted to increase the amount of the check. 2. Separate dollars and cents by using the word “and”, then write the cents portion as a fraction. vii. If space permits on the check write the purpose of the check payment at the area noted as “memo”. viii. Get authorized payer signature G. Explain types of check endorsements. i. Endorser transfers all rights of the check to another party. ii. Endorsement is made in ink with a rubber stamp at the medical facility. iii. Endorse no more than 1 ½” from the trailing edge of the check. iv. Blank endorsement 1. Payee signs only his or her name 2. Common for personal checks v. Restrictive endorsement: 1. Besides signing the company’s name or endorser’s signature, words such as “for deposit only” are added so checks can’t be used for any purpose other than stated. 2. The account number is also noted vi. Limited and full endorsements 1. Includes words specifying the person to whom the endorser makes the check payable 2. Are used to sign over insurance checks to the medical practice vii. Be sure to inspect checks thoroughly before acceptance. 1. Date on check is not over 6 months old 2. For a “limited” check, there is a time limit during which the check is negotiable; cannot be postdated. 3. Make sure payee line is correctly made out to the medical practice. 4. Numerical amount of check and written amount of check must agree. 5. Affixed signature (payer) has signed the check, person signed who signed the check is listed on the check 6. If check states “paid in full”, verify this comment. 7. Current address and phone number H. Explain the purpose of a safe deposit box and an office safe i. Provides protection for valuable papers and personal property ii. Safe deposit box is a metal container inside a locked compartment in the bank and requires two keys to open. 1. One key is issued to customer and the other the bank retains for their use. 2. Usually has a monthly or annual service fee iii. Requires authorization signature to open each time iv. Office safe is also used for protection of paper and personal property within the office. 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Audiovisual; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C134.htm[4/8/2013 1:25:50 PM] HCRS C134 2. Computational Work; 3. Discussion; 4. Lecture; 5. Presentations (by students); 6. Problem Solving; 7. Written work; 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Required Readings: outline chapter prior to lecture. B. Homework Assignments: complete chapter questions. C. Five page research paper on an assigned topic such as the methods of establishing professional fees, customer credit, and identify the laws and regulations that affect follow-up and collection procedures. D. Practice scenario-based insurance and billing techniques on forms provided. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to A. Scenario-based insurance forms practice exercises B. Week Quizzes using multiple choice, true-false, or short answer questions. Example of questions: Fees should be based on 1. What the patient can afford 2. An established fee schedule 3. The number of patients in the family 4. The demographics of the community C. Mid-Term and Final Exams: Example of questions: When attempting to collect past-due fees you may 1. Call the home at 7:00am to catch the patient before work 2. Call daily until the fee is sent 3. Call the patientâ€™s employer 4. Tell the patientâ€™s husband or wife the current amount owed. 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Fordney, Marilyn. (2012) Insurance Handbook for the Medical Office , 12th, Saunders/Elsevier Fordney, Marilyn. (2012) Insurance Handbook for the Medical Office Workbook, 12th, Saunders Elsevier Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online with some required face-to-face meetings (â€œHybridâ€);Online (purely online no face-to-face contact) ;iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality ;Face to face; 30. MINIMUM QUALIFICATIONS: Health Care Ancillaries; 31. APPROVALS: Origination Date 04/06/2012 Last Outline Revision 05/04/2012 Curriculum Committee Approval Board of Trustees 05/04/2012 06/14/2012 State Approval UC Approval CSU Approval UC Approval Status 70 = Fall 2012 IGETC Approval CSU GE Approval CSU Approval Status Approved IGETC Approval Status CSU GE Approval Status file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C134.htm[4/8/2013 1:25:50 PM] HCRS C134 Data Element Changes Data Justification This is a new course being offered for the new/revised Medical Assisting Program. This course meets the competency standards for CAAHEP and CCBMA certification for Medical Assistants. Medical Assisting program is pending and will be sent forward when all courses are completed. Course Element Changes Course Change Justification Course ID (CB00) XXXXXXXXXX TOP Code (CB03) 1208.20 - Administrative Medical As; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 3 Course Units of Credit Minimum Low (CB07): 3 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Not part of Coop Work Exp; Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): CAN-Code Seq (CB15): Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C134.htm[4/8/2013 1:25:50 PM] HCRS C135 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE HCRS C135 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: HCRS C135 2. COURSE TITLE: Basic ICD and CPT Coding 3. SHORT BANWEB TITLE: Basic ICD/CPT Coding 4. COURSE AUTHOR: Hodgins, Annette 5. COURSE SEATS: 6. COURSE TERMS: 70 = Fall 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC New Course 9. START TERM: 70 = Fall, 2012 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This course presents a thorough discussion of basic International Classification of Diseases (ICD) and current procedural terminology (CPT) coding. Procedural coding and International Classification of Diseases prepares the student to undertake the details necessary for implementing the specialized coding needed for billing insurance companies. 12. GRADING METHOD S = Standard Letter Grade Default: Optional: 13. TOTAL UNITS: 2 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 2 Lab 0 Min Hours 36 0 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: HCRS Administrative Medical Assisting- (Certificate of Achievement) HCRS Medical Assisting (AS Degree Program) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C135.htm[4/8/2013 1:25:51 PM] HCRS C135 IGETC: CSU: UC Transfer Course: CSU Transfer Course: California State University, Channel Islands = HRT 275: Medical Assisting Office Procedures 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Analyze the basics of medical insurance related to insurance billing and procedural coding. 2. Differentiate between current procedural terminology (CPT) and International Classification of Diseases (ICD) coding. 3. Accurately complete all ICD and CPT coding forms. 4. Consider the three coding systems used to describe diseases, injuries, and procedures. 5. Compare at least 2 issues related to insurance fraud and abuse. 23. REQUISITES Prerequisite: HCRS C134 or Corequisite: HCRS C134 24. DETAILED TOPICAL OUTLINE: Lecture: I. Insurance billing coding. A. Coding is a way to standardize medical information for various purposes: 1. Collecting health care statistics 2. Performing a medical care review 3. Mainly for health insurance claims processing. B. Coding is linked to reimbursement, it is imperative to code accurately and precisely. C. Incorrect, insufficient or incomplete coding on claim forms can lead to improper reimbursement for the hospital or individual physicians as well as an inaccurate database. D. Claim is the tool used to request insurance payment under an insurance contract E. Patient- one who receives medical care F. Provider-physician or supplier who provides medical care and supplies G. Coordination of benefits prevents duplication of benefits for the same medical expense (selecting which insurance company to bill first) II. The Coder’s Rule A. Define QIO. B. Distinguish between Medicare Part A and Part B. C. Interpret rules of Health Insurance Portability and Accountability Act (HIPAA). D. Locate information in the Federal Register . III. Health Care Fraud and Abuse A. Understand the framework of Medicare Fraud and Abuse. B. Identify the major components of Managed Health Care IV. Three coding systems International classification of diseases ICD-9 CM is a statistical classification system based on the international 9th version (ICD-9) developed by the World Health Organization (WHO). A. file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C135.htm[4/8/2013 1:25:51 PM] HCRS C135 ICD-9 represents the most current and comprehensive statistical classification of its kind. Contains more than 10,000 diagnostic codes and over 1,000 procedure codes Consist of three volumes: a. Volume 1: Tabular, numerical list of diseases b. Volume 2: Alphabetic index of diseases c. Volume 3: Tabular list and alphabetic index of procedures, used primarily in hospitals. Note: Volumes 1 and 2 are used in physician’s offices in order to complete insurance claims. 4. Diagnostic coding was developed for the following reasons: a. Tracking of disease processes b. Classification of medical procedures c. Medical research purposes d. Evaluation of hospital utilization. B. Physician’s current procedural terminology (CPT) is a comprehensive listing of medical terms and codes for the uniform coding of procedures and services provided by physicians. 1. CPT-4 was developed by the American Medical Association and is updated annually for modifications and additions. 2. The purpose of CPT coding is to provide a uniform language that accurately identifies medical, surgical, and diagnostic services, resulting in a reliable means of nationwide communication between physicians, patients, and third parties. 3. CPT-4 uses a 5-digit system for coding physician services, plus 2-digit modifiers to indicate complications or special circumstances. 4. Code numbers represent diagnostic and therapeutic procedures on medical insurance claims forms. 5. Procedural coding considers two categories of patients. a. A new patient is one who has not received any professional services from the physician or group in the past 3 years. b. An established patient is one who has received such services within the past 3 years. C. Health Care Common Procedure Coding System 1. Posted by centers for Medicare and Medicaid services 2. Two principle sub-systems a. Level one- CPT b. Level two- Standardized coding system for products, supplies, and services not included in CPT codes 1. 2. 3. V. An Overview of ICD-10-CM A. Explain the development of the ICD-10-CM. B. Describe how the ICD-10-CM replaces the ICD-9-CM, Volumes 1 and 2. C. Identify the improvements in the ICD-10-CM. D. List the official instructional notations in ICD-10-CM. E. Analyze the ICD-10-CM Official Guidelines for Coding And Reporting. F. Describe the format of ICD-10-CM. VI. An Overview of ICD-9-CM A. List the uses of the ICD-9-CM. B. Identify the characteristics of the Tabular List, Volume 1. C. Identify the characteristics of the Alphabetic Index, Volume 2. D. Explain the uses of coding conventions when assigning codes. E. Identify the characteristics of the Procedures Index and Tabular List, Volume 3. F. Demonstrate use of ICD-9-CM. VII. Principles of coding. A. Procedural Coding: Current Procedural Terminology, (CPT) 1. Updated on an annual basis file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C135.htm[4/8/2013 1:25:51 PM] HCRS C135 2. New codes added and deleted shown by the use of symbols 3. Should have a current CPT book on hand for reference 4. Transformation made of written descriptions of procedures and professional services into code numbers by use of a five-digit coding system with two digit modifiers 5. Procedure codes are a standardized method used to precisely describe the services provided by physicians and allied health personnel to report medical, surgical, and diagnostic services they provide. 6. Codes are used by payers for appropriate reimbursement for services. 7. Six primary sections, each beginning with guidelines that cover definitions and terms unique to that section a. Evaluation and management 1) New patient versus established patient 2) Referral versus consultation b. Anesthesia c. Surgery 1) Global period 2) Surgical package 3) Laceration repair d. Radiology e. Pathology and Laboratory f. Medicine 8. Index 9. Main terms and sub-terms 10. Code ranges 11. Cross-References and conventions a. See synonyms, eponyms and abbreviations b. See also Common Procedure Coding System; Health Care Financing Administration (HCFA) Common procedure Coding System, (HCPCS) B. Common Procedure Coding System; Health Care Financing Administration (HCFA) Common procedure Coding System, (HCPCS). 1. Standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician's office. 2. Because Medicare and other insurers cover a variety of services, supplies, and equipment that are not identified by CPT codes, the level II HCPCS codes are established for submitting claims for these items. 3. Updated on an annual basis 4. Alpha numeric codes assigned and maintained by each local or regional Medicare fiscal agent or carrier. a. Alpha numeric range from W0000 through Z9999 b. Special alpha modifiers are used to further explain a given service, ranging from WA through ZZ. 5. Procedural Coding Steps a. Become familiar with the CPT and HCPCS coding books. b. Determine procedures and services to report from the superbill, fee ticket, or encounter form. c. Identify the correct code(s). d. Determine the need for appropriate modifiers. e. Record the procedure code in the computer software system or type on the claim form. C. Diagnostic Coding; International Classification of diseases, 9th edition, Clinical Modification. These are known as the ICD-9-CM codes. 1. Data on the types and number of diseases in the United States provide important information to help us understand the overall condition of our nation’s health. 2. The World Health Organization collaborates with the United State to strengthen their health services where ever possible. The ICD-9-CM consists of: a. Volume I is a tabular list containing a numerical list of the disease code numbers in tabular form. b. Volume II is an alphabetical index to the disease entries, organized by condition not anatomical site: 1) Main terms bold type 2) Sub-terms indented two spaces to the right under main term 3) Sub-term to a sub-term 4) Non-essential modifiers 5) Conventions 6) Carryover lines 7) Cross-references 8) V codes 9) Neoplasm table 10) Hypertension table 11) 5 th digits c. Volume III is a classification system for surgical, diagnostic, and therapeutic procedures alphabetic index and tabular list). 