Download 2015-2016 FINAL Paramedic Handbook

Yale-New Haven Sponsor Hospital
Paramedic Education Program
Program Handbook
A NATIONALLY ACCREDITTED PROGRAM
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Copyright Yale-New Haven Sponsor Hospital Program Paramedic Handbook, 2015 - 2016
Administrative Offices and Classrooms:
77-D Willow Street
New Haven, Connecticut 06511
Phone: (203) 562-3320
Fax: (203) 562-9070
Web: www.sponsorhospital.org
University of New Haven
300 Boston Post Road
West Haven, CT 06516
Phone: 203-479-4232
[email protected]
This handbook contains information for all Yale-New Haven Sponsor Hospital Paramedic Students
including those matriculated with our degree partner the University of New Haven and those who are
certificate only program students
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Table of Contents
YALE-NEW HAVEN SPONSOR SPONSOR HOSPITAL AND THE UNIVERSITY OF NEW HAVEN
PARTNERSHIP
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THE YALE-NEW HAVEN SPONSOR HOSPITAL PROGRAM MISSION STATEMENT
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YALE-NEW HAVEN SPONSOR HOSPITAL PROGRAM (YNHSHP) EDUCATIONAL PHILOSOPHY 10
YALE-NEW HAVEN SPONSOR HOSPITAL PROGRAM RESOURCES
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NON DISCRIMINATION POLICY
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SEXUAL HARASSMENT POLICY
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SMOKE AND TOBACCO FREE POLICY
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DRUG AND ALCOHOL POLICY
12
BEHAVIORAL STANDARDS
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IN CLASS USE OF ELECTRONIC MEDIA
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CLASSROOM ATTIRE
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DRUG TESTING AND CRIMINAL RECORD CHECKS
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STUDENT RECORDS
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Release of and Access to Student Records:
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Petition by Student for Change in Personal Record:
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Permanence, Duplication and Disposal of Student Records:
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YALE-NEW HAVEN SPONSOR HOSPITAL PARAMEDIC PROGRAM GOAL
PARAMEDIC PROGRAM PHILOSOPHY
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DESCRIPTION OF THE PARAMEDIC PROFESSION
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FUNCTIONAL JOB ANALYSIS
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DESCRIPTION OF TASKS
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PROGRAM TECHNICAL STANDARDS
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YNHSHP PARAMEDIC EDUCATION PROGRAMS
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PROGRAM CURRICULUM
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Challenging a Module/Advanced Standing Applications/Credit for experiential or Prior Learning
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THE MODULAR YNHSH CERTIFICATE PROGRAM
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UNH DEGREE BASED PROGRAM
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CLINICAL SITES
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TEXTBOOKS
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National Registry of Emergency Medical Technicians
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PROGRAM ETHICS and PROFESSIONALISM
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YNHSHP HONOR CODE
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YNHSHP PARAMEDIC PROGRAM GRADE POLICY
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RETESTING POLICY
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MODULAR/COURSE GRADING POLICY
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SEMESTER CUMULATIVE EXAMS FOR UNH DEGREE PROGRAM STUDENTS
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FINAL CUMULATIVE COGNITIVE EXAMINATION
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APPEAL OF DIDACTIC GRADES
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HOMEWORK POLICY
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MODULE/COURSE COMPLETION
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SUCCESSFUL PROGRAM COMPLETION
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ACADEMIC COUNSELING
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ACADEMIC PROBATION
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GRIEVANCE PROCESS
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ATTENDANCE POLICY
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CANCELLATION OF CLASSES
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LEAVE OF ABSENCE
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WITHDRAWAL
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ADMINISTRATIVE PROBATION
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REINSTATEMENT AFTER PROBATION
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TRANSCRIPTS
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STUDENT GOVERNMENT
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“MODULE” DESCRIPTIONS
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ANATOMY AND PHYSIOLOGY I & II
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INTRODUCTION TO PARAMEDIC SKILLS
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PHARMACOLOGY
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TRAUMA EMERGENCIES
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CARDIOLOGY I
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CARDIOLOGY II
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CARDIOLOGY III
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MEDICAL/GERIATRIC EMERGENCIES
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OBSTETRIC/GYNECOLOGICAL EMERGENCIES
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PEDIATRIC EMERGENCIES
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PSYCHIATRIC EMERGENCIES
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ENVIRONMENTAL EMERGENCIES
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TOXICOLOGY
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HAZMAT for EMS
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THE ART OF PARAMEDICINE
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INCIDENT COMMAND SYSTEM FOR EMS PROVIDERS (NIMS)
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Laboratory Section
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Laboratory Documentation
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Safety and Procedures in the Laboratory
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DISEASE TRANSMISSION & ACTUAL PATIENT PERFORMANCE OF CPR
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Laboratory Safety Contingencies
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ANATOMY AND PHYSIOLOGY MODULE EDUCATIONAL OBJECTIVES
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PHARMACOLOGY EDUCATIONAL OBJECTIVES
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CARDIOLOGY EDUCATIONAL OBJECTIVES
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TRAUMA MODULE EDUCATIONAL OBJECTIVES
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OBSTETRICS/GYNECOLOGY MODULE EDUCATIONAL OBJECTIVES
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PEDIATRICS EDUCATIONAL OBJECTIVES
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MEDICAL AND GERIATRIC EMERGENCIES MODULE EDUCATIONAL OBJECTIVES
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INFECTIOUS DISEASE
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ANAPHYLAXIS
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NERVOUS SYSTEM
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ACUTE ABDOMEN
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ENDOCRINE EMERGENCIES
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GERIATRICS/GERONTOLOGY
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RESPIRATORY SYSTEM
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PSYCHIATRIC MODULE EDUCATIONAL OBJECTIVES
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TOXICOLOGY EDUCATIONAL OBJECTIVES
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ENVIRONMENTAL EMERGENCIES EDUCATIONAL OBJECTIVES
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PARAMEDIC MODULE EDUCATIONAL OBJECTIVES
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EMS SYSTEMS
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MEDICAL / LEGAL CONSIDERATIONS
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EMS COMMUNICATIONS
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RESCUE
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MAJOR INCIDENT RESPONSE
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HANDBOOK AGREEMENT
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Medical Forms
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Lab Sheet
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YNHSHP Clinical Interaction Evaluation Form
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CLINICAL INCIDENT REPORT FORM
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PROFESSIONAL BEHAVIOR EVALUATION
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PROFESSIONAL BEHAVIOR COUNSELING RECORD
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Student Contact Form
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Student Progress Report
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APPENDICES
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*Class Syllabus & Book List to be handed out on first day of class with electornic copy placed on the classes
online learning site.
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The Yale-New Haven Sponsor Hospital Program is accredited by the
Commission on Accreditation of Allied Health Education Programs
(www.caahep.org) upon the recommendation of the Committee on
Accreditation of Educational Programs for the Emergency Medical
Services Professions (CoAEMSP).”
“To contact CAAHEP:
Commission on Accreditation of Allied Health Education Programs
1361 Park Street
Clearwater, FL 33756
727-210-2350
www.caahep.org”
“To contact CoAEMSP:
8301 Lakeview Parkway, Suite 111-312
Rowlett TX 75088
(214) 703-8445
FAX (214) 703-8992
www.coaemsp.org”
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Section
I
Yale-New Haven
Sponsor Hospital Program
History, Mission Statement,
Structure and Programs Philosophy
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YALE-NEW HAVEN SPONSOR SPONSOR HOSPITAL AND THE UNIVERSITY OF NEW HAVEN
PARTNERSHIP
In 2014 Yale-New Haven Sponsor Hsopital Program (YNHSH) and the University of New Haven
(UNH) partnered to offer an A.S. and B.S Degree in Paramedicine. UNH students attend paramedic
specific classes at YNHSH and coordinate clinical experinces through YNHSH.