3. Volumes I and II are utilized in physicians’ offices. 4. Updated on an annual basis. 5. Transformation of a written diagnosis into a three to five digit code number. The more digits the higher the specificity. a. Primary diagnosis b. Secondary diagnosis 6. Diagnostic Coding steps a. Determine the primary diagnosis, condition, or symptom(s). b. Locate the term in the alphabetical index. c. Use any supplementary terms in the diagnostic statement to help locate the main term. d. Read and follow any notes below the main term. e. Review the sub-terms to find the most specific match to the diagnosis. file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C135.htm[4/8/2013 1:25:51 PM] HCRS C135 f. Read and follow any cross-references. g. Verify the code in the tabular list. h. Read include or excludes notes. i. Be alert for and observe fifth-digit requirements. j. Follow any instructions requiring the selection of additional codes. k. List multiple codes in the correct order. 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Audiovisual; 2. Case Study; 3. Demonstration; 4. Discussion; 5. Lecture; 6. Outside reading; 7. Presentations (by students); 8. Problem Solving; 9. Skills Development and Performance; 10. Written work; 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Games: word searches, crossword puzzles, family feud, jeopardy, bingo, spelling bee, hangman, and concentration. B. Discuss learning gaps and plan for applying vocabulary related to ICD and CPT Coding. C. Assigned Readings: outline chapters prior to lecture. E. Textbook and workbook chapter questions and assignments. F. Assign students to report on the various coding systems: 1. ICD9/10 2. CPT-4 3. HCPCS for services and supplies 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to A. Scenario-based coding practice exercises. Coding Practice Example: 55 year-old Mr. Jensen arrived to the physician's office because he does not feel well. Dr. Green assesses Mr. Jensen and gives him the following diagnoses: community acquired pneumonia, diabetes type 2, and infected right big toe. What CPT and ICD 9/10 codes would you use to bill Medicare? Blue Cross? Medi-Cal? B. Week Quizzes using multiple choice, true-false, or short answer questions. Example of questions: Fraudulent billing of a patientâ€™s insurance is A. A misdemeanor B. Acceptable if done in error C. Tolerated in some cases D. A felony C. Mid-Term and Final Exams: Example of questions: Current Procedural Terminology (CPT) codes A. are updated annually B. are used instead of ICD-9 codes C. have 6 to 8 numbers D. are not used on the CMS -1500 form 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Buck, C. (2011) Step-by-Step Medical Coding 2012 Edition , 1st, Saunders Elsevier Buck, C. (2011) Step-by-Step Medical Coding 2012 Edition, Workbook, 1st, Saunders Elsevier Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online with some required face-to-face meetings (â€œHybridâ€);iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality ;Online (purely online no face-to-face contact) ;Online course with on ground testing;Face to face; 30. MINIMUM QUALIFICATIONS: Health Care Ancillaries; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C135.htm[4/8/2013 1:25:51 PM] HCRS C135 31. APPROVALS: Origination Date 04/06/2012 Last Outline Revision 05/04/2012 Curriculum Committee Approval 05/04/2012 06/14/2012 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 70 = Fall 2012 IGETC Approval CSU Approval Status Approved IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification This is a new course being offered for the new/revised Medical Assisting Program. This course meets the competency standards for CAAHEP and CCBMA certification for Medical Assistants. Medical Assisting program is pending and will be sent forward when all courses are completed. Course Element Changes Course Change Justification Course ID (CB00) XXXXXXXXXX TOP Code (CB03) 1208.20 - Administrative Medical As; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 2 Course Units of Credit Minimum Low (CB07): 2 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Not part of Coop Work Exp; Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): CAN-Code Seq (CB15): Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C135.htm[4/8/2013 1:25:51 PM] HCRS C136 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE HCRS C136 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: HCRS C136 2. COURSE TITLE: Clinical Medical Assisting I 3. SHORT BANWEB TITLE: Clinical Medical Assisting I 4. COURSE AUTHOR: Hodgins, Annette 5. COURSE SEATS: 6. COURSE TERMS: 70 = Fall 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC New Course 9. START TERM: 70 = Fall, 2012 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This is an introductory course designed to provide basic education and training for the individual who is interested in working as a Clinical Medical Assistant in a medical or clinical back office. Topics include basic infection control; Occupational Safety and Health Act regulations; principles of nutrition; vital signs and height/weight measurements; initial medical record documentation; and maintenance of the clinical facility. Common office practices, such as vital signs are discussed and practiced in the Skills Lab. 12. GRADING METHOD S = Standard Letter Grade Default: Optional: 13. TOTAL UNITS: 3 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 2 Lab 1 Min Hours 36 54 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: HCRS Clinical Medical Assisting- (Certificate of Achievement) HCRS Medical Assisting (AS Degree Program) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C136.htm[4/8/2013 1:25:51 PM] HCRS C136 IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Discuss the legal and ethical roles of the medical assistant. 2. Evaluate the infection control cycle and demonstrate the approved infection control techniques. 3. Discuss the elements of nutrition and the impact on oneâ€™s health. 4. Analyze medical record documentation and the importance of HIPAA. 5. Compare and contrast quality control measures that apply to health/safety policies and procedures to prevent illness and injury. 6. Analyze the importance of vital signs and height/weight measurements in data collection. 7. Perform medical assisting procedures which includes vital signs; infection control; document care; and protective practices. 23. REQUISITES Prerequisite: HCRS C150 and HCRS C130 and HCRS C131 and HCRS C132 24. DETAILED TOPICAL OUTLINE: Lecture: I. Introduction to Medical Assisting 1. Administrative 2. Clinical II. Introduction to Medical/Surgical Asepsis (Standard III) 1. Terminology 2. Hand washing 3. OSHA Guidelines 4. Standard Precautions (PPE) 5. Infection Control Techniques 6. Infection Cycle 7. Medical/Surgical asepsis 8. Quality Control 9. Center for Disease Control (CDC) III. Nutrition and Diet Therapy (Standard I) 1. Terminology 2. Metabolism 3. Nutrients 4. Intake and Output 5. Ethnic/ religious dietetic education IV. Vital Signs (Standard I) file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C136.htm[4/8/2013 1:25:51 PM] HCRS C136 1. Cardinal signs 2. Terminology 3. Temperature, Pulse, Respiration, Blood Pressure 4. Anthropometric measurement V. Medical Records Documentation (Standard IV) 1. HIPAA 2. Patient Privacy 3. Diversity respect for patients and families 4. Documentation of patient care and patient education VI. Protective Practices (Standard XI) 1. Identify safety techniques that can be used to prevent accidents and maintain a safe work environment 2. Describe the importance of Materials Safety Data Sheets (MSDS) in a healthcare setting 3. Identify safety signs, symbols and labels 4. State principles and steps of professional/provider CPR 5. Describe basic principles of first aid 6. Describe fundamental principles for evacuation of a healthcare setting 7. Discuss fire safety issues in a healthcare environment 8. Discuss requirements for responding to hazardous material disposal 9. Identify principles of body mechanics and ergonomics. 10. Discuss critical elements of an emergency plan for response to a natural disaster or other emergency 11. Identify emergency preparedness plans in your community 12. Discuss potential role(s) of the medical assistant in emergency preparedness Lab: I. Obtain Vital Signs (Standard I) 1. Measure and record temperatures using the following equipment Disposable thermometer Digital thermometer Tympanic thermometer 2. Locate pulse sites on a person. 3. Measure and record a radial and apical pulse. 4. Measure and record respirations. 5. Measure and record blood pressures using an aneroid sphygmomanometer and a stethoscope. 6. Document the measurement of all vital signs in patient’s chart. 7. Demonstrate procedure for cleaning and disposing of all supplies for taking vital signs. 8. Select correct size of blood pressure cuff for the individual patient. 9. Use your knowledge of a standardized patient’s medical history to determine which limb to use to take a blood pressure. II. Infection Control (Standard III) 1. Participate in training on Standard Precautions 2. Practice Standard Precautions. 3. Select appropriate barrier/personal protective equipment (PPE) for potentially infectious situations file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C136.htm[4/8/2013 1:25:51 PM] HCRS C136 4. Perform hand washing 5. Prepare items for autoclaving 6. Perform sterilization procedures III. Medical Record (Standard IV) 1. Document patient care Record/document vital signs and chief complaint on progress notes. Prepare a source-oriented and problem oriented medical record. 2. Document patient education Communicate information concerning a chronic condition using medical terms appropriately and in language the patient can understand. Document patient education on a procedure to follow prior to and after having surgery. IV. Protective Practices (Standard XI) 1. Comply with safety signs, symbols and labels. 2. Evaluate the work environment to identify safe vs. unsafe working conditions. 3. Develop a personal (patient and employee) safety plan. 4. Develop an environmental safety plan. 5. Demonstrate proper use of the following equipment: Eyewash Fire extinguishers Sharps disposal containers 6. Perform first aid procedures 7. Explain an evacuation plan for a physician’s office 8. Participate in a mock environmental exposure event with documentation of steps taken. 9. Demonstrate methods of fire prevention in the healthcare setting 10. Use proper body mechanics 11. Maintain a current list of community resources for emergency preparedness 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Audiovisual; 2. Demonstration; 3. Discussion; 4. Lecture; 5. Problem Solving; 6. Skills Development and Performance; 7. Written work; 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. The student will write a 5 page research paper on the importance of HIPAA in the medical office and/or on the role of the CMA in the health care field. B. The student will read the assigned text chapters prior to lecture. C. The student will outline the chapters and incorporating lecture notes with chapter outlines. D. The student will answer assigned questions from the Medical Assistant Study Guide and other homework assignments. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to 1. The student will demonstrate clinical patient care in the skills lab, e.g., taking vital signs using a Completion Check-off List. 2. The student will demonstrate medical back office procedures in the skills lab, e.g., setting up an exam room using a Completion Check-off List. 3. Student will need to complete each objective successfully. 4. Theory applications will be evaluated by weekly quizzes, chapter tests, and a final exam. Questions could include short answers, multiple choice, and true false: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C136.htm[4/8/2013 1:25:51 PM] HCRS C136 Question Example: What is the name given to a tiny living plant or animal that cannot be seen with the naked eye? a. Pathogen b. Microorganism c. Nonpathogen d. Microbiology 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Bonewit-West, K. . (2012) Clinical Procedures for Medical Assistants , 8th, Saunders Elsevier Bonewit-West, K.. (2012) Clinical Procedures for Medical Assistants, Study Guide, 8th, Saunders Elsevier Manuals Periodicals Software Other 29. METHOD OF DELIVERY: iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality ;Online with some required face-to-face meetings (â€œHybridâ€);Face to face; 30. MINIMUM QUALIFICATIONS: Health Care Ancillaries; 31. APPROVALS: Origination Date 04/06/2012 Last Outline Revision 05/04/2012 Curriculum Committee Approval 05/04/2012 06/14/2012 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 70 = Fall 2012 IGETC Approval CSU Approval Status Approved IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification This is a new course being offered for the new/revised Medical Assisting Program. This course meets the competency standards for CAAHEP and CCBMA certification for Medical Assistants. Medical Assisting program is pending and will be sent forward when all courses are completed. Course Element Changes Course Change Justification Course ID (CB00) XXXXXXXXXX TOP Code (CB03) 1208.10 - Clinical Medical Assistin; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 3 Course Units of Credit Minimum Low (CB07): 3 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Not part of Coop Work Exp; Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C136.htm[4/8/2013 1:25:51 PM] HCRS C136 CAN Code (CB14): CAN-Code Seq (CB15): Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C136.htm[4/8/2013 1:25:51 PM] HCRS C137 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE HCRS C137 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: HCRS C137 2. COURSE TITLE: Clinical Medical Assisting II 3. SHORT BANWEB TITLE: Clin Med Assting II 4. COURSE AUTHOR: Hodgins, Annette 5. COURSE SEATS: 6. COURSE TERMS: 70 = Fall 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC New Course 9. START TERM: 70 = Fall, 2012 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This course is designed to provide advanced education and training for the individual who is interested in working as a Clinical Medical Assistant in a medical or clinical back office. Topics include patient history and interviewing; techniques of assisting the physician with patients; minor surgeries and sterile dressing changes; staple and suture removal; theory of x-ray examination and treatment; patient education; electrocardiographic methods; and first aid. Common office procedures are discussed and practiced in the Skills Lab. Emphasis is placed the role of the medical assistant. 12. GRADING METHOD S = Standard Letter Grade Default: Optional: 13. TOTAL UNITS: 3 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 2 Lab 1 Min Hours 36 54 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: HCRS Clinical Medical Assisting- (Certificate of Achievement) HCRS Medical Assisting (AS Degree Program) Elective: 21. GENERAL EDUCATION APPLICABILITY file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C137 Local: IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Compare and contrast the infection cycle and infection control in an outpatient facility. 2. Demonstrate the ability to assist with routine physical and specialty examinations. 3. Perform medical assisting procedures which includes patient interviews; documentation on medical history forms; patient emergency procedures; minor surgery; and wound care. 4. Evaluate the patient interview process and documentation on the medical history form. 5. Explain the role of the medical assistant in the care of patients with minor wounds as well as the application of wound dressings. 6. Evaluate cardiac arrest and abstracted airway procedures in an outpatient facility. 7. Analyze the role the medical assistant plays in patient satisfaction and performance improvement. 8. Analyze theoretical and procedural requirements for assisting with patient screening and intake. 9. Analyze the theoretical and procedural requirements for positioning and draping patients. 10. Consider strategies to obtain and maintain employment as a medical assistant. 23. REQUISITES Prerequisite: HCRS C136 24. DETAILED TOPICAL OUTLINE: Lecture: I. Spell and define key terms A. Review the terms listed in the terminology section. B. Spell the listed terms accurately. C. Pronounce the terms correctly. D. Use the terms in their proper context. II. Medical history A. Preprinted forms 1) Section 1 - data or data base a) Patient’s name b) Date of birth c) Address d) Home and work phone numbers e) Insurance carrier, policy number f) Social security number g) Gender and race 2) Section 2 - past history a) Allergies b) Immunizations c) Childhood diseases d) Current and past medication e) Previous illness f) Traumatic illnesses g) Surgeries h) Hospitalizations 3) Section 3 - review of systems a) Respiratory b) Digestive c) Reproductive d) Immune e) Integumentary f) Sensory g) Musculoskeletal h) Nervous file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C137 i) Cardiovascular j) Urinary 4) Section 4 – family history, health status of: a) Parents b) Siblings c) Grandparents d) Include specific diseases and disorders 5) Section 5 - social history a) Life style b) Marital status c) Occupation d) Education e) Hobbies f) Use of alcohol and tobacco g) Sexual history III. Six C’s of charting A. Client’s words recorded exactly B. Clarity – use medical terminology and precise descriptions. C. Completeness D. Conciseness – save time and space. E. Chronological order – dates on all entries F. Confidentiality – cannot discuss patient’s record, forward to another office, fax or show to anyone except physician without patient’s written permission to do so. IV. Guidelines for conducting a successful patient interview A. Effective learning 1) Think and respond to what patient has said. 2) Provide feedback. B. Be aware of nonverbal clues and body language. 1) Tone of voice 2) Facial expression C. Use broad knowledge base. 1) Medical terminology 2) Symptoms 3) Diseases D. Plan and research before interview. 1) Review patient history. 2) Have general questions ready. 3) Ask patient’s permission to ask questions. E. Make the patient fill at ease. 1) Icebreakers 2) Sit with patient 3) Be relaxed F. Conduct interview in private without interruption. 1) Private room 2) Door closed 3) Do not rush 4) Maintain eye contact 5) Use patient’s name G. Deal with sensitive topics with respect. 1) Non-threatening 2) Know when to stop H. Avoid making diagnosis or giving diagnostic opinion. I. Summarize key points. 1) Ask patient if they have questions. 2) Ask patient if they have additional information that should be added. V. Signs and symptoms A. Signs are objective indications of disease or bodily dysfunction that can be perceived by others. 1) Rash 2) Bleeding 3) Cough 4) Discharge 5) Vital signs B. Symptoms are subjective indications of disease and changes in body as sensed by patient and not recognized by anyone else. 1) Leg pain 2) Nausea 3) Headache VI. Explain chief complaint and present illness A. Chief complaint – description of symptoms that led patient to seek physician care such as: 1) Headache for two days 2) Lifted and strained back file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C137 3) Document in patient’s chart, patient’s own words B. Resent illness – more specific account of chronic complaint, chronological order of events including: 1) Onset 2) Home remedies 3) Over the counter medications VII. Contents of a patient’s chart A. Patient registration form B. Patient medical history form C. Test results 1) Laboratory 2) Radiological 3) Other D. Records from other physicians or hospital E. Physician diagnosis and treatment plan F. Operative reports G. Informed consent forms, signed by patient H. Discharge summary forms from hospitalizations I. Correspondence with or about the patient VIII. Formats used for documenting information A. Source – oriented medical records/all similar categories or sources of information are grouped together in reverse chronological order. 1)Billing/Insurance 2)Physician’s orders 3)Progress notes 4)Laboratory results 5)Radiographic results 6)Patient education B. Problem - oriented medical records lists each patient problem at the beginning of the folder and references each problem with a number throughout the folder. 1)Data base a) Chief complaint b) Present illness c) Patient profile d) Review of systems e) Physical examination f) Laboratory reports 2)Problem list a) Social b) Demographic c) Medical d) Surgical 3)Treatment plan a) Management b) Additional work-ups c) Therapist 4)Progress notes a) Structured b) According to SOAP C. Documentation forms 1)Progress notes are written statements about various aspects of patient care, recorded on lined paper with two columns, left column date and time; right column to write note. 2)Formats a) Narrative – paragraph i. What is wrong with patient? ii. What was done to help the patient? iii. Did treatment work? b) SOAP i. Subjective component – what patient says, accurate quotes ii. Objective component – what is observed about patient during assessment iii. Assessment – phrase stating your impression of what is wrong with the patient iv. Plan – list of interventions that have been done c) PIE i. Problem – statement of patient’s problem ii. Implementation – interventions provided iii. Evaluation – how implementation helped the patient d) Focus i. Focus ii. Data iii. Action iv. Result e) Flow sheets – preprinted check list of most commonly asked questions f) Charting by exception (CBE) file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C137 i. Only abnormal events are charted in narrative form ii. Normal or expected findings are checked off in flow sheets g) Computerized charting IX. Rules for medical record entry A. All entries are to be accurate, timely and legible. B. Golden Rule of documentation is “if it isn’t documented, it wasn’t done.” C. Correct patient chart; use birth date, or SS# for double check. D. Document in ink (black or dark blue only). E. Always sign your name and title. F. Date and time all entries (military time). G. Write legibly. H. Check spelling, medical terminology, and abbreviations. I. Use quotation marks for direct patient statements. J. Document as soon as possible after completing a task. K. Document missed appointments and your attempts to contact the patient by phone. L. Document any telephone conversations with the patient in the chart. M. If you have made an error, given the wrong medication, performed an incorrect procedure, notify the MD immediately, document it, then complete an incident report. N. Never document for someone else, and don’t allow anyone else to document for you. O. Never document false information. P. Never delete, erase, scribble over, or white-out in a medical record. This will be construed as tampering with a legal document. 1)To correct a written error, draw a single line through the entry, initial it, and write error. 2)Document the correct information immediately adjacent to the lined-through information. X. The origin and purpose of screening patients A. Origin 1)Screening is one of the most critical and significant of all the responsibilities. a) The term triage originated during war time. b) Referred to the sorting and assessment of soldiers’ injuries. c) After the medic made a decision about care, the soldier was dispatched for treatment. 2)The term triage also used in prioritizing the conditions of injured persons following a disaster. a) Injured separated into groups according to the seriousness of their needs. b) Injured tagged with a particular color-coded tape or cloth. B. Purpose in medical facility 1)Term common in medical facilities across the country. a) Emergency room b) Office c) Clinics 2)Private area established for the interview process. 3)Patient’s symptoms are appraised and a judgment is made regarding the nature of the patient’s complaints. a) It is vital that the patient’s immediate needs are met. The nature of their managed care should be a secondary concern. b) Reason for the patient’s visit may be determined by the medical assistant who performs the screening interview along with input as necessary from other members of the health care team. c) Process occurs both via the telephone and with the patient present in the office. C. Job responsibility under much debate 1)The terms triage, screening, and assessment are often interchanged. 2)The medical assistant’s role is to interview the patient for the necessary information. a) It is essential that accurate and thorough information be obtained and documented. b) The medical assistant is not to make any medical judgments. c) The information obtained is passed on to the physician. 3)The physician’s role is to make medical judgments regarding the patient’s care relying in part or information obtained by the medical assistant during the screening interview. XI. Forms used to document patient information A. Progress note sheet B. Flow sheets C. Problem lists D. Telephone message forms E. Medical history form XII. Obtaining pertinent information regarding a patient’s condition A. Effective listening 1)Listening attentively (active listening) is one of the most important skills you will need for a successful interview. 2)Active listening a) Hear what’s said. b) Think about what is said. c) Respond to what the patient has said. B. Be aware of nonverbal clues and body language. 1)Nonverbal communication a) Tone of voice b) Facial expression c) Body language 2)The medical assistant may need to have extra patience and offer encouragement. C. Use a broad knowledge base. D. Summarize to form a general picture. file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C137 E. Steps to help you conduct a successful interview: 1)Do your research before the patient’s interview: a) Patient’s history b) Medications c) Chronic problems d) Family issues 2)Plan the interview. a) Have a general idea of questions to ask. b) Stay focused. c) Obtain all the necessary information. 3)Approach the patient and request the interview. a) It is courteous to seek permission to ask questions than to say you need to take a history. b) Helps patient feel more comfortable and emphasizes importance of the interview process. 4)Making the patient feel at ease: a) Use icebreakers to put patient at ease and create a relaxed atmosphere. i. Acknowledge patient’s reason for the visit. ii. Comment on weather. iii. Ask how patient prefers to be addressed. iv. Clarify pronunciation of a difficult name. b) Sit with the patient. c) Appear relaxed. d) Recognize if patient is anxious or depressed. 5)Conduct the interview in private without interruptions. a) Escort patient to private room or area. b) Close the door. c) Develop a rapport. d) Do not rush. e) Maintain eye contact. f) Effective methods of collecting patient data: i. Ask open-ended questions. ii. Ask hypothetical questions. iii. Mirror patient’s responses and verbalize the implied. iv. Focus on the patient. v. Encourage patient to take the lead. vi. Encourage patient to provide additional information. vii. Encourage patient to evaluate his situation. XIII. Patient education A. Talking to the patient is a prime time to give patient education appropriate to their needs. 1)Give appropriate printed material. 2)Discuss how to stay healthy. B. Ask if there are further questions. C. Instruct patients to write down questions and subjects they wish to discuss. D. Include companion / caregiver in discussions when appropriate. E. Supply phone number where the physician can be reached day or night. F. Hand out appropriate printed material. G. Clarification of medical terminology, tests and procedures decrease patient confusion. H. If patient is sedated, only give one instruction at a time. I. If you perceive embarrassment, explain the need for the position, and help the patient assume the position when necessary. J. Always tell the patient what movement to expect. K. Give specific instructions to the patient on whether the gown should be open in the back or the front. L. Patient needs to know why the physical exam must be performed accurately. M. Explain the data collected forms a database against which all future exams and observations will be compared. N. Patient needs to understand what is taking place and why. O. Important that patient be relaxed while being examined. 1)Some exams can be embarrassing. 2)Clearly explain to relieve anxiety. P. Never assume patient knows what clothing to remove or what position to assume simply because it is not the first visit to the office. Q. Answer all questions the patient has regarding the procedure to be performed. XIV. Legal and ethical implications of screening patients A. Remember all data you obtain are subject to legal and ethical considerations. 