UNH Students are allowed to earn course credits consistent with UNH academic policies and will be
treated as being in good standing by the university in accordance with all standard UNH academic
policies. Students enrolled in the program must meet external requirements as set forth by the
Committee on Accreditation of Educational Programs for the Emergency Medical Services
Professions to continue in the program and will only receive licensure upon passage of the national
licensing examination as administered by the National Registry of Emergency Medical Technicians
or as excepted by any state licensing authority. Students admitted to the Paramedicine program must
also meet all program requirements as established by YNHSHP in order to be certified by YNHSHP
as having met all the requirements to sit for the registry exam.
UNH students enrolled in the UNH-YNHSHP Paramedicine academic degree program will be
subject to the same tuition and fees as all other UNH students, and will be treated the same as all
other UNH students for all types of university based programs and support, including but not limited
to financial aid programs. All academic Paramedicine program courses will be billed as part of
normal tuition charges to UNH enrolled students and will be administered in the same manner as all
other UNH programs. UNH will follow standard university policies with regard to tuition refunds,
billing, and student financial aid.
Students admitted to the UNH Paramedicine degree program and participating in credit earning
academic instruction at YNHSHP shall be considered to be governed by all policies and procedures
of the university. All academic policies of the university shall apply to instruction delivered at the
YNHSHP site. Students enrolled at the YNHSHP site will be treated as UNH students and UNH will
be responsible for all issues associated with academic program assessment and review. UNH
policies concerning the issuance of grades, grade appeals and supervision of instructional staff shall
apply to UNH academic courses delivered at the YNHSHP site. The Medical Director for YNHSHP
will continue to maintain responsibility for the YNHSHP Paramedic training certification program as
required for continuing accreditation by the Committee on Accreditation of Educational Programs for
the Emergency Medical Services Professions (CoAEMSP) and Commission on Accreditation of
Allied Health Education Programs (CAAHEP). YNHSHP will continue to be responsible for
certification that students have met all requirements as established by CoAEMSP and CAAHEP to be
able to sit for the Paramedic licensing exam. UNH will recognize the Paramedicine courses delivered
under this agreement at the YNHSHP facility as UNH courses and will assure that such courses are
recorded, transcripted, and credited as UNH courses.
Unless otherwise indicated UNH students are responsible for compliance with all aspects of this
program handbook.
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THE YALE-NEW HAVEN SPONSOR HOSPITAL PROGRAM MISSION STATEMENT
The Yale-New Haven Sponsor Hospital Program is committed to the promotion of excellence in all
aspects of out of hospital emergency health care systems.
OUR HISTORY AND MISSION
The Yale-New Haven Sponsor Hospital Program (YNHSHP) was founded in 1989 jointly by YaleNew Haven Hospital and the former Hospital of Saint Raphael.
Mission of the YNHSHP: The Emergency Medical Services (EMS) system is a vital component of the care
of many patients requiring hospital services. State of Connecticut legislation mandates that EMS providers
work through the auspices of a "Sponsor Hospital". In light of the legislation and to assure a high level of prehospital care to the greater New Haven area, the Hospital of Saint Raphael and Yale-New Haven Hospital
jointly operated a sponsor hospital program which combines the financial, clinical, and managerial resources
from both hospitals. In 2012 the Hospital of Saint Raphael ceased to exist and Yale-New Haven Hsospital
assumed the entire direction of the sponsor hospital program. The major goals of the hospitals in establishing
the Yale-New Haven Sponsor Hospital Program are as follows:
1. ensure standardization of pre-hospital care;
2. offer the highest quality of training and continuing medical education for all professionals involved in
EMS; and
3. maintain a comprehensive system which will aid pre-hospital personnel in providing high quality
professional patient care services.
Structure of the YNHSHP: To accomplish this mission Yale-New Haven Sponsor Hospital Program has two
intertwined branches: operations and education. The operations branch provides and manages medical
oversight for the sponsored EMS agencies and their providers of the New Haven participating hospitals.
Operations branch also operates the Sponsor Hospital Area Response Physicians (SHARP) Team with two
response vehicles to provide on-scene medical oversight and physician assistance in the field. The operations
branch is also active in EMS research.
The education branch provides refresher and continuing education for Yale-New Haven Sponsor Hospital
participating EMS services. The education branch provides initial provider education for all levels of
emergency medical service as well as public Emergency Medical Services education. Yale-New Haven
Sponsor Hospital Program is an American Heart Association (AHA) Training Center for all areas of
Emergency Cardiac Care Programs including traditional CPR training at all levels, Advanced Cardiac Life
Support (ACLS), Advanced Cardiac Life Support for Experienced Providers (ACLS EP), and Pediatric
Advanced Life Support (PALS) certification and recertification programs. YNHSHP provides skills
verification for AHA on line programs. YNHSHP is a training site for many other EMS continuing education
programs including those of the National Association of Emergency Medical Technicians (NAEMT), such as
NAEMT’s Pre-Hospital Trauma Life Support program in cooperation with the American College of Surgeons
Committee on Trauma and the Advanced Medical Life Support program in cooperation with the National
Association of EMS Physicians. YNHSHP also provides other nationally recognized programs including the
Pediatrics Education for Prehospital Professionals program, Geriatric Emergency Medical Services program
and others. YNHSHP also designs and delevers custom initial and continuing EMS education programs for
special groups.
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Governing Structure of the YNHSHP to assist in its mission:
The YNHSHP maintains three standing committees.
1. The Providers committee is made up of service representatives of the licensed EMS provider agencies
in the Yale-New Haven Sponsor Hospital catchment area.
2. The Operations committee oversees the operations section, day to day activities of YNHSHP and the
SHARP team.
3. The Paramedic Program Advisory Committee gives input to the direction of the Paramedic program
from various communities of interest. It is made up of representatives from Law Enforcement, the
Fire Service, Private EMS providers, Nursing, current and former students of YNHSHP, CMED, the
local hospitals and each of the following medical specialties: anesthesia, emergency medicine,
surgery and trauma services, psychiatry and pediatrics, there is also a representative of local
government and the CT. Office of Emergency Medical Services.
Yale-New Haven Sponsor Hospital Program is a part of the Yale-New Haven Hospital. The program’s faculty
and employees are employees of the Yale-New Haven Hospital and /or Yale University .
YALE-NEW HAVEN SPONSOR HOSPITAL PROGRAM (YNHSHP) EDUCATIONAL
PHILOSOPHY
In furtherance of the educational mission of Yale-New Haven Sponsor Hospital Program, we offer our
students a learning environment filled with problem-solving, critical thinking and “systems-thinking” in order
to ensure a strong base on which to build. Our emphasis on anatomy, physiology, and pathophysiology
provides YNHSHP students with the tools needed to address basic and advanced pre-hospital and out of
hospital medicine both today and in the future. Our programs exceed all Department of Transportation (DOT)
National Highway Traffic Safety Administration’s (NHTSA) National Standard Curriculum and National
Education Standard’s objectives and include optional skills adopted by many states. YNHSHP believes in
evidence driven medical practice and education. Our initial education programs such as the Paramedic
Program are not specific to local protocol. YNHSHP believes that good Advanced Life Support first and
foremost begins with a strong base of excellent Basic Life Support. YNHSHP initial provider programs are
directed toward providers who take responsibility for their own education, growth, and development and
especially for the professional behavior and attitude necessary for providers who will be the practitioners and
leaders of EMS in the future.
YALE-NEW HAVEN SPONSOR HOSPITAL PROGRAM RESOURCES
YNHSHP is a part of, and supported by, the resources of both Yale-New Haven Hospital and its campuses.
Yale-New Haven Hospital (YNHH) is a 900-bed tertiary care medical center and Level I trauma center that
includes the 201-bed Yale-New Haven Children's Hospital and the 76-bed Yale-New Haven Psychiatric
Hospital and the 511 bed Yale-New Haven campus, formerly known as Hospital of Saint Raphaels (HSR).
Both campuses are teaching hospitals for Yale University School of Medicine and other allied health
professions programs and are licensed by the State of Connecticut and accredited by the Joint Commission on
Accreditation of Healthcare Organizations (JCAHO) and the Accreditation Council for Graduate medical
Education (ACGME). YNHSHP in addition has contractual relationships with a number of other hospitals,
clinics and patient care settings for the purpose of providing student experiences all with the same or similar
accreditations and licensure. YNHSHP students will have rotations at the New Haven Central Medical
Communications (CMED) Agency and the Connecticut State Poison Control Center.
YNHSHP maintains close ties and contracts with a variety of EMS agencies in the immediate New Haven area
and beyond for the purpose of student field internship experiences including high volume urban and suburban;
transport, first response and intercept EMS services. These services represent fire based, private, and third
service agencies. Students may need to travel out of the New Haven area for additional field internship sites.
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At our New Haven campus, students have the use of a library containing over 300 EMS books, over 100
videos, and 10 monthly EMS and medical journal subscriptions. In addition we have a growing collection of
computerized EMS tutorial programs of interest to students of all levels. There are computer work stations and
Wi-Fi access for student use at the Willow street campus. In addition we have access to the libraries of Yale
University and Yale-New Haven Hospital. For access to these resources contact the YNHSHP faculty. The
Willow Street facilities have a student lounge and kitchenette, and multiple laboratory spaces and other study
spaces, when not scheduled for other programs, that are open for student use. Students are welcome to use the
Willow Street facility to study or practice with non-human invasive lab skills at any time we are open
including Monday through Saturday 0830 hrs to 1700 hrs and many evenings. Often faculty is on campus and
may be available ad hoc to assist with questions or additional laboratory practice time but students should
make an appointment to be sure of faculty availability.
YNHSHP maintains a web page which has “hot links” to faculty mailboxes for student questions or comments.
Our internet address is www.sponsorhospital.org and the link to faculty mailboxes can be found in the faculty
section of our home page. Our e-mail addresses are all structured as [email protected].
NON DISCRIMINATION POLICY
The Yale-New Haven Sponsor Hospital Program admits students on the basis of merit and without
discrimination on the basis of race, color, age, gender, national or ethnic origin, sexual orientation or marital
status to all of the rights, privileges, programs and activities generally accorded or made available to students
at the school. The Yale-New Haven Sponsor Hospital Program does not discriminate on the basis of race,
color, age, sex, marital status, national or ethnic origin, or sexual orientation in the administration of its
educational policies, admissions policies, scholarships and loan programs and athletic or other school
administered programs. In addition to the policy, UNH Non Discrimination Policy Page 75 of UNH Student
Handbook applies to UNH enrolled students.
SEXUAL HARASSMENT POLICY
Harassment on the basis of sex is a violation of Title VII of the Civil Rights Act of 1964 as amended.
Unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual
nature constitute sexual harassment when:
1. Submission to such conduct is made either explicitly or implicitly a term or condition of an
individual’s employment or student status;
2. Submission to or rejection of such conduct by an individual is used as the basis for
employment or program status decisions affecting such individual; or
3. Such conduct has the purpose or effect of unreasonably interfering with an individual’s work
performance or creating an intimidating, hostile, or offensive work or learning environment.
(Excerpt from U.S. Equal Opportunity Commission)
Any student who feels that they have been subjected to sexual harassment by a fellow student or faculty
member should fill out an incident report form as objectively as possible and submit it to the director of the
particular course, Educational Programs Coordinator or the YNHSHP Director or a member of YNHSHP
Operations Commetttee. A meeting will be held with the student writing the report to discuss the matter.
Sexual harassment allegations will be taken with the utmost of seriousness, fully investigated and this
behavior will not be tolerated. In addition to the policy, UNH Policies on Hazing and Harrassement Pages 99
- 114 of UNH Student Handbook applies to UNH enrolled students.
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SMOKE AND TOBACCO FREE POLICY
Recognizing that smoking and exposure to smoke and the use of nicotine in general is a major cause of
chronic health problems and preventable deaths, YNHSHP prohibits smoking and chewing of tobacco within
the classroom building in New Haven. This includes the use of “e-cigerettes”. Students who must smoke or
chew are expected to utilize the designated smoking area at the eastern corner of the parking lot across the
street. Cigarette butts must be disposed of properly in a trash receptacle. There is to be no smoking around
the doorways or walkways of 77 Willow Street. When YNHSHP courses are held away from the Willow
street campus, smoking and chewing will still be prohibited within the classroom. YNHSHP students will
follow the smoking policies of the host facility for designated smoking areas or will follow respective hospital
policy during clinical and field internships. Students should be aware that many clinical sites, including YaleNew Haven Hospital and its campus formerly known as Hospital of Saint Raphaels, do not allow tobacco use
anywhere on their property including in personal vehicles. Missing parts of classes or being absent from
clinical sites in order to use tobacco will be treated as an unexcused absence.
DRUG AND ALCOHOL POLICY
The use of drugs or alcohol or any substance for recreational purpose during class and clinical hours is
prohibited. In addition, students are expected to come to class and clinical rotations alert, fully functional and
ready to learn and participate fully in class or perform patient care. Any student who is found attending class
or clinical experiences under the influence of drugs or alcohol or suspected to be under the influence shall be
immediately suspended from class/clinical pending investigation and may be dismissed from the program. The
student may requested to provide sample for drug testing, at their own expense, as a condition of continued
matriculation with the program. YNHSHP believes that the ability to handle (and not abuse) substances that
have recreational use potential is an inherent responsibility of the EMT or the Paramedic. The inability to
manage substances such as ETOH reflects poorly on the potential of the student’s ability to handle this
responsibility in their future professional life. Many states will not license Paramedics with a history of law
infractions regarding drugs or alcohol.
Students who voluntarily approach the Education Programs Coordinator, YNHSHP Director or Medical
Director will be referred for professional assistance at the student’s expense. Continuation in the program will
be evaluated on case by case bases by the Education Coordinator in consultation with the YNHSHP Director
and the Medical Director. Students may be allowed temporary withdrawal and reenrollment at a later date
depending on an agreed remediation plan and the amount of the program missed. Enrollment in the next
available program may be necessary. In addition to the policy, UNH Policy for Drug Free Environment Pages
146 - 154 of UNH Student Handbook applies to UNH enrolled students.
BEHAVIORAL STANDARDS
Students will be evaluated constantly throughout all YNHSH Programs regarding academic performance,
clinical skills and judgment, and professional behavior.
Students are expected to conduct themselves in accord with the highest ethical standards expected of health
professionals. Because students, after graduation, may be licensed as health care professionals and may be
required to assume responsibility for the life and welfare of other human beings, every student is expected to
demonstrate a level of competence and patterns of behavior which are consistent with these professional
responsibilities and which are deserving of the public’s trust. The Program has the right and responsibility to
sever, at any time, its connection with any student considered in its opinion unfit for a career in the health or
related professions. Some behaviors are so severe or dangerous to staff or student well being that they may
require immediate dismissal from the program. Allegations of prohibited conduct will receive a thorough
review.
Prohibited conduct that may lead to immediate dismissal includes but is not limited to:
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1. Submitting material or demonstration by any means, including electronic, for: assignments,
examinations (including practical examinations) or other academic work, to include on JB learning , or
other class web learning system or FISDAP, which is based upon sources prohibited by the instructor
or the furnishing of materials to another person for the purposes of aiding another person to cheat,
including the use of social media to post answers and questions to previously taken quizzes and
exams. Cheating in any form will not be tolerated.
2. Submitting material by any means, including electronic, in assignments, examinations, or other
academic work, to include on JB learning , or other class web learning system or FISDAP, which is
not the work of the student in question and where there is no indication or citation in writing that the
work is not that of the student. This is also known as plagiarism. Plagiarism wills not be tolerated.
3. Knowingly producing false evidence or false statements, making charges in bad faith against any other
person, or making false statements about one’s own behavior related to educational or professional
matters. This includes entries on FISDAP and other class web learning systems.
4. Falsification, making false statements, or misuse of Program records, permits or documents. This
includes electronic and on-line records and exams including those on the FISDAP or JB learning or
other electronic learning systems.
5. Violating existing or amended YNHSH Program, Yale University, West Haven VA Hospital, YaleNew Haven Hospital and its campus the former Hospital of Saint Raphaels, Griffin Hospital or any
other affiliated clinical or internship site policies or regulations relating to non-academic matters.
6. Exhibiting behavior, which is disruptive to the learning process or to the academic or community
environment.
7. Obstruction or disruption of teaching, research, administration, disciplinary procedures, or other
institutional activities including the institution’s public service functions or other authorized activities
on institutionally owned or controlled property or that of the clinical and field internship affiliates.
8. Possession or use of firearms, explosives, dangerous chemicals or other dangerous weapons or
instrumentalities on institutionally owned or controlled property, or while in the role of student on any
property of a clinical or field internship affiliate in contravention of law or institutional rules.
9. Detention or physical or emotional abuse of any person or conduct intended to threaten imminent
bodily harm or endanger the health or welfare of any person. This includes sexual harassment.
10. Malicious damage, misuse or theft of institutional property, or the property of any other person where
such property is located on institutionally owned or controlled property or, regardless of location, is in
the care, custody or control of the institution. This applies to YNHSHP and all it’s affiliated clinical
and internship sites.
11. Unauthorized entry to or use of institutional facilities or equipment of YNHSHP or any other affiliated
clinical or internship site, including buildings and grounds.
12. Illegal use, possession, or distribution of drugs or weapons at any time.
13. Inciting others to engage in any of the conduct or to perform any of the acts prohibited herein. Inciting
means that advocacy of proscribed conduct, which calls upon a person or persons addressed for
imminent action, and is coupled with a reasonable apprehension of imminent danger to the functions
and purposes of the institution, including the safety of persons and the protection of its property.
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Any person who witnesses or has first-hand knowledge of the misconduct as described above is obligated to
send a written and documented report of the infraction to the Education Coordinator, the Medical Director or
the YNHSHP Director as soon as discovered. Any student who is arrested for any reason while matriculated
with YNHSHP must report this to the Education Coordinator before returning to any function of the program.
IN CLASS USE OF ELECTRONIC MEDIA
Yale-New Haven Sponsor Hospital Program Acceptable Computer and Network Usage Policy:
We expect electronic equipment in the classroom will always be used as part of the learning process and not
for extra curricular activities during the class time. All cell phones must make no noise or disturbance during
class time. Texting, facebook communications or other such activites are prohibited during class time.
This acceptable use policy governs the use of computers and networks on the Yale-New Haven Sponsor
Hospital Program campus. As a user of these resources, you are responsible for reading and understanding this
document. This document protects the consumers of computing resources, computing hardware and networks,
and system administrators. This document is a license. Use of any Yale-New Haven Sponsor Hospital
Program’s computing resource implies acceptance of the term of this license agreement. In general, acceptable
use means respecting the rights of other computer users, the integrity of the physical facilities and all pertinent
license and contractual agreements. If an individual is found to be in violation of the Acceptable Use Policy,
the Program will take disciplinary action, including the restriction and possible loss of network privileges. A
serious violation could result in more serious consequences, up to and including suspension or termination
from the Program. Individuals are also subject to federal, state and local laws governing many interactions that
occur on the Internet. These policies and laws are subject to change as state and federal laws develop and
change.
The uses of the Yale-New Haven Sponsor Hospital Program’s computer resources are provided for academic
use. Conduct which violates this policy includes, but is not limited to the activities in the following list:
1. Unauthorized use of a computer account.
2. Using the Campus Network to gain unauthorized access to any computer systems.
3. Connecting unauthorized peripherals to any Yale-New Haven Sponsor Hospital Program’s
computers.
4. Unauthorized attempts to circumvent data protection schemes or uncover security loopholes. This
includes creating and/or running programs that are designed to identify security loopholes and/or
decrypt intentionally secure data.
5. Knowingly or carelessly performing an act that will interfere with the normal operation of
computers, terminals, peripherals, or networks.
6. Knowingly or carelessly running or installing software programs on any computer system or
network, or giving to another user a program intended to damage or to place excessive load on a
computer system or network. This includes, but is not limited to, programs known as computer
viruses, Trojan Horses, and worms.
7. Deliberately wasting/overloading computing resources, such as printing documents without prior
authorization or too many copies of a document.
8. Violating terms of applicable software licensing agreements or copyright laws.
9. Violating copyright laws and their fair use provisions through inappropriate downloading,
reproduction or dissemination of copyrighted audio, video, text, images, etc.
10. Using program resources for commercial activity such as creating products or services for sale.
11. Using electronic mail to harass or threaten others. This includes sending repeated, unwanted email to another user.
12. Use of peer to peer (p2p) file sharing software of any kind.
13. Inappropriate mass mailing. This includes multiple mailings to newsgroups, mailing lists, or
individuals, e.g. "spamming," "flooding," or "bombing."
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14. Forging the identity of a user or machine in an electronic communication.
15. Transmitting or reproducing materials that are slanderous or defamatory in nature or that
otherwise violate existing laws or program regulations.
16. Displaying obscene, lewd, sexually harassing images, hate speech or text that is not directly
related to academic research or assignments in a public computer facility.
17. Attempting to monitor or tamper with another user's electronic communications, or reading,
copying, changing, or deleting another user's files or software without the explicit agreement of
the owner.
CLASSROOM ATTIRE
YNHSHP recognizes students need to be comfortable in order to enhance learning. Professionalism and
appearance are part of the affective domain objectives of all of the programs at YNHSHP. In order to strike a
balance between these two issues and creative an environment that is comfortable to all students, classroom
attire should be neat, clean and modest. Undergarments should always be covered, and red polo shirts with
Sponsor Hospital logo and Navy Blue EMS pants will be worn during class. The opportunity to order and
purchase Yale-New Haven Sponsor Hopstial red polos will be handeled on day one of class. Due to the use of
realistic simulations in the classroom and the possibility of students getting moluge blood or other fluids on
their uniform it is highly recommended that students keep a second set of clothing in their car. All clothes
should be loose enough for movement in laboratory situations but not so loose that it will fall off during
exercises or expose the student. No open toe shoes, heels or sneakers allowed in class, ONLY black workboots
or dress shoes are to be worn. See the clinical section regarding attire standards for clinical and field internship
sites.
DRUG TESTING AND CRIMINAL RECORD CHECKS
Some clinical or field internship sites may require drug and/or criminal record checks. If a student wishes to
attend that clinical or field internship site or if there are no alternative sites for a particular clinical experience
required of the program then the student will need to obtain those at their own expense. Students should be
aware that the NREMT and many states may not allow candidates to become registered or licensed if they
have certain criminal convictions. The program may require drug testing as part of remediation plans for
students on academic or administrative probation.
STUDENT RECORDS
The Program shall create and maintain records containing information concerning a student furnished by the
student or by others at the student’s or the Program’s request, including but not limited to application
materials, records of grades attained, information concerning discipline and counseling, clinical performance,
and other individual student behavioral records. Official records of current students shall be maintained by the
Education Coordinator. Records will not be removed from the YNHSHP office. Students shall be responsible
for notifying the Program staff of changes including but not limited to address, email address, phone numbers,
cell phone numbers and employment status, and other directory information within one (1) week of said
changes. Failure to do so may result in administrative probation or program suspension.
Release of and Access to Student Records:
Every endeavor is made to keep the student's record confidential and out of the hands of those who would use
it for other than legitimate purposes. All members of the faculty, administration, and clerical staff will respect
confidential information about students which they acquire in the course of their work. At the same time, the
program will be flexible enough in its policies not to hinder the student, the institution, or the community in
their legitimate pursuits. This policy is intended to fully comply with The Family Educational Rights and
Privacy Act of 1974, Pub. L.90-247, as amended. Student’s records and information may only be released
when authorized by the student to do so. This restriction includes release to any employers and/or sources of
funding. Such authorizations must be written and kept with the students file. Personal records may be
disclosed to state, or statutorily authorized federal officials or employees who need the information in order to
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fulfill their official, professional responsibilities as required by law. Disclosure of personally identifiable
information may also be disclosed to accrediting organizations when necessary to their accrediting functions.
Education records will be forwarded on request to any other school in which a student seeks or intends to
enroll upon written request only. See transcripts request section. The first copy of transcripts will be no charge
and subsequent copies are fifteen dollars ($15.00) each. Personal records may not be released to any other
person or agency without the student’s written consent, unless on receipt of a subpoena or other court order or
process. The Education Coordinator may make an exception to the foregoing rule and may disclose personally
identifiable information from the educational records of a student to appropriate parties in connection with an
emergency if knowledge of the information is necessary to protect the health or safety of the student or other
individual. The need to make information regarding students available for research is acknowledged. The
Program shall provide adequate provisions to conceal the identity of students whose personal data or
information is included in research.
Petition by Student for Change in Personal Record:
The student shall have the right to review with the Education Coordinator, YNHSHP Director or Medical
Director, information contained in the student’s records, and to petition the Education Coordinator, YNHSHP
Director and Medical Director for additions or deletions to the record where the accuracy of the information is
in question, except in the following instances:
Records created or maintained by a physician, psychiatrist, psychologist, or other recognized professional or
para-professional acting in a professional or para-professional capacity or assisting in that capacity.
Records created, maintained or used only in connection with the provision of treatment to the student and not
disclosed to anyone other than individuals providing the treatment; provided that the records can be reviewed
by a physician or other appropriate professional of the student’s choice.
Records relating exclusively to an individual in that individual’s capacity as an employee.
Confidential letters or statements of recommendation will not be accessible by the student.
Permanence, Duplication and Disposal of Student Records:
Individual student records shall be maintained by the Program for a period of seven years.
Duplication of student records shall be done only with the express authorization of the Education Coordinator
or YNHSHP Director and these duplicate student records shall be destroyed in a manner assuring
confidentiality when no longer essential. In addition to the policy, UNH Academic Policy and Regulations
Page 45 of UNH Student Handbook applies to UNH enrolled students.
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Section
II
Paramedic Education Programs
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YALE-NEW HAVEN SPONSOR HOSPITAL PARAMEDIC PROGRAM GOAL
Yale-New Haven Sponsor Hospital’s Paramedic Program goal is to produce competent, entry-level paramedics
who are capable of serving in career and volunteer roles in traditional prehospital, out-of-hospital, urban,
suburban, rural, wilderness and non-traditional EMS settings.
PARAMEDIC PROGRAM PHILOSOPHY
As the healthcare field grows, faces changes, and makes advances, so do our programs at YNHSHP. The
traditional role of paramedics as solely rapid care and transportation to a hospital is being challenged.
Paramedics are now seen as critical care providers practicing in a “street medicine” setting. A number of
healthcare systems in our country have embraced the utilization of paramedics in non-traditional roles and
settings. YNHSHP’s candidates will be trained to provide for patients at home, in clinics, and in private
practices as well as emergency care in street and extended care settings. Our Paramedic graduates and
affiliated faculty are currently employed and have experience in a variety of traditional and non-traditional
settings including transporting and non transporting EMS, critical and specialty care transport special
operations medicine, walk-in clinics, remote construction sites, and hospital emergency rooms.
DESCRIPTION OF THE PARAMEDIC PROFESSION
Paramedics have fulfilled prescribed requirements by a credentialing agency to practice the art and science of
out-of-hospital medicine in conjunction with medical direction. Through performance of assessments and
providing medical care, their goal is to prevent and reduce mortality and morbidity due to illness and injury.
Paramedics primarily provide care to emergency patients in an out-of-hospital setting.
Paramedics possess the knowledge, skills, and attitudes consistent with the expectations of the public and the
profession. Paramedics recognize that they are an essential component of the continuum of care and serve as
linkages among health resources.
Paramedics strive to maintain high quality, reasonable cost health care by delivering patients directly to
appropriate facilities. As an advocate for patients, paramedics seek to be proactive in affecting long term
health care by working in conjunction with other provider agencies, networks, and organizations. The
emerging roles and responsibilities of the Paramedic include public education, health promotion, and
participation in injury and illness prevention programs. As the scope of service continues to expand, the
Paramedic will function as a facilitator of access to care, as well as an initial treatment provider.
Paramedics are responsible and accountable to medical direction, the public, and their peers. Paramedics
recognize the importance of research and actively participate in the design, development, evaluation, and
publication of research. Paramedics seek to take part in life-long professional development, peer evaluation,
and assume an active role in professional and community organizations.
FUNCTIONAL JOB ANALYSIS
The Functional Job Description is outlined here and describes the required skills and job requirements
essential to EMS personnel.
Paramedic Characteristics from DOT NHTSA
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The Paramedic must be a confident leader who can accept the challenge and high degree of responsibility
entailed in the position. The Paramedic must have excellent judgment and be able to prioritize decisions and
act quickly in the best interest of the patient, must be self-disciplined, able to develop patient rapport,
interview hostile patients, maintain safe distance, and recognize and utilize communication unique to diverse
multicultural groups and ages within those groups. The Paramedic must be able to function independently at
optimum level in a non-structured environment that is constantly changing.
Even though the Paramedic is generally part of a two-person team generally working with a lower skill and
knowledge level Basic EMT, it is the Paramedic who is held responsible for safe and therapeutic
administration of drugs; including narcotics. Therefore, the Paramedic must not only be knowledgeable about
medications but must be able to apply this knowledge in a practical sense. Knowledge and practical
application of medications include thoroughly knowing and understanding the general properties of all types of
drugs including analgesics, anesthetics, anti-anxiety drugs, sedatives and hypnotics, anti-convulsants, central
nervous stimulants, psychotherapeutics which include antidepressants, and other anti-psychotics,
anticholinergics, cholinergics, muscle relaxants, anti-dysrhythmics, anti-hypertensives, anticoagulants,
diuretics, bronchodilators, opthalmics, pituitary drugs, gastro-intestinal drugs, hormones, antibiotics,
antifungals, anti-inflammatories, serums, vaccines, anti-parasitics, and others.
The Paramedic is personally responsible, legally, ethically, and morally for each drug administered, for using
correct precautions and techniques, observing and documenting the effects of the drugs administered, keeping
one’s own pharmacological knowledge-base current as to the changes and trends in administration and use,
keeping abreast of all contraindications to administration of specific drugs to patients based on their
constitutional make-up, and using drug reference literature.
The responsibility of the Paramedic includes obtaining a comprehensive drug history from the patient that
includes names of drugs, strength, daily usage and dosage. The Paramedic must take into consideration that
many factors, in relation to the history given, can affect the type medication to be given. For example, some
patients may be taking several medications prescribed by several different doctors and some may lose track of
what they have or have not taken. Some may be using non-prescription/over the counter drugs. Awareness of
drug reactions and the synergistic effects of drugs combined with other medicines and in some instances, food
is imperative. The Paramedic must also take into consideration the possible risks of medication administered
to a pregnant mother and the fetus, keeping in mind that drugs may cross the placenta.
The Paramedic must be cognizant of the impact of medications on pediatric patients based on size and weight,
special concerns related to newborns, geriatric patients and the physiological effects of aging such as the way
skin can tear in the geriatric population with relatively little or no pressure. There must be an awareness of the
high abuse potential of controlled substances and the potential for addiction; therefore, the Paramedic must be
thorough in report writing and able to justify why a particular narcotic was used and why a particular amount
was given. The ability to measure and remeasure drip rates for controlled substances/medications is essential.
Once medication is stopped or not used, the Paramedic must send back unused portions to the proper inventory
area.
The Paramedic must be able to apply basic principles of mathematics to the calculation of problems associated
with medication dosages, perform conversion problems, differentiate temperature reading between centigrade
and Fahrenheit scales, be able to use proper advanced life support equipment and supplies (i.e. proper size of
intravenous needles) based upon a patient’s age and condition of veins, and be able to locate sites for obtaining
blood samples and perform these tasks, administer medication intravenously , administer medications by
gastric tube, administer oral medications, administer rectal medications, and comply with universal
precautions and body substance isolation, disposing of contaminated items and equipment properly.
The Paramedic must be able to apply knowledge and skills to assist overdosed patients to overcome trauma
through antidotes, and have knowledge of poisons and be able to administer treatment. The Paramedic must
be knowledgeable as to the stages drugs/medications go through once they have entered the patient’s system
and be cognizant that route of administration is critical in relation to patient’s needs and the effect that occurs.
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The Paramedic must also be capable of providing advanced life support emergency medical services to
patients including conducting of and interpreting electrocardiograms (EKGs), electrical interventions to
support the cardiac functions, performing advanced endotracheal intubations in airway management and relief
of pneumothorax and administering of appropriate intravenous fluids and drugs under direction of off-site
designated physician.
The Paramedic is a person who must not only remain calm while working in difficult and stressful
circumstances, but must be capable of staying focused while assuming the leadership role inherent in carrying
out the functions of the position. Good judgment along with advanced knowledge and technical skills are
essential in directing other team members to assist as needed. The Paramedic must be able to provide top
quality care, concurrently handle high levels of stress, and be willing to take on the personal responsibility
required of the position. This includes not only all legal ramifications for precise documentation, but also the
responsibility for using the knowledge and skills acquired in real life threatening emergency situations.
The Paramedic must be able to deal with adverse and often dangerous situations which include responding to
calls in districts known to have high crime and mortality rates. Self-confidence is critical, as is a desire to
work with people, solid emotional stability, a tolerance for high stress, and the ability to meet the physical,
intellectual, and cognitive requirements demanded by this position.
Physical Demands
Aptitudes required for work of this nature are good physical stamina, endurance, and body condition that
would not be adversely affected by frequently having to walk, stand, lift, carry, and balance at times, in excess
of 125 pounds. Motor coordination is necessary over uneven terrain. The patient’s, the Paramedic’s and other
workers’ well being must not be jeopardized.
Comments
The Paramedic provides the most extensive pre-hospital care and may work for fire departments, private
ambulance services, police departments or hospitals. Response times for nature of work are dependent upon
nature of call. For example, a Paramedic working for a private ambulance service that transports the elderly
from nursing homes to routine medical appointments and checkups may endure somewhat less stressful
circumstances than the Paramedic who works primarily with 911 calls in districts known to have high crime
rates. Thus, the particular stresses inherent in the role of the Paramedic can vary, depending on place and type
of employment.
However, in general, in the analyst’s opinion, the Paramedic must be flexible to meet the demands of the everchanging emergency scene. When emergencies exist, the situation can be complex and care of the patient
must be started immediately. In essence, the Paramedic in the EMS system uses advanced training and
equipment to extend emergency physician services to the ambulance.
The Paramedic must be able to make accurate independent judgments while following oral directives. The
ability to perform duties in a timely manner is essential, as it could mean the difference between life and death
for the patient.
Use of the telephone or radio dispatch for coordination of prompt emergency services is required, as is a pager,
depending on place of employment. Accurately discerning street names through map reading, and correctly
distinguishing house numbers or business addresses are essential to task completion in the most expedient
manner. Concisely and accurately describing orally to dispatcher and other concerned staff, one’ s impression
of patient’s condition, is critical as the Paramedic works in emergency conditions where there may not be time
for deliberation. The Paramedic must also be able to accurately report orally and in writing, all relevant
patient data. At times, reporting may require a detailed narrative on extenuating circumstances or conditions
that go beyond what is required on a prescribed form. In some instances, the Paramedic must enter data on a
computer from a laptop in the ambulance. Verbal skills and reasoning skills are used extensively.
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DESCRIPTION OF TASKS
(Encompasses the range of all tasks performed by lower level EMT’s)
Answers verbally to telephone or radio emergency calls from dispatcher to provide advanced efficient and
immediate emergency medical care to critically ill and injured persons using a full range of equipment.
Drives ambulance to scene of emergency, reads map, responds safely and quickly to the address or location as
directed by radio dispatcher, observes traffic ordinances and regulations. Visually inspects and assesses or
“sizes up”: the scene upon arrival to determine if scene is safe, determines the mechanism of illness or injury,
the total number of patients involved, and remains calm and confident while demonstrating leadership and
responsibility. Radios dispatcher for additional help or special rescue and / or utility services. Reports verbally
to the responding EMS unit or communications center as to the nature and extent of injuries and the number of
patients. Recognizes hazards. Conducts triage, sorting out and classifying priorities for most immediate need
for treatment. Uses excellent judgment to identify priorities based on the most critical needs for patient
survival.
Searches for medical identification as a clue in providing emergency care, i.e. identification bracelet for patient
who is diabetic. Reassures patient and bystanders while working in a confident and efficient manner, avoids
misunderstandings and undue haste while working expeditiously to accomplish the task. Extricates patient
from entrapment, works with other EMS providers in rendering emergency care and protection to the
entrapped patient. Performs emergency moves, assists other EMS providers in the use of prescribed
techniques and appliances for safe removal of the patient.
Determines nature and extent of illness or injury in patient, takes pulse, blood pressure, and temperature,
visually observes patient, recognizes the mechanism of injury, takes, comprehensive medical history of
patient, including patient’s current usage of prescribed and non-prescribed medications/drugs. Communicates
with and provides verbal direction to Basic EMT to assist with tasks within the Basic’s scope of practice.
Obtains consent and/or refusal. Uses good judgment to draw conclusions with often limited information;
verbally communicates effectively to provide quality treatment to diverse age and cultural groups. Provides
family support, manages the difficult patient, conducts fundamental mental status assessment, restrains patient,
and intervenes pharmacologically.
Positions unresponsive patient, protects the seizing patient, identifies and treats the hypoglycemic patient,
provides heating/cooling intervention, manages burns and exposures, overdoses, conducts ingestion
management. Manually stabilizes neck and body of child and adult, immobilizes extremities, straightens
selected fractures and reduces selected dislocations. Delivers newborn. Provides pre-hospital emergency care
of simple and multiple system trauma such as controlling hemorrhage, bandaging wounds, manually
stabilizing painful, swollen joints and injured extremities, and immobilizing spine.
Uses basic and advanced life support equipment to open airway and upper airway adjuncts, removes foreign
bodies, uses upper airway suction devices, performs orotracheal intubation, nasotracheal intubation, oral
intubation with pharmacological assistance and surgery on airway. Uses dual or single lumen airway devices.
Provides mouth to mouth barrier device ventilation, oxygen administration, chest injury management, bagvalve mask resuscitation. Uses powered ventilation devices, hand held aerosol nebulizer. Performs cardiopulmonary resuscitation, uses automatic defibrillator apparatus in application of electric shock to heart,
manages amputation, uses anti-shock garment, conducts peripheral venous access, intraosseous infusion,
manual defibrillation, interprets EKGs, uses external pacemaker.
Administers medication (narcotics), determines the patient’s most appropriate body route based on patient
diagnosis. Calculates amount of medication to be given in relation to patient’s weight, age and other factors
that warrant adjustment of volume. Uses oral, auto-injection, sublingual, inhalation, subcutaneous,
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intramuscular, intraosseous, transcutaneous, rectal, endotracheal, and intravenous routes including central and
peripheral lines and venesection as well as infusion pumps to administer medications.
Assists other EMS providers in lifting patient onto stretcher, places patient in ambulance, secures stretcher.
Continues to monitor patient enroute to the hospital.
Checks, maintains vehicles, and provides mechanical report. Restocks and replaces used supplies, uses
appropriate disinfecting procedures to clean equipment, checks all equipment to insure adequate working
condition for next response. Takes inventory of and accounts for all medications (narcotics) given. Keeps log
of all transactions. Prepares accurate and legible medical reports. Provides medical reports to staff.
Transports non-emergency patients to regularly scheduled appointments, for example, transport geriatric
patients in nursing homes. Uses computer to enter data for EMS reports.
Supervises the activities and educational experiences of assigned observers and students. Complies with
regulations in handling the deceased.
Functions as the primary direct care provider of emergency health care services to sick and injured patients in
pre-hospital settings. Works primarily in advanced life support units affiliated with fire departments, police
departments, rescue squads, hospitals, or private ambulance services under the off-site supervision of a
physician, usually through radio communication, is usually the senior level member of a two person team,
working in conjunction with a Basic EMT.
Accepts primary responsibility for all aspects of advanced life support given to the patient, including use of
advanced life support equipment and administration of medication that includes narcotics; responsible for
thorough written documentation of all activity related to patient care and medication dispensation.
Successfully completes continuing education and refresher courses required by employers, medical direction,
and licensing or certifying agencies. Meets qualifications within the functional job analysis.
-1999 NATIONAL STANDARD DOT EMT-PARAMEDIC CURRICULUM
PROGRAM TECHNICAL STANDARDS
As a student in the Yale-New Haven Sponsor Hospital’s Paramedic Program, you should be aware that certain
physical and mental abilities will be needed to successfully complete portions of your classroom, clinical and
field internship requirements. The following technical standards describe the physical and mental abilities
necessary to complete the PARAMEDIC program and to practice as a paramedic in the field. These are NOT
standards for admission.
A PARAMEDIC must possess the physical capability, mental capacity and sufficient strength and motor
coordination required to perform the following:
1.
2.
3.
4.
5.
6.
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Lift, carry and balance a minimum of 125 lbs (250 with assistance) for the purpose of frequently
lifting patients and stretchers often over uneven ground and footing.
Demonstrate manual dexterity, good motor skills, eye-hand coordination skills, and
sensory functions using both upper and lower extremities. You must be able to
perform these skills in confined spaces or under time constraints as well.
See and hear in a manner sufficient to respond to emergencies and assess patients
while working alone often in an environment with loud noises and flashing lights and other
distractions. To include reading and interpreting both fine print and signs at a distance and under time
constraint.
Drive an ambulance or rescue unit under emergency conditions, as well as at night and in adverse
weather conditions.
Stand and walk for sustained periods of time.
Write and orally communicate under stressful conditions promptly and effectively.
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Express or exchange ideas and interact with patients, peers, and other medical staff in
person, or via portable radio in a professional manner in English.
8. Work with frequent interruptions and respond appropriately to unexpected situations.
Work throughout an entire work shift with wide variations in work load and stress levels.
9. Cope with personal stresses (e.g. mood changes, loss of concentration) in a way that
does not interfere with performance.
10. Demonstrate appropriate judgment and decision-making skills under highly stressful
situations.
7.
Essential Functions and Standards for Successful Performance
To successfully complete the classroom and clinical components of the YNHSHP Paramedic program, the
paramedic student must, either independently or with reasonable accommodation, be able to perform all of the
following essential functions within a limited time frame:
1. Speech: Establish interpersonal rapport and communicate verbally and in writing with clients,
physicians, peers, family members, and the health care team from a variety of social, emotional,
cultural, and intellectual backgrounds.
2. Hearing: Auditory acuity sufficient to respond to verbal instruction, perceive and interpret various
equipment signals, use the telephone, and hear faint body sounds.
3. Vision: Visual acuity sufficient to identify and distinguish colors, read handwritten orders and any
other handwritten or printed data such as medication
4. records or scales, chart data, and provide for the safety of clients' condition by clearly viewing
monitors and other equipment in order to correctly interpret data.
5. Mobility: Stand and/or walk eight-twelve hours daily in the clinical or field setting. Bend, squat,
or kneel. Assist in lifting or moving clients of all age groups
6. and weights. Assist in lifting and transporting the ambulance stretcher. Perform cardiopulmonary
resuscitation (move around client to manually compress chest and ventilate). Work with arms fully
extended overhead. Work in non-climate controlled environments.
7. Manual Dexterity: Demonstrate eye/hand coordination sufficient to manipulate equipment
(syringes, infusion pumps, EKG machines, etc.).
8. Fine Motor Ability: Ability to use hands for grasping, pushing, pulling, and fine manipulation.
Tactile ability sufficient for physical assessment.
9. Mentation: Maintain reality orientation for at least a twelve-hour period of time.
10. Assimilate, organize and apply knowledge and skills acquired through lectures, discussions, and
readings.
11. Smell: Olfactory ability sufficient to monitor and assess health needs.
12. Writing: Ability to organize thoughts and present them clearly and logically in writing.
13. Reading: Ability to read and understand written directions, instructions and comments in both
classroom and clinical setting
In summary,…the general environmental conditions in which the Paramedic works cannot be adequately
assessed in an indoor evaluative environment. Because of the variance in climate, environmental conditions
and locations in the United States and the infinite possibilities in which a Paramedic is expected to provide
advanced life support, working conditions, at best, may be less than optimal. The Paramedic must be able to
focus on providing the best care possible in often adverse and dangerous situations. This can include servicing
neighborhoods known to have high crime rates and performing optimally in situations where multiple
incidents and trauma exist, i.e. a major highway accident that involves numerous persons and vehicles. The
Paramedic may be required frequently to walk, climb, crawl, bend, push, or lift and balance over less than
ideal terrain, such as an icy highway, muddy ground, dilapidated stairs/flooring, and any other scenario or
combination of scenarios. There may be exposure to a variety of noise levels, which at times can be quite
high, particularly when multiple sirens are sounding, and crowds/bystander/s families are upset and may be
screaming, crying hysterically, and making demands that may or may not be reasonable.
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Applicants who feel they may be deficient in one or more of the areas mentioned above should speak
with the Education Coordinator or YNHSHP Director. We will seriously consider applicants who are
deficient in any of these areas providing the deficiency can be remedied or reasonably accommodated.
When the YNHSHP faculty and the Medical Director of the Paramedic Program recommend a student for
licensing or certification examinations as part of graduation, the faculty is verifying that the student has met all
of the requirements of the school, the National Standard Curriculum and National Education Standards and can
safely perform at the level of a Paramedic. There are accommodations that are not allowed in the program
because they are not in compliance with the essential job functions of a paramedic as outlined in the
Functional Job description above. These include but may not be limited to:
1. Students are not allowed additional time for skills with specific time frames.
Obviously patients would suffer due to life threatening conditions in emergency
situations if treatment were delayed.
2. Students are not allowed unlimited time to complete a written exam.
This request is not considered reasonable because a candidate should be able to
complete a test (problem solve) within a finite amount of time. Time frame allowed will depend on
the length of the test.
3. Students are not allowed to have written exams given by an oral reader.
The ability to read and understand small English print is an essential function of the
profession, and written exams are designed, at least in part, to measure that ability.
4. Students are not provided a written exam with a reading level of less than grade eight.
The EMS profession requires a reading level of at least grade eight to work safely and
efficiently. Text books used may exceed this reading level.
5. Students must answer all written test questions as written..
No explanation of the question can be provided by the test proctor or any other individual.
Additional descriptions of test questions would not be a reasonable accommodation because reading
and understanding written English is an essential part of EMS communications. Student must be able
to understand and converse in medical terms appropriate to the profession.
6. Students must complete some skills under certain conditions designed to mimic realistic situations.
The ability to operate in physically and mentally demanding or stressful situations is an essential
function of the profession.
Because of the critical nature of the tasks needed in emergency situations, accommodation requests
are considered very carefully, on a case by case basis. The safety and welfare of the community must
be insured while providing full protection of the certification applicant’s rights. The main question to be
considered is: with the accommodation being requested, can this individual perform the essential
functions of the job safely and efficiently?
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YNHSHP PARAMEDIC EDUCATION PROGRAMS
PROGRAM CURRICULUM
At YNHSHP we recognize that many of our Paramedic students are already practicing members of the
Emergency Medical Services (EMS) community either in career or volunteer roles. Taking this into
consideration, along with part and full-time job commitments and family and home responsibilities, YNHSHP
has designed our programs for working adult learners. With flexibility and choices built into our programs,
students can more easily attain their goal of becoming a paramedic. However, this philosophy requires that the
student is self-directed and self-motivated. Time management is a key responsibility of the student and is
essential to successful completion of the program.
Challenging a Module/Advanced Standing Applications/Credit for experiential or Prior Learning
Yale-New Haven Sponsor Hospital Paramedic Program is approved by and operated under the regulations of
the State of Connecticut Department of Public Health Office of Emergency Medical Services. The current state
regulations do not allow for advanced placement or challenge of any part of the paramedic program. Many
applicants may have completed portions of some of the modules, for example, ACLS in the Cardiology
module. Although we recognize the substantial work that you have put into such a certification, we cannot
exempt you from part of the module as the information for such a certification is integrated throughout our
entire module. In all cases we require that the student successfully complete the module final exam and
demonstrate laboratory skills to the satisfaction of the Program Director and Medical Director.
THE MODULAR YNHSH CERTIFICATE PROGRAM
In this format the YNHSHP paramedic curriculum is broken up into subject areas or “modules”. These
modules are similar to a college course. The modules or courses all togeather make up the entire program.
Each subject area, a module, has didactic, psychomotor and affective educational objectives to be completed in
each of the three areas of the classroom, the laboratory, and clinical or field sites. In order to successfully
complete a module, the didactic, psychomotor and affective domain skills must be successfully demonstrated
in all three areas. See the grading policies below. All modules stand alone and all must be independently
completed for successful program graduation. Some modules have to be completed as prerequisite to others.
It is expected that the student will schedule a minimum of eight (8) hours per week to attend clinical following
successful completion of the Prepatory Module. After the didactic section ends for each section the student
has one full year to complete the remaining clinical requirements and field internship. The field internship
must be completed after all other requirements are completed. Students in good standing are welcome to audit
any didactic portion of another section. If a student wishes to get additional laboratory time with other than
their own section, this available but they must make arraignments with the faculty to insure enough laboratory
instructors are present ahead of time.
YNHSHP uses an on line learning system for the paramedic programs called JB Learning. All students will be
given individual accounts to this system. There are many additional resources to support the texts and class
discussions that will be found on this system. Quizzes, interactive class discussions and other materials will be
posted to this site for students to complete outside of class time. Terminals and WIFI access are available at
our facilities on Willow Street for students that do not have other access. Students may also log on to the
system from any internet access.
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UNH DEGREE BASED PROGRAM
In this format the UNH degree based paramedicine curriculum is broken up into 3 and 4 credit semester
based courses. Thease courses are the same as the modules above. Each course, has didactic, psychomotor
and affective educational objectives to be completed in each of the three areas of the classroom, the
laboratory, and clinical or field sites. In order to successfully complete the paramedcine program, the
didactic, psychomotor and affective domain skills must be successfully demonstrated in all three areas for
each course. Once you have successfully completed the classroom and laboratory portions of the appropriate
“module” (specified below), you are eligible for clinical rotations. It is expected that the rotations will occur
during the following listed semesters for successful on time graduation. There is an order in which you must
accomplish the clinical portion of the U N H / YNHSH Paramedic Program. You should normally be
working on one clinical rotation at a time until you meet your objectives and the hour requirement of that
rotation. Some rotations require a minimum number of certain skills to be performed (i.e. 10 ETs) regardless
of the minimum number of hours listed in the rotation. You will need to attend as many hours as is required
to accomplish this minimum number. The following is the clinical progression guideline that we follow (the
actual order may vary slightly depending on when you complete specific modules).
Rotation

Cadaver Lab

Pharmacy

Anesthesia (Intubations)

Emergency Room

Cardiac Care Unit

Intensive Care Unit

Psychiatric/Behavioral

Trauma Rotations

Geriatrics
Emergencies –

OB/GYN

Pediatrics
PALS cert) –

Poison Control
&Hazmat–

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Field Internship
Didactic/Lab Prerequisites
Anatomy & Physiology –
• Sophomore Fall
Preparatory Patient Assessment (PPA) –
• Sophomore