1)Privacy 2)Confidentially B. Discuss the components of the patient’s bill of rights. C. Review the physician’s and medical assistant’s role in screening patients. 1)Only physician can give diagnosis. 2)Medical assistant can only obtain information and is NOT to offer any medical advice. XV. Purpose of each of the patient examination positions A. Anatomic (erect or standing) position 1)Examine musculoskeletal development 2)Examine skin color 3)Assess posture file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C137 B. Sitting position 1)Examine anterior / posterior aspect of head 2)Examine anterior / posterior aspect of chest C. Supine (recumbent, horizontal recumbent) position 1)Examine abdomen, chest, leg 2)Anterior aspects of body available for examination D. Dorsal recumbent position 1)Vaginal exam when lithotomy position is not advisable 2)Rectal examination 3)Examination of abdomen 4)Resting E. Lithotomy position 1)Pelvic examination 2)Examination of the female genitalia F. Trendelenberg position 1)Treat shock 2)Abdominal surgery 3)Treat hypotension 4)Postural drainage G. Semi-Fowler’s (45º angle) position 1)Patients with difficult breathing 2)Examination of the head, neck and chest H. Fowler’s (90º angle) position 1)Patients with difficult breathing 2)Examination of the head, neck and chest 3)Good for lower back injury patients I. Prone position 1)Examination of the back, spine or legs 2)Posterior (ventral) aspects of body available for examination J. Sim’s (lateral Sim’s) position 1)Anal and rectal examination 2)Perineal and certain pelvic examination 3)Flexible sigmoidoscopy on elderly patients K. Knee – chest position 1)Exam of anal and perineal areas 2)For certain proctologic procedures L. Proctologic position 1)Proctologic examination with sigmoidoscopy 2)Exam of perineal area, anus, and hemorrhoids M. Jackknife position 1)Examination and instrumentation of the male urethra 2)Often referred to as proctologic position (controversial issue) XVI. Safety precautions regarding patient positioning A. If a power table is used, the medical assistant must know how to operate it. B. A female medical assistant should remain in the room when a female patient is being examined by a male physician. C. Instruct the patient on the use of the gown to avoid unnecessary exposure. D. Never leave a very ill patient or small child alone on a table. E. Utilize effective body mechanics. F. Explain the need for the position and help the patient assume the position when necessary. G. Changes in position should be done gradually. H. Always tell the patient what movement to expect. I. Cover the patient with an appropriate drape. 1)Warmth 2)Privacy J. Assist the patient onto and off of the exam table to decrease the chance of an accidental fall. XVII. Basic principles of properly draping a patient for examination A. Anatomic 1)Patient with hospital gown on, open either in front or back 2)Can hold drape around waist. B. Sitting position 1)Drape placed across the patient’s lap for men 2)Drape placed across the patient’s chest and lap for a woman C. Supine position 1)Normally draped from the neck down to the feet 2)Draped from the underarms down to the feet D. Dorsal recumbent position 1)Drape from the neck or underarms down to the feet 2)Diamond drape E. Lithotomy position 1)Large drape that covers the patient from the breast to the ankles 2)Drape wide enough to prevent the sides of the thighs from being exposed F. Trendelenberg 1)Drape from the neck down to the knees 2)Drape from the underarms down to the knees file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C137 G. Semi-Fowler’s and Fowler’s position 1)Drape from the neck or underarms down to the feet. 2)The drape will vary according to the exposure of the patient. 3)Female patients should have their breasts covered. H. Prone 1)Drape from the upper back to the feet 2)Female patients should be draped high enough to cover the breasts if she is to be turned over to the dorsal recumbent position. I. Sim’s 1)Drape from the upper back to the feet 2)Drape from under the arms to below the knees J. Knee-chest and proctologic positions 1)Commonly covered with a fenestrated drape 2)Opening provides access to the area being examined. XVIII. Legal and ethical implications in positioning and draping patients. A. Utilize a variety of safety measures to protect you, the physician and the patient from disease transmission. B. Never leave an acutely ill or medicated patient or an infant/child unattended on the exam table. C. If the patient is unclothed, a second person should be present during the physical exam. XIX. Preparing for the complete physical examination (CPE) of a patient A. Prepare the room for the physician and patient. 1)Clean 2)Well lighted 3)Well ventilated 4)Comfortable temperature for the patient. 5)Ensure all instruments and supplies are readily available for the physician. 6)Restock as necessary. B. Prepare the patient. 1)Develop a positive rapport with the patient. 2)Create a positive, supportive, caring and friendly atmosphere. 3)Assess patient’s facial expression and level of anxiety. 4)Treat the patient as an individual and speak clearly and with a confident tone of voice. 5)Use simple, direct language the patient can understand. 6)Describe what the patient can expect to feel and how their cooperation can contribute to the success of their procedure. 7)Emotional preparedness is especially important when dealing with children. 8)Prepare patient physically by allowing an opportunity to empty bladder/bowels and disrobe/gown as necessary. C. Assisting the physician 1)May need to remain in room for legal reasons. 2)Hand the instruments and supplies as needed. 3)Direct the light appropriately. 4)Adjust patient’s position/drape as necessary. 5)Document findings as provider dictates XX. Instruments, equipment, and supplies used on the complete physical examination (CPE) A. Patient’s chart, black pens, forms needing completion B. Stethoscope, sphygmomanometer C. Tonometer D. Otoscope E. Nasal speculum, penlight F. Tongue depressor, sterile gauze square, laryngeal mirror G. Latex gloves, water-soluble lubricant H. Vaginal speculum, gooseneck lamp, tissues I. Test of occult blood J. Tape measure, percussion hammer K. Vision chart L. Alcohol, alcohol wipes, betadine, hydrogen peroxide M. Chlorhexidine Gluconate- in swab form also known as Choraprep N. Bandages, gauze dressings (4x4, 3x4, 2x2) O. Cotton balls, cotton-tipped applicator, drapes, emesis basin P. Biohazardous waste containers Q. Gloves – latex, non-sterile disposable, sterile disposable R. Soap dispenser S. Tape, tape measure T. Tissues, personal wipes U. Thermometers XXI. Basic sequence of the physical examination A. General appearance B. Head C. Neck D. Eyes E. Ears F. Nose and sinuses G. Mouth and throat H. Chest and lungs I. Heart J. Breasts file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C137 K. Abdomen L. Genitalia M. Rectum N. Musculoskeletal system O. Neurological system XXII. Examination methods used by physicians A. Inspection (visual examination) 1)Posture/Gait 2)Mannerisms 3)Affect 4)Hygiene B. Auscultation 1)Lungs 2)Heart 3)Carotid arteries 4)Bowel Sounds C. Palpation 1)Chest 2)Abdomen D. Percussion 1)Chest 2)Abdomen 3)Extremities XXIII. Recommended physical examination schedules for adults and children A. Adults 1)EKG –PRN with baseline at 40 if not before 2)Eye exam – tonometry and fundoscopy at 40, then every 4 years 3)H&P – every 3 years between ages 20-30, annually after 40 4)Mammogram – baseline at 35, then annually 5)Pap test, pelvic – begin at 20 or when female becomes sexually active, annually thereafter 6)Pulmonary function tests – PRN for high risk patients, COPD, and smokers 7)Sigmoidoscopy – 2 consecutive at 50, every 3-5 years thereafter 8)Rectal exam – begin at 40, then annually 9)Stool for guaiac – begin at 40, then annually 10) Thyroid screening – PRN, baseline at menopause females every 2 years B. Children 1)3 days –diet and nutrition assessed, exam 2)3-4 weeks – diet and nutrition assessed, lab tests and procedures, exam 3)2 months – check up, immunizations begin 4)4-6 – check up, immunizations continues 5)9 mo., 12 mo., 15 mo., - exam, immunizations 6)4 years – 6 years – annual exam XXIV. Legal and ethical implications of the physical examination A. The medical assistant may be required to act as a witness during some examinations. B. The medical assistant must recognize that a legal and ethical contract exists between the patient and physician and therefore any information gained through the CPE is confidential and must remain that way. XXV. Three primary structures of the integumentary system A. Epidermis 1)Top layer 2)Composed of tightly packed epithelial cells 3)Keratin B. Dermis 1)Second layer 2)Composed mainly of connective tissue 3)Contains several appendages a) Hair b) Receptors c) Nails d) Glands i. Sebaceous (oil) ii. Sudoriferous (sweat) C. Subcutaneous 1)Third layer 2)Composed of adipose cells XXVI. Factors that might affect wound healing A. Blood supply 1)It is adequate for proper oxygenation and the need for an increased blood flow. B. Presence of infection 1)Most common complication in wound healing. 2)Causes an increase in edema, erythema, temperature and pain. 3)Adherence to standard precautions is necessary when handling an infected wound. C. Nutrition - Must have adequate supply of the essential nutrients to encourage wound healing and prevent infection. 1)Protein synthesis requires amino acids, vitamin B complex and magnesium. 2)Collagen synthesis and maturation requires vitamin C and D and the minerals iron and copper. file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C137 3)Immune reaction requires vitamin C. Inflammatory response and anti-inflammatory action requires vitamins A and E. 4)Prothrombin synthesis requires vitamin K. D. Size, shape and location of wound which can affect: 1)Likelihood of bleeding – Head and neck wounds bleed more readily. 2)Extent of swelling is more likely to cause difficulties in the distal extremities than in other areas. 3)Need for compression and/or immobilization – bone for joint injuries 4)Type and amount of drainage expected - Abdominal, thoracic and alimentary tract wounds tend to drain fluid in higher volume and of more varied character. E. Extent and nature of injury/surgical procedure 1)Degree to which tissue has been injured or surgical dissected 2)Clean, approximated and uncomplicated wounds 3)Contaminated, accidental wounds F. Age and physical condition 1)Wound healing is delayed due to the overall slowing down of body system. 2)Conditions such as atherosclerosis, cardiopulmonary disease, renal pathology and immobility often associated with the aging process will delay wound healing. G. Presence of drainage - possible complication 1)Healthy skin surrounding the wound may become over-hydrated, macerated and susceptible to breakdown. 2)May increase the need for additional dressings. 3)Client may experience doubt and apprehension, with a possible impact on convalescence. 4)Sudden profuse drainage of clear, pale pink fluid saturating the dressing on an abdominal wound may indicate wound dehiscence. 5)Sudden bloody drainage is a sign of hemorrhage. 6)Increase in viscosity, a strong and unpleasant odor and a color change may indicate infection XXVII. Various types of wound dressings A. Primary dressings 1)Placed directly on the wound and the adjacent to the skin. 2)Wick away drainage (exudate) from wound. 3)Preserve a moist environment between the wound margins. B. Secondary dressings: 1)Placed over primary dressing 2)Provide compression 3)Provide protection XXVIII. Various wound dressings according to specific qualities A. Non-occlusive 1)Absorbent, ventilated 2)Woven or non-woven material B. Occlusive 1)Tightly woven gauze material heavily impregnated with a petrolatum emulsion 2)Does not allow the passage of air or fluid to or from the wound. C. Semi-permeable (semi-occlusive) 1)Transparent, waterproof, plastic film 2)Barrier to external fluids and bacteria 3)Permeability allows skin to “breathe” 4)Helps prevent wound dehydration 5)Allows for inspection of the wound without removing dressing, which may decrease the number of dressing changes. D. Non-adhering 1)Designed not to stick to the wound site or skin 2)Must be used in conjunction with a primary dressing in the presence of drainage. E. Medicated 1)Contains medication 2)Can be applied by the manufacturer or the medical health care provider. 3)Used primarily to treat skin ulceration, burns and some postoperative infections. F. Conforming bandages 1)Secondary bandages 2)Provide compression 3)Hold primary dressing in place 4)Increase absorbency XXIX. Dynamics of wound healing A. First 24-72 hours are marked by the inflammatory and repair processes. 1)Wound begins to seal 2)Critical phase B. Sequence of events 1)Blood vessels release blood which fills the wound area. 2)Blood components, called platelets, form a clot which helps create stasis in surrounding small vessels, preventing hemorrhage at site. 3)Scab begins to form on the surface of the wound. a) Usually begins to form within 2 hours b) Composed of dried blood proteins c) Provides a natural seal to prevent invasion of pathogens. 4)Plasma and white blood cells escape through the walls of the nearby blood vessels and enter the wound site. a) Plasma contains proteins which are needed for the formation of new cells. b) White blood cells – phagocytosis 5)Granulated forms to fill the gaps and allow epithelial cells to migrate. file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C137 6)Proliferation of cells within the wound closes the surface of the wound under the scab. 7)The scab sloughs off and newly formed skin tissue is exposed. XXX. Postoperative wound complications A. Infection 1)Contamination of a wound 2)Recall signs and symptoms of infection. 3)Prevention is aimed at: a) Utilizing medical asepsis b) Patient education B. Dehiscence 1)Bursting open of the wound 2)Most frequently seen in surgical abdominal wounds. 3)Prevention is aimed at: a) Assessing nutritional status and risk factors such as obesity b) Support for the wound during coughing and movements that may strain the incision XXXI. Types of wounds based on cause A. According to manner in which it is made 1)Incised a) Made by a clean cut with a sharp instrument. b) Example: surgeon’s incision with a scalpel 2)Contused a) Made by blunt force b) Skin remains intact c) Causes soft tissue damage d) Example: bruises 3)Lacerated a) Made by an object that tears tissues b) Results in jagged irregular edges c) Example: blunt knife, glass 4)Puncture a) Made by a pointed device. b) Example: ice pick, bullet, knife stab, nail B. Surgical classification 1)Clean a) Aseptically made wound b) Blood vessels have been ligated 2)Contaminated a) Exposed to excessive amounts of bacteria b) Not grossly infected and have a higher risk for infection than other wounds. c) Examples: unprepared colon surgery, dirty laceration 3)Infected a) Contains bacteria b) Cannot be closed as it may contain devitalized material XXXII. Closed wound and an open wound A. Closed wound 1)Integrity of skin remains intact. 2)Reduces risk of infection due to contamination. B. Open wound 1)Integrity of skin has been interrupted. 2)Increase in risk of contamination XXXIII. Reasons a physician might choose to dress a wound A. To protect the wound from mechanical injury B. To absorb drainage and fluid wastes C. To promote homeostasis and minimize accumulation of fluid, as in a pressure dressing D. To prevent contamination from bodily discharges E. To inhibit or kill organisms by using dressings that contain antiseptic medications F. To reduce the risk of contamination from the environment XXXIV. The advantages and disadvantages of dressing a wound A. Advantages 1)Reduces the risk of infection 2)Protects the wound from mechanical injury 3)Absorbs drainage and fluid wastes B. Disadvantages 1)Provides bacteria with growth requirements 2)Expense of dressings XXXV. The functions of a bandage and guidelines when applying a bandage A. Functions 1)Apply pressure to control bleeding. 2)Holds a dressing in place 3)Protects dressings and wounds from contamination. 4)Immobilize an injured body part. B. Application guidelines 1)Maintain medical asepsis – prevent the transfer of pathogens into the wound. 2)Keep area to be bandaged dry and clean file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C137 a) Moisture encourages the growth of pathogens. b) Moist dressing will be uncomfortable to client. 3)Do not place bandage directly over a wound. a) Apply a sterile dressing first. b) Bandage should extend approximately 1-2 inches beyond the edge of the dressing. 4)Do not allow skin surfaces of two body parts to touch each other. During wound healing opposing surfaces may adhere and result in scar tissue. 5)Pad joints and any body prominence – reduces irritation caused by the bandage rubbing against the skin over a bony area. 6)Bandage the affected part in the normal position -joints should be slightly flexed to avoid muscle strain, discomfort and pain. 7)Apply bandages beginning at the distal part and extending to the proximal part of the body. a) Aid in the return of venous blood to the heart b) Blood flow and valves in the veins c) Help make the bandage more secure 8)When bandaging hands and feet, leave fingers and toes exposed if possible – check for circulatory impairment, such as: a) Coldness b) Pallor c) Cyanosis of nail beds d) Swelling XXXVI. The role and responsibilities in minor office surgery A. Medical assistant administrative role in minor surgical procedures B. Medical assistant clinical role in minor surgical procedures C. Guidelines the medical assistant must follow during a sterile procedure XXXVII. Five main components of the circulatory system A. Heart – acts as pump to circulate the blood B. Arteries - the vessels that carry blood away from the Heart C. Veins – the vessels that return blood to the heart D. Capillaries – the microscopic vessels where exchange between the blood and the body’s tissue take place E. Blood – the fluids and cells that are circulated to carry oxygen and nutrients to tissues and wastes away from tissues XXXVIII. The circulation of blood and the pulmonary system A. Located in the center of the thoracic cavity B. Muscular organ, the size of your fist C. Four chambers 1) Right atrium 2) Left atrium 3) Right ventricle 4) Left ventricle D. Heart mechanism 1) Atria contract at the same time 2) Blood forced into the heart’s lower chambers 3) Ventricles contract simultaneously to pump blood out of heart E. Path of the blood flow 1) Right atrium 2) To right ventricle which pumps blood to lungs via pulmonary arteries 3) Returned to the heart, via pulmonary veins 4) Blood re-enters heart in the left atrium 5) To left ventricle which pumps the blood to aorta, which carries oxygenated blood to the body tissue F. Pulmonary circulation 1) Blood enters lungs via the pulmonary arteries a. Very low in oxygen b. Carrying waste carbon dioxide 2) Air enters body via the nose through the trachea 3) Air passes into lungs via the bronchioles 4) Wastes are exchanged from the blood with fresh oxygen at the alveoli XXXIX. Major causes of cardiac arrest A. Heart disease 1) Risk factors a. High blood pressure b. Elevated cholesterol and triglyceride c. Cigarette smoking d. Obesity e. Stress 2) Disease process a. Atherosclerosis b. Coronary artery spasm c. Myocardial infarction B. Drowning C. Electrocution D. Suffocation E. Drug intoxication F. Trauma file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C137 XL. Management of a patient with chest pain A. Chest pain 1) May have existed for several days before presenting to the doctor’s office. 2) Usually patient has one or more risk factors for cardiac disease. 3) Risk factors a. Hypertension, previous MI, History of Coronary artery bypass graft (CABG), Coronary artery disease (CAD). b. Hypercholesterolemia, LDL and HDL abnormalities, and atherosclerosis. B. Primary approach to patient with chest pain 1) Notify MD and RN to assess patient. 2) Ask patient if they have medication for chest pain (Nitroglycerine-NTG) and instruct them to take it as prescribed. 3) If MD or RN not available, follow protocol for notifying Emergency Medical System (EMS). If in an outpatient setting, call 911 immediately. 4) Get AED or send someone to get it. 5) Place patient in low or high fowlers position if tolerated and or a position of comfort. 6) Loosen clothing – or assist patient with a hospital gown (for EKG) 7) Reassure patient in a calm manner. 8) Take vital signs. C. Gathering data about chest pain (if registered nurse or doctor not available, while waiting for EMS) 1) Onset 2) Activity at onset – what waste patient doing 3) Location 4) Severity/intensity (scale 1-10) 5) Duration/Quality (length/time of pain, pressure, jabbing?) 6) Radiation 7) Associated symptoms 8) Review any history of previous chest pain episodes and compare to current experience 9) Assess for any mechanism of injury D. Subjective signs and symptoms (what patient reports or demonstrates as discomfort), 1) Central chest pain, substernal, or crushing pain 2) Pressure, tightening, heaviness, cramping, burning, aching sensation 3) Pain radiating to the neck , jaw, back and/or arms 4) Shortness of breath (SOB) 5) Nausea and/or vomiting 6) Diaphoresis E. Objective signs and symptoms: (what the patient physically manifests and you observe during data collection) 1) Increased blood pressure. 2) Diaphoresis 3) Dilated pupils 4) Restlessness 5) Shortness of breath 6) Anxiety 7) Facial mask of pain, chest or throat guarding (patient defending airway). 8) Crying or moaning. XLI. Job Preparation and Success Skills A. Obtain and maintain employment 1)Job market issues and prepare an organized plan of action for a job search. 2)Job descriptions or titles that match individual areas of experience and training. 3)Networking activities utilizing newspapers, internet, community agencies and personal contacts. 4)Advantages and perils of internet applications 5)“Dress for Success.” 6)Employers in person, by telephone, fax or letter of interest to arrange interviews for employment. 7)Portfolio, professional resume, and cover letter. 8)In depth employment interview and questions. 9)Business thank you notes. 10) Application for employment utilizing a “master application”. Lab: I. Examinations: A. Routine physicals B. Specialty examinations file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C137 II. Patient interviews III. Medical history forms and documentation A. Chief complaint (cc) B. Present illness (P.I.) C. Past medical history 1. Childhood diseases 2. Major illness 3. Injuries 4. Hospitalization 5. Surgeries 6. Allergies 7. Immunizations 8. Current medications a. Prescription b. O.T.C. D. Family medical history (blood relative) E. Personal history (lifestyle patterns) F. Assessment of body systems (ROS) G. Other areas your physician / institution has deemed your responsible IV. Minor surgery A. Prepare and maintain the surgical area 1. Instruments in performing minor surgeries 2. Setting up and maintaining a sterile field 3. Sterile pack B. Surgical prep for post operative wounds 1. Techniques for preparing the patient’s skin for minor surgery. 2. Types of anesthetics most frequently seen in minor procedures. 3. Methods of skin closure performed in the medical office. 4. Techniques used for removal of sutures and surgical staples. 5. Instruments used for minor surgery 6. Informed consent form. 7. Surgical asepsis 8. Set up a sterile field. V. Wound care A. Supplies needed to change a non-sterile and sterile dressing 1. Sterile gloves or sterile transfer forceps 2. Sterile dressings 3. Scissors 4. Appropriate bandages and tapes 5. Medication to be applied to the dressing as ordered file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C137 B. The removal and application of a non-sterile dressing 1. Don non-sterile exam gloves. 2. Have appropriate waste receptacle at hand. 3. Remove tape, pulling gently towards the center of the dressing. 4. If dressing adheres to wound, saturate with sterile normal saline to loosen dressing. C. Wound culture 1. Written order 2. Assemble the equipment – culture kit with transport media 3. Do not clean the wound prior to culturing as this may remove contaminates D. Documentation 1. Date and time of procedure 2. Wound and drainage observations 3. Approximate size of the wound 4. Description of the wound and surrounding tissue 5. Description of drainage if present 6. Client reactions VI. Emergency Procedures A. Chest pain B. Airway obstruction C. Stroke D. Shock E. Chest compressions VII. Positioning and draping patients A. Anatomic position B. Sitting position C. Supine (recumbent, horizontal recumbent) D. Dorsal recumbent E. Lithotomy F. Trendelenberg G. Semi-Fowler’s H. Fowler’s I. Prone J. Sim’s (lateral Sim’s) K. Knee-chest L. Proctologic M. Jackknife 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Audiovisual; 2. Case Study; 3. Demonstration; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C137 4. Discussion; 5. In-class writing; 6. Laboratory; 7. Lecture; 8. Outside reading; 9. Performance; 10. Presentations (by students); 11. Problem Solving; 12. Skills Development and Performance; 13. Written work; 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to 1. Write a 5 page research paper on a assigned topic such as the importance of HIPAA in the medical office or the role of the CMA in the healthcare field. 2. Read and outline the assigned textbook chapters prior to lecture. 3. Incorporating lecture notes with chapter outlines. 4. Answer assigned questions from the textbook study guide. 5. Practice scenario-based back office procedures: Case Scenario Example: Jimmy Stewart, a 19 year-old male patient, came to the physician's office after getting a cast in the emergency room for a broken right wrist. Jimmy is complaining of pain to his right arm. Jimmy's right hand is swollen and slightly bluish in color. His capillary refill is greater than 4seconds. What can you conclude about Jimmy's cast and right arm? What would you document? 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to 1. The student will demonstrate clinical patient care in the skills lab. 2. The student will demonstrate medical back office procedures in the skills lab. 3. Student will need to complete each objective successfully. 4. Skills lab participation will be monitored with a Completion Check-off List. 5. Theory applications will be evaluated by Chapter Quizzes, Mid-term and Final, e.g., questions include multiple choice, true-false, and short answer: Question Example: All of the following are problems associated with childhood obesity except a. High blood pressure b. Skin disorders c. Type 2 diabetes d. Asthma 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Bonewit-West, K.. (2012) Clinical Procedures for Medical Assistants , 8th, Saunders/Elsevier Bonewit-West, K.. (2012) Clinical Procedures for Medical Assistants, Study Guide, 8th, Saunders/Elsevier Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online with some required face-to-face meetings (â€œHybridâ€);iTV â€“ Interactive video = Face to face course with significant required activities in a distance modality ;Face to face; 30. MINIMUM QUALIFICATIONS: Health Care Ancillaries; 31. APPROVALS: Origination Date 04/06/2012 Last Outline Revision 05/04/2012 Curriculum Committee Approval Board of Trustees 05/04/2012 06/14/2012 State Approval UC Approval CSU Approval UC Approval Status 70 = Fall 2012 IGETC Approval CSU GE Approval CSU Approval Status Approved IGETC Approval Status CSU GE Approval Status file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C137 Data Element Changes Data Justification This is a new course being offered for the new/revised Medical Assisting Program. This course meets the competency standards for CAAHEP and CCBMA certification for Medical Assistants. Medical Assisting program is pending and will be sent forward when all courses are completed. Course Element Changes Course Change Justification Course ID (CB00) XXXXXXXXXX TOP Code (CB03) 1208.10 - Clinical Medical Assistin; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 3 Course Units of Credit Minimum Low (CB07): 3 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Not part of Coop Work Exp; Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): CAN-Code Seq (CB15): Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C137.htm[4/8/2013 1:25:52 PM] HCRS C138 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE HCRS C138 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: HCRS C138 2. COURSE TITLE: Medication Administration for Medical Assisting 3. SHORT BANWEB TITLE: Medication Adm for Med Asst 4. COURSE AUTHOR: Gates, Cheryl G. 5. COURSE SEATS: 6. COURSE TERMS: 70 = Fall; 30 = Spring; 50 = Summer 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC New Course 9. START TERM: 70 = Fall, 2012 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This course provides basic education and training in medications and administration for the individual who is interested in working as a Clinical Medical Assistant in the medical back office environment. Topics include basic mathematics, terminology, medication orders, medication administration including oral and injection and documentation. Emphasis is on client education and the role of the medical assistant. 12. GRADING METHOD S = Standard Letter Grade Default: Optional: 13. TOTAL UNITS: 2 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 1.5 Lab 0.5 Activity Min Hours 27 27 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: HCRS Clinical Medical Assisting- (Certificate of Achievement) HCRS Medical Assisting (AS Degree Program) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C138.htm[4/8/2013 1:25:53 PM] HCRS C138 IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Calculate accurate occupational mathematics and metric conversions for proper medication administration. 2. Select the correct PDR, drug handbook, and other drug references to identify a drug's classification, usual dosage, usual side effects, and contraindications. 3. Differentiate the common abbreviations that are accepted in prescription writing. 4. Select proper sites for administrating parenteral medications. 5. Prepare proper dosages of medication for administration by oral and parenteral routes. 6. Analyze and apply the 'six' rights of medication administration. 23. REQUISITES Prerequisite: HCRS C136 or Corequisite: HCRS C136 24. DETAILED TOPICAL OUTLINE: Lecture: 1. Numerals and Fractions a. Arabic and Roman Numerals b. Fractions 2. Decimals a. Fraction Decimals b. Common Fractions 3. Ratio and Proportion 4. The Metric System a. Language b. Conversion c. Guidelines 5. Calculation of Medication Dosages a. Adult Dosages i. Oral and Parenteral Routes ii. Weight and Volumes iii. Measurements in Units iv. Calculations b. Calculation of Children’s Dosage i. Guidelines ii. Calculations 6. Introduction to Pharmacology a. Drug Sources, Schedules and Dosages b. Forms of Drugs and how they Act c. The Medication Order i. Abbreviations ii. Vocabulary d. Medication Administration Essentials i. Guidelines ii. Storage of Medications iii. Emergency Medications iv. Documentation e. Administration of NonParenteral Medications i. Oral Medications ii. Ophthalmic Medications iii. Otic Medications iv. Nasal Medications v. Rectal Medications f. Administration of Parental Medications i. Syringe parts and classifications ii. Preventing needle stick injuries iii. Measuring Medication in a syringe file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C138.htm[4/8/2013 1:25:53 PM] HCRS C138 iv. Advantages and Disadvantages of the Parenteral Route v. Preparing the Patient for an Injection vi. Site Selection vii. Basic Guidelines viii. Subcutaneous, Intramuscular and dermal injections ix. Administration of Insulin 7. Medications, Supplements and Drug Abuse a. Antibiotic Agents b. Antifungal, Antiviral and Immunizing Agents c. Vitamins, Minerals and Herbs d. Psychotropic Agents e. Substance Abuse 8. Effects of Medications on the Body a. Medications for Musculoskeletal System Disorders b. Medications for Gastrointestinal System Disorders c. Medications for Cardiovascular System Disorders d. Medications for Respiratory System e. Diuretics and Medications for Urinary System Disorders f. Medications for Endocrine System Disorders g. Medications that Affect the Nervous System h. Medications that Affect the Reproductive System Lab: 1. Administration of oral medications 2. Administration of parenteral medications 3. Problem solving 4. Measurements in Metric system 5. Basic math computations 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Audiovisual; 2. Computational Work; 3. Demonstration; 4. Discussion; 5. Group Work; 6. Instruction through examination or quizzing; 7. Laboratory; 8. Lecture; 9. Problem Solving; 10. Skills Development and Performance; 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to 1. Read the assigned chapters and outline the chapters prior to lecture. 2. Incorporate lecture notes within the chapter outlines. 3. Complete assignment from questions at the end of each chapter of the textbook or workbook. 4. Practice scenario-based medication administration. Example Case Study: The doctor ordered Oxycontin (Morphine) 80mg by mouth for Mrs. Smith. Mrs. Smith stated she does not need all of the Oxycontin and she would like half of the dose ordered. The Medical Assistant found that the Oxycontin pills came in 40mg tablets. How much Oxycontin should the Medical Assistant give to Mrs. Smith? 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to 1. Demonstration of oral and parental medication administration is skills lab using a Check-off list. 2. Demonstration of the 'six rights' of medication administration. 3. Theory applications will be evaluated by Chapter Quizzes, Mid-term, and Final exam, e.g., questions include multiple choice, truefalse, and short answer: Question Example: What is the name of a drug preparation that is applied externally to produce a feeling of heat or warmth? a. Spirit b. Ointment c. Liniment d. Tincture file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C138.htm[4/8/2013 1:25:53 PM] HCRS C138 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Rice, J. (2011) Prinicples of Pharmacology for Medical Assisting , 5th, Delmar Cengage Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online with some required face-to-face meetings (“Hybrid”);iTV – Interactive video = Face to face course with significant required activities in a distance modality ;Face to face; 30. MINIMUM QUALIFICATIONS: Health Care Ancillaries; 31. APPROVALS: Origination Date 04/06/2012 Last Outline Revision 05/04/2012 Curriculum Committee Approval 05/04/2012 06/14/2012 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 70 = Fall 2012 IGETC Approval CSU Approval Status Approved IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification This is a new course being offered for the new/revised Medical Assisting Program. This course meets the competency standards for the CAAHEP & CCBMA certification for Medical Assistants. Course Element Changes Course Change Justification Course ID (CB00) XXXXXXXXXX TOP Code (CB03) 1208.10 - Clinical Medical Assistin; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 2 Course Units of Credit Minimum Low (CB07): 2 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Not part of Coop Work Exp; Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): CAN-Code Seq (CB15): Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C138.htm[4/8/2013 1:25:53 PM] HCRS C138 Course Program Status (CB24): 1 - Program Applicable; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C138.htm[4/8/2013 1:25:53 PM] HCRS C139 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE HCRS C139 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: HCRS C139 2. COURSE TITLE: Laboratory Procedures 3. SHORT BANWEB TITLE: Laboratory Procedures 4. COURSE AUTHOR: Hodgins, Annette 5. COURSE SEATS: 6. COURSE TERMS: 70 = Fall 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC New Course 9. START TERM: 70 = Fall, 2012 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This introductory laboratory course provides basic education and training in physicians’ office laboratory as a medical assistant. The focus of the training includes methods of specimen collection; principles of routine office laboratory tests; techniques for blood tests; microbiology office procedures; and blood withdrawal. 12. GRADING METHOD S = Standard Letter Grade Default: Optional: 13. TOTAL UNITS: 2 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 1 Lab 1 Min Hours 18 54 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: HCRS Clinical Medical Assisting- (Certificate of Achievement) HCRS Medical Assisting (AS Degree Program) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C139.htm[4/8/2013 1:25:53 PM] HCRS C139 IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Discuss the reasons for clinical laboratory testing and purpose of physician office lab (POL). 2. Distinguish the medical assistant’s duties from the vocation nurse's duties in a physician’s office laboratory. 3. Analyze the regulatory controls under Clinical Laboratory Improvement Amendment (CLIA), which govern procedures completed in the physician’s office. 4. Compare and contrast quality control measures to quality assurance programs in a physician’s office laboratory. 5. Explain the purpose of equipment found in a physician’s office laboratory. 6. Discuss and demonstrate accepted techniques for safety rules employed within the physician’s office laboratory to prevent accidents and properly dispose of hazardous waste using Standard Precautions. 7. Demonstrate competency with laboratory procedures including specimen collection and blood withdrawal. 23. REQUISITES Prerequisite: HCRS C136 or Corequisite: HCRS C136 24. DETAILED TOPICAL OUTLINE: Lecture: I. Key terms A. Review the terms listed in the terminology section. B. Spell the listed terms accurately. C. Pronounce the terms correctly. D. Use the terms in their proper context. II. Clinical laboratory testing A. Reasons to perform clinical tests 1. Diagnose or rule out disease process 2. Establish treatment plans 3. Monitor treatment plans B. Purpose of physician office laboratory (POL) 1. Diagnostic testing on site a. Screening test for diabetes b. Establish dietary or insulin related treatment plans. c. Monitor effectiveness of treatment plan using Point of care (POC) glucose monitors. 2. Convenience for patient 3. Cost-effective (managed care) III. The medical assistant’s duties in a physician’s office laboratory 1. Medical assistant duties in POL a. Specimen collection b. Specimen processing c. Test performance d. Quality control i. Logs ii. Record keeping iii. Proficiency testing 5. Quality assurance 6. Preventative maintenance 7. Documentation file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C139.htm[4/8/2013 1:25:53 PM] HCRS C139 8. Laboratory safety i. Chemicals ii. Physical iii. Personnel iv. Patient 9. Hazardous waste disposal 10. Patient education/instruction IV. Regulatory controls under Clinical Laboratory Improvement Amendment (CLIA) A. Laboratory regulations for physician office lab 1. CLIA a. Categories of testing b. Testing personnel c. Documentation d. Proficiency testing e. Fees B. State 1. Laws and regulations 2. Inspections 3. Fees V. Quality control and quality assurance programs A. Quality control 1. Definition 2. Quality of work 3. Accuracy of testing 4. Documentation/logs B. Quality control programs 1. Set up 2. Review C. Documentation VI. Common reference materials used for the performance standards of a test A. Performance standards 1. Accuracy 2. Precision 3. Calibration 4. Control samples 5. Relevance B. Reference materials 1. Package inserts 2. Manufacturer’s user guide 3. Clinical laboratory technical procedure manuals 4. OSHA standards 5. CLIA’88 requirements VII. Safety rules, accidents, hazardous waste A. Standard Precautions 1. Infection control 2. Body surface isolation B. OSHA Bloodborne Pathogen Standard C. Hazard Communications Standard 1. Material Safety Data Sheets (MSDS) 2. Biohazard symbol 3. Hazard labels 4. Record keeping D. Accident Prevention Guidelines 1. Physical safety 2. Fire and electrical safety 3. Biologic safety 4. Sharps safety (no recapping needles) 5. Accident reporting 6. Housekeeping E. Hazardous Waste Operations and Emergency Response Final Rule F. Hazardous Waste Disposal (OSHA regulations) 1. What is considered hazardous waste? 2. Proper disposal a. Chemicals b. Biohazardous file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C139.htm[4/8/2013 1:25:53 PM] HCRS C139 c. Medical Sharps 3. Proper storage prior to pickup 4. Disposal companies 5. Record keeping VIII. The composition and function of blood A. Composition of blood 1. Erythrocytes 2. Leukocytes 3. Thrombocytes 4. Fluid or plasma B. Production of blood 1. Hematopoiesis a. Bone marrow b. Liver c. Spleen C. Function of blood 1. Oxygen transportation a. Hemoglobin b. Hematocrit 2. Infection control a. Leukocytes total b. Lymphocytes c. Monocytes d. Neutrophils e. Eosinophils f. Basophils 3. Transport chemical components a. Electrolytes b. Proteins c. Glucose d. Hormones e. Enzymes 4. Remove waste products IX. Common fears and concerns of patients A. Common fears 1. Physical harm/injury 2. Emotional/test results 3. Misunderstanding B. Reducing fears 1. Explanation of procedure 2. Knowledge of equipment 3. Assessment of patient age, emotional and physical condition 4. Language barriers addressed 5. Professional attitude 6. Compassion X. Common blood tests and their purpose A. Common blood tests 1. Complete blood count (CBC) 2. Chemistry panels a. Glucose b. BUN c. Creatinine d. Proteins e. Electrolytes f. Cardiac enzymes g. Liver enzymes h. Lipids 3. Tests for hormone levels XI. The basic characteristics of urine A. Urine formation 1. Urinary system 2. Organs 3. Filtering process a. Urine composition 25% water b. Urine composition 5% organic and inorganic waste products 4. Remaining urine composition file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C139.htm[4/8/2013 1:25:53 PM] HCRS C139 B. Physical properties 1. Color 2. Clarity 3. Odor 4. Specific gravity C. Chemical properties 1. Albumin (protein) 2. Bacteria (nitrites) 3. Bilirubin 4. Blood (red blood cells, hemoglobin) 5. Blood (white blood cells) 6. Glucose 7. Ketone bodies 8. pH 9. Urobilinogen 10. Specific gravity D. Formed elements 1. Red blood cells 2. White blood cells 3. Casts 4. Bacteria 5. Crystals 6. Artifacts E. Purpose 1. To establish and/or rule out disease process. 2. To set up treatment program. XII. OSHA Standards for Specimen Collection 1. Hand washing 1. When performing clinical procedures, before and after patient contact, before and after applying gloves, and after contact with blood or other potentially infections materials. 2. Gloves no substitute for hand washing 2. Biohazard containers 1. Infectious waste into these containers (closable and clearly marked). 2. Containers leak-proof and properly constructed to contain the contents during handling, transport, or shipping. 3. Urine specimen not qualified for placement into biohazard containers. 3. Clean disposable gloves 1. Worn when in contact with blood and other body fluids that are potentially infectious. 2. Examples: body fluids, mucous membranes, non-intact skin, and contaminated articles or surfaces. 4. Appropriate protective clothing 1. 2. 3. 4. Gown Apron Laboratory coat Face shields or masks in combination with eye protection devices. a. In case of splashes splatter, or droplets of blood. b. Other potentially infectious materials XIII. Maintain the chain of custody when processing urine specimens A. Chain of custody 1. Specimen documentation form 2. Labels 3. Patient identification B. Collection procedure 1. Preparation of restroom 2. Collection container 3. Patient instruction XIV: Microorganisms cause disease A. Pathogenic organisms 1. Used-up nutrients needed by cells and tissues for survival. 2. Reproduce within cells causing destruction of cells. 3. Body cells become targets of the body’s own defense mechanism. 4. Produce toxins which damage cells and tissues. XV. Viruses, bacteria, fungi, and parasites differ A. Bacteria 1. Single cell prokaryotic file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C139.htm[4/8/2013 1:25:53 PM] HCRS C139 2. 3. 4. 5. 6. Rapid reproduction Major cause of disease Identified by gram stain Identified by shape Ability to grow in the presence or absence of oxygen Presence of special groups a. Mycobacteria b. Rickettsia c. Chlamydiae d. Mycoplasms B. Virus 1. Smallest known infectious organism 2. Not visible with regular microscope 3. Simpler life form than cell 4. Live and grow only within living cells of other organisms. 5. Diseases caused a. Common cold b. Influenza c. Chicken pox d. Hepatitis e. Warts f. AIDS g. Mumps h. Rubella i. Encephalitis j. Herpes C. Fungi 1. Eukaryotic organism 2. Single celled organism 3. Budding reproduction (yeast) 4. Large fuzzy multi celled (molds) 5. Cause superficial infections a. Athlete’s feet b. Ringworm c. Thrush d. Vaginal yeast infections 6. Life-threatening illness possible if internal tissue invaded. D. Parasites 1. Complete organism 2. Existence dependent on another organism for nourishment or some other advantage. 3. Examples of parasitic infections (“infestations”) a. Worms 1) Round 2) Flat 3) Tape b. Insects 1) Mosquitoes 2) Ticks 3) Lice 4) Mites XVI. Transport specimens to outside laboratories A. Specimen transportation 1. Follow the collection and packing directions from the laboratory that will receive and test the specimen. 2. Maintain the specimen in a state as close to original as possible. 3. Protect anyone who handles a specimen container from exposure to potentially infectious material. B. Methods 1. Regularly-scheduled daily pick-ups by the reference laboratory. 2. As-needed pick up 3. Through the mail a. CDC procedures based on U.S. Public Health Service regulations. b. Special mailing containers and labels Lab: I. Procedures for the collection of blood, urine, stool, sputum, throat and other bacteriological specimens A. Collection procedures/types 1. Venous a. Evacuated system b. Syringe c. Winged infusion sets file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C139.htm[4/8/2013 1:25:53 PM] HCRS C139 2. Capillary 3. Urine a. Clean catch mid-stream b. Random c. 24 hour d. Performance 1) Observe and record physical characteristics. 2) Perform chemical analysis (Multistix). 3) Record chemical analysis results. 4) Prepare aliquot for centrifugation. 5) Prepare slide with sediment for microscopic examination. 4. Stool / feces a. Random b. 24 hour 5. Sputum a. First morning b. Random 6. Throat a. Random b. Culturette 7. Microbiology (all other) a. Random b. Culturette c. Transport media II. The purpose of equipment found in a physician’s office laboratory A. Basic equipment 1. Microscope 2. Centrifuge 3. Electronic a. Photometers b. Mechanical pipettes c. Computerized cell counters 4. Equipment used for measurement a. Glucose meters b. Hemoglobin meters c. Microhematocrit readers 5. Autoclave B. Microscope parts 1. Oculars (eye pieces) 2. Objectives 3. Arm and focus controls 4. Stage and substage 5. Light source 6. Iris 7. Condenser 8. Slides and cover slips C. Use of microscope 1. Set up 2. Adjusting eye pieces 3. Focusing 4. Slide preparation 5. Viewing the specimen 6. Cleaning 7. Storage III. Clinical Laboratory Improvement Amendment (CLIA) waived tests A. Hemoglobin 1. HemoCue 2. Copper sulfate drop B. Hematocrit 1. Microhematocrit centrifuge 2. Microhematocrit reading device C. Erythrocyte sedimentation rate (ESR) 1. Wintrobe tube 2. Transfer pipette 3. Timer D. Blood glucose 1. Glucose meter (many types available) 2. Glucose reagent strips file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C139.htm[4/8/2013 1:25:53 PM] HCRS C139 E. Fecal occult blood 1. Hemoccult slides (other types are available) 2. Developer F. Dipstick urinalysis 1. Mulitstix 10 SG reagent strips 2. Urinometer G. Ovulation (visual comparison) 1. Over the counter test kit 2. Package insert H. Pregnancy (visual comparison) 1. Over the counter test kit 2. Package insert I. Cholesterol (visual comparison) 1. Over the counter test kit 2. Package insert J. Rapid strep 1. Throat swab 2. Qtest strep for group A streptococcus IV. The general guidelines for collection of bodily fluids for microbiological cultures A. Collection guidelines 1. Collect specimens with care to avoid harm, discomfort or embarrassment to the patient. 2. If a patient is to collect specimen, give clear detailed instructions along with the proper container. 3. Collect a specimen from the area where organism is most likely to be found and contamination is least likely to occur. 4. Collect a specimen at a time when optimal recovery of the organism can be expected. 5. Use appropriate collection devices, specimen containers, transport systems and culture media. 6. Obtain appropriate quantity of specimen necessary to perform the requested procedures. 7. Obtain specimen before antimicrobial therapy begins. If patient is already on antimicrobial therapy, place note in chart. 8. Label the collection container or device. a. Patient name and ID number b. Source (collection site of specimen) c. Date and time of collection d. Physician name e. Your first initial and last name 9. Fill out and include the appropriate requisition form. a. Patient name b. Patient address c. Patient date of birth and sex d. Patient billing information e. Type and source of microbiological specimen f. Date and time of specimen collection g. Test requested h. Medications patient is taking i. Diagnosis j. Physician name, address, and phone number k. Special instructions 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Audiovisual; 2. Case Study; 3. Demonstration; 4. Discussion; 5. Group Work; 6. Laboratory; 7. Lecture; 8. Presentations (by students); 9. Problem Solving; 10. Skills Development and Performance; 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. The student will read the assigned text chapters prior to lecture. B. The student will outline the chapters and incorporating lecture notes with chapter outlines. C. The student will answer assigned questions from the Medical Assistant Study Guide and other homework assignments. D. Practice scenario-based physician’s laboratory procedures. file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C139.htm[4/8/2013 1:25:53 PM] HCRS C139 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to 1. The student will demonstrate laboratory procedures in the skills lab. 2. Student will need to complete each objective successfully. 3. Skills lab participation will be monitored with a Completion Check-off List. 4. Theory applications will be evaluated by Chapter Quizzes, Mid-term and Final, e.g., questions include multiple choice, true-false, and short answer: Question Example: All of the following are guidelines that should be followed when assembling equipment and supplies for a venipuncture except a. Check each blood tube for damage. b. Do not substitute one blood tube for another. c. Check the expiration date of the blood tubes. d. Label each blood tube with one unique patient identifier. 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Bonewit-West, K.. (2012) Clinical Procedures for Medical Assistants , 8th, Saunders/Elsevier Bonewit-West, K.. (2012) Clinical Procedures for Medical Assistants, Study Guide, 8th, Saunders/Elsevier Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online with some required face-to-face meetings (“Hybrid”);iTV – Interactive video = Face to face course with significant required activities in a distance modality ;Face to face; 30. MINIMUM QUALIFICATIONS: Health Care Ancillaries; 31. APPROVALS: Origination Date 04/06/2012 Last Outline Revision 05/04/2012 Curriculum Committee Approval 05/04/2012 06/14/2012 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 70 = Fall 2012 IGETC Approval CSU Approval Status Approved IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification This is a new course being offered for the new/revised Medical Assisting Program. This course meets the competency standards for CAAHEP and CCBMA certification for Medical Assistants. Medical Assisting program is pending and will be sent forward when all courses are completed. Course Element Changes Course Change Justification Course ID (CB00) XXXXXXXXXX TOP Code (CB03) 1208.10 - Clinical Medical Assistin; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 2 Course Units of Credit Minimum Low (CB07): 2 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C139.htm[4/8/2013 1:25:53 PM] HCRS C139 SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Not part of Coop Work Exp; Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): CAN-Code Seq (CB15): Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C139.htm[4/8/2013 1:25:53 PM] HCRS C142 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE HCRS C142 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: HCRS C142 2. COURSE TITLE: Medical Assistant Administrative Externship 3. SHORT BANWEB TITLE: Med. Asst. Adm. Externship 4. COURSE AUTHOR: Hodgins, Annette 5. COURSE SEATS: 6. COURSE TERMS: 70 = Fall 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC New Course 9. START TERM: 70 = Fall, 2012 10. C-ID: 11. CATALOG COURSE DESCRIPTION: The Clinical Externship is a practical application of the theory and skills learned in the classroom. The student participates in front office procedures under the direct supervision of the physician and the office manager and the indirect supervision of the classroom instructor. 12. GRADING METHOD P = Pass/No Pass Default: Optional: 13. TOTAL UNITS: 1.5 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0 Lab 0 Min Hours 0 0 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 1.5 90 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: HCRS Clinical Medical Assisting- (Certificate of Achievement) HCRS Medical Assisting (AS Degree Program) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C142.htm[4/8/2013 1:25:54 PM] HCRS C142 IGETC: CSU: UC Transfer Course: CSU Transfer Course: California State University, Stanislaus = HS 195: Medical Assisting Office Internship/Administrative Externship 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Demonstrate professional conduct and skills in the medical office setting. 2. Demonstrate medical front office procedures competently. 3. Evaluate and demonstrate receptionist responsibilities including answering the telephone; scheduling appointments; locate resources and information for patients; and prepare an inventory of required equipment and supplies. 4. Demonstrate OSHA Standard Precautions at all times. 23. REQUISITES Prerequisite: HCRS C133 and HCRS C134 and HCRS C135 or Corequisite: HCRS C133 and HCRS C134 and HCRS C135 Limitation on Enrollment (e.g. Performance tryout or audition): up for this course through "Student Services. Limitation on Enrollment (e.g. Performance tryout or audition) Students must sign 24. DETAILED TOPICAL OUTLINE: Lab: A. Reception activities 1. Answer telephone 2. Transfer telephone 3. Place phone party on hold 4. Complete telephone messages 5. Identify and greet patients 6. Obtain patient registration and health history information 7. Obtain “consent” signatures 8. Schedule in patient and out patient appointments 9. Maintain appointment book 10. Maintain safe and clean medical office facility 11. Process incoming and outgoing mail 12. Observe purchasing and inventory maintenance procedures B. Working with patient files 1. Employ appropriate filing procedures 2. Make corrections to files 3. Correctly document all pertinent information in the patient’s files 4. Maintain patient confidentiality C. Collection file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C142.htm[4/8/2013 1:25:54 PM] HCRS C142 1. Assist with handling time-of-visit payments 2. Process statements correctly 3. Observe procedures for handling of delinquent accounts D. Bookkeeping procedures 1. Assist with patient ledger card files 2. Make appropriate journal entries 3. Check invoices for accuracy 4. Assist with office booking measures E. Insurance procedures 1. Assist with obtaining all pertinent information 2. Accurately code diagnosis and procedures using CPT-4 and ICD-9-CM 3. Collect copayments when applicable 4. Observe follow-up procedures for unpaid insurance claims F. Written communications 1. Compose and type collection letters 2. Compose and type general information letters 3. Type physician reports 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Discussion; 2. Job Shadowing; 3. Laboratory; 4. Lecture; 5. Performance; 6. Problem Solving; 7. Skills Development and Performance; 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. Daily front office assignments will vary according to office and type of patient visits. B. Review and discuss receptionist responsibilities, e.g., operating multiple types of telecommunication methods and equipment. C. Discuss the legal and ethical issues related to maintaining a medical record. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to Observation of daily front office assignments which will vary according to office and type of patient visits. Evaluated by the physician and the medical office manager using a completion check list and rubric. Example: making patient appointments, billing insurance, and ICD coding. 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Booth, K.A.. (2011) Administrative Procedures for Medical Assisting Workbook, 4th, McGraw Hill-Higher Education Lewis, A.L., Tamparo, C.D., Tatro, B.M.. (2012) Medical Law, Ethics, & Bioethics for the Health Professions , 7th, F.A.Davis Fordney. (2012) Insurance Handbook for the Medical Office , 12th, Saunders/Elsevier Buck, C. (2011) Step-by-Step Medical Coding 2012 Edition , 1st, Saunders Elsevier Manuals Periodicals Software Other Office procedural manuals 2. Assigned readings by the Office Manager relating to physician preferences 3. Assigned readings by the Office Manager and instructor related to procedures in the office 29. METHOD OF DELIVERY: Face to face; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C142.htm[4/8/2013 1:25:54 PM] HCRS C142 30. MINIMUM QUALIFICATIONS: Health Care Ancillaries; 31. APPROVALS: Origination Date 04/06/2012 Last Outline Revision 05/04/2012 Curriculum Committee Approval 05/04/2012 06/14/2012 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 70 = Fall 2012 IGETC Approval CSU Approval Status Approved IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification This is a new course being offered for the new/revised Medical Assisting Program. This course meets the competency standards for CAAHEP and CCBMA certification for Medical Assistants. Medical Assisting program is pending and will be sent forward when all courses are completed. Course Element Changes Course Change Justification Course ID (CB00) XXXXXXXXXX TOP Code (CB03) 1208.20 - Administrative Medical As; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1.5 Course Units of Credit Minimum Low (CB07): 1.5 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): B = Advance Occupational; Cooperative Education Course Status (CB10): Part of Coop Work Exp; Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): CAN-Code Seq (CB15): Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C142.htm[4/8/2013 1:25:54 PM] HCRS C143 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE HCRS C143 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: HCRS C143 2. COURSE TITLE: Clinical Medical Assistant Externship 3. SHORT BANWEB TITLE: Clinical Med Asst Extern 4. COURSE AUTHOR: Hodgins, Annette 5. COURSE SEATS: 6. COURSE TERMS: 30 = Spring 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: CC New Course 9. START TERM: 30 = Spring, 2013 10. C-ID: 11. CATALOG COURSE DESCRIPTION: The Clinical Externship is a practical application of the theory and skills learned in the classroom and lab. The student participates in physician's office or clinic providing patient care under the direct supervision of the physician and the office manager with indirect supervision of the classroom instructor. 12. GRADING METHOD P = Pass/No Pass Default: Optional: 13. TOTAL UNITS: 1.5 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 0 Lab 0 Min Hours 0 0 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 1.5 90 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: Non-Repeatable Credit 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: HCRS Clinical Medical Assisting- (Certificate of Achievement) HCRS Medical Assisting (AS Degree Program) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C143.htm[4/8/2013 1:25:54 PM] HCRS C143 IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Demonstrate professional conduct and skills in the medical office setting. 2. Demonstrate medical back office procedures competently. 3. Analyze and demonstrate the â€˜6 Rightsâ€™ of safe medication administration. 4. Analyze OSHA guidelines and demonstrate Standard Precautions at all times. 5. Differentiate and demonstrate accepted techniques for obtaining urine, blood, stool and culture specimens. 6. Demonstrate oral and parenteral medication administration. 23. REQUISITES Prerequisite: HCRS C136 and HCRS C137 or Corequisite: HCRS C137 Limitation on Enrollment (e.g. Performance tryout or audition): Limitation on Enrollment (e.g. Performance tryout or audition) Students must complete core classes in the first semester and complete HCRS C136: Clinical Medical Assisting I prior to signing up for this course. Students must sign up for this course through "Student Services." Students must be able to perform simple medical assisting procedures prior to working as a volunteer in a healthcare facility. 24. DETAILED TOPICAL OUTLINE: Lecture: Lab: 1. Physical Exams a. Obtaining accurate patient vital signs b. Positioning and draping patient as needed c. Obtaining equipment needed by physician d. Assist with physical exam as needed e. Assist with sterile procedures as needed f. Preparation of procedural instrumentation as needed g. Assist with autoclaving and other sterilization procedures h. Application of dressings and bandages as needed i. Obtaining EKG data j. Obtaining blood, urine or other specimens as needed 2. Medication Administration a. Basic guidelines b. Storage of medications c. Preparation of medications d. Administration of oral and parenteral medications e. Emergency medications f. Proper site selection for injections and topical medications 3. Patient Education: a. Preparing patient for an injection b. Participation in patient education 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Audiovisual; 2. Case Study; 3. Discussion; 4. Laboratory; 5. Problem Solving; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C143.htm[4/8/2013 1:25:54 PM] HCRS C143 6. Skills Development and Performance; 7. Written work; 8. Other Methods: Work experience (volunteer) 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to A. The student maintains a daily journal of experiences or objectives met in clinical settings. B. The student answers weekly objectives assignments; e.g., student will assist the physician with a physical assessment within the scope of practice of a medical assistant. C. The student maintains history of clinical hours completed through a time sheet signed by both student and facility staff. D. The student writes a 5 page research paper on a topic assigned, for example, discussing the importance of HIPAA in the medical office setting. 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to A. Observation of clinical patient care: evaluated by the physician and the medical office manager using a completion check list and rubric. Example: wound care, minor surgery, and vital signs. B. Observation of injection competency: evaluated by the physician and the medical office manager using a completion check list and rubric. Example: intramuscular injections. C. Observation of medication administration using the "6 rights" of medication administration: evaluated by the physician and the medical office manager using a completion check list and rubric. Example: right patient and right medication. 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Rice, J. . (2011) Principles of Pharmacology for Medical Assisting , 5th, Delmar Cengage Learning Maki, E.. (2013) Using the Electronic Health Record in the Health Care Provider Practice, 2nd, Petterson Bonewit-West, K.. (2012) Clinical Procedures for Medical Assistants , 8th, Saunders Elsevier Bonewit-West, K.. (2012) Clinical Procedures for Medical Assistants, Study Guide, 8th, Saunders Elsevier Manuals Periodicals Software Other Assigned readings by the Office manager and Instructor related to procedures in the medical office. 2. Assigned readings by the Office manager relating to physician preferences. 3. Office procedural manuals. 29. METHOD OF DELIVERY: Face to face; 30. MINIMUM QUALIFICATIONS: Health Care Ancillaries; 31. APPROVALS: Origination Date 04/06/2012 Last Outline Revision 05/04/2012 05/04/2012 Curriculum Committee Approval 06/14/2012 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 30 = Spring 2013 IGETC Approval CSU Approval Status Approved IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification This is a new course being offered for the new/revised Medical Assisting Program. This course meets the competency standards for CAAHEP and CCBMA certification for Medical Assistants. Medical Assisting program is pending and will be sent forward when all courses are completed. Course Element Changes Course Change Justification file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C143.htm[4/8/2013 1:25:54 PM] HCRS C143 Course ID (CB00) XXXXXXXXXX TOP Code (CB03) 1208.10 - Clinical Medical Assistin; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 1.5 Course Units of Credit Minimum Low (CB07): 1.5 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): B = Advance Occupational; Cooperative Education Course Status (CB10): Part of Coop Work Exp; Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): CAN-Code Seq (CB15): Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/Academic%20Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C143.htm[4/8/2013 1:25:54 PM] HCRS C150 KERN COMMUNITY COLLEGE DISTRICT – CERRO COSO COLLEGE HCRS C150 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: HCRS C150 2. COURSE TITLE: Med. Terminology for Health 3. SHORT BANWEB TITLE: Med. Terminology for Health 4. COURSE AUTHOR: KCCD, KCCD 5. COURSE SEATS: 6. COURSE TERMS: 7. CROSS-LISTED COURSES: 8. PROPOSAL TYPE: System Loaded 9. START TERM: , 10. C-ID: 11. CATALOG COURSE DESCRIPTION: This course is designed to familiarize the student with the language of medicine. The components of medical terminology are highly beneficial for any individual with a healthcare employment objective. The course presents the components of medical works including word roots, combining forms, suffixes, and prefixes. Using medical terminology as a focal point, the systems of the body are discussed. Advisory: Level 2 Writing, Level 1 Reading. 12. GRADING METHOD S = Standard Letter Grade Default: A = Audit;P = Pass/No Pass;Pass/NoPass;A = Audit;CR Optional: 13. TOTAL UNITS: 3 14. INSTRUCTIONAL METHODS / UNITS & HOURS: Method Min Units Lecture 3 Lab 0 Min Hours 54 0 Activity 0 0 Open Entry/Open Exit 0 0 Volunteer Work Experience Paid Work Experience Non Standard 0 0 0 0 0 0 Non-Standard Hours Justification: 15. REPEATABILITY Type: 16. MATERIALS FEE: No 17. CREDIT BY EXAM: No 18. CORE MISSION APPLICABILITY: Associate Degree Applicable (AA/AS);Certificate of Achievement (COA);CSU Transfer;Career Technical Education (CTE) 19. STAND-ALONE: No 20. PROGRAM APPLICABILITY Required: Vocational Nursing (AS Degree Program) Vocational Nursing Cert (Certificate of Achievement) Elective: 21. GENERAL EDUCATION APPLICABILITY Local: file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C150.htm[4/8/2013 1:25:54 PM] HCRS C150 IGETC: CSU: UC Transfer Course: CSU Transfer Course: 22. STUDENT LEARNING OUTCOMES Upon completion of the course, the student will be able to 1. Define word root, combining form, suffix, and prefix 2. Divide medical words into their component parts 3. Describe how medical words are formed 4. List and define diminutive suffixes 5. List and define adjective suffixes 6. List and define noun suffixes 7. Identify prefixes of position, number and measurement, negation, and direction 8. List and briefly define the levels of organization in the human body 9. Define the main functions of the following body systems 1. Integumentary 2. Respiratory 3. Musculoskeletal 4. Cardiovascular 5. Genitourinary 6. Neurosensory 7. Endocrine 8. Reproductive 9. Lymphatic and Immunity 10. Gastrointestinal 10. Define terminology related to the following specialty areas: 1. Oncology 2. Pharmacology 3. Radiology 4. Psychology 11. Relate basic pathophysiology and disease processes utilizing medical terminology. 23. REQUISITES Advisory: Advisory 5 Writing - 2 Levels Prior to Transfer Advisory 5 Reading - 1 Level Prior to Transfer 24. DETAILED TOPICAL OUTLINE: Lecture: A. Medical Terminology Basics (A, B, C, D, E, F, G) 1. Word parts 2. Definitions 3. Common abbreviations 4. Common symbols B. Terminology related to the systems of the body (H, I, K) 1. Integumentary 2. Respiratory 3. Musculoskeletal 4. Cardiovascular 5. Genitourinary 6. Neurosensory 7. Endocrine 8. Reproductive 9. Lymphatic and immunity 10. Gastrointestinal C. Terminology related to specialty areas (J, K) 1. Oncology 2. Pharmacology 3. Radiology 4. Psychology 25. METHODS OF INSTRUCTION--Course instructional methods may include but are not limited to 1. Discussion; 2. Other Methods: Overhead transparencies or PowerPoint slides In class group discussions In class didactic exercises 26. OUT OF CLASS ASSIGNMENTS: Out of class assignments may include but are not limited to 27. METHODS OF EVALUATION: Assessment of student performance may include but is not limited to A. Completion of textbook exercises (A-K) file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C150.htm[4/8/2013 1:25:54 PM] HCRS C150 B. Chapter assignments (A-K) C. Exams or quizzes (A-K) 28. TEXTS, READINGS, AND MATERIALS: Instructional materials may include but are not limited to Textbooks Chabner, D. . (2004) Language of Medicine , 7th, Lippincott Manuals Periodicals Software Other 29. METHOD OF DELIVERY: Online (purely online no face-to-face contact) ; 30. MINIMUM QUALIFICATIONS: Health Care Ancillaries;Nursing (Masters Required); 31. APPROVALS: Origination Date 08/18/2010 Last Outline Revision Curriculum Committee Approval 05/06/2005 Board of Trustees State Approval UC Approval UC Approval Status CSU Approval 50 = Summer 2006 IGETC Approval CSU Approval Status IGETC Approval Status CSU GE Approval CSU GE Approval Status Data Element Changes Data Justification Course Element Changes Course Change Justification Course ID (CB00) CCC000368954 TOP Code (CB03) 1230.00 - Nursing*; Course Credit Status (CB04) D - Credit - Degree Applicable; Course Transfer Status (CB05) B = Transferable to CSU only Course Units of Credit Maximum High (CB06): 3 Course Units of Credit Minimum Low (CB07): 3 Course Basic Skills (BS) Status (CB08): N = Course is not a basic skills course. SAM Code (CB09): C = Occupational; Cooperative Education Course Status (CB10): Course Classification Code (CB11): Career-Technical Education; Course Special Status (CB13): N - Not Special; CAN Code (CB14): YYYYYY - Not qualified for CAN cod; CAN-Code Seq (CB15): XXXXXXXX = Not qualified for SEQ code (qual for CAN only); Course Prior to College Level (CB21): Not Applicable; Course Non-Credit Category (CB22): Not Applicable, Credit Course; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C150.htm[4/8/2013 1:25:54 PM] HCRS C150 Funding Agency Category (CB23): Not Applicable Course Program Status (CB24): 1 - Program Applicable; file:///G|/...0Affairs/Vice%20President/Substantive%20Change%20Proposal/Appendix%2016%20COR's%20for%20all%20courses/HCRS%20C150.htm[4/8/2013 1:25:54 PM]

Top subcategories

Top subcategories

Top subcategories

Top subcategories

Top subcategories

Top subcategories

Top subcategories

Top subcategories

Download BSAD C070 - Cerro Coso Community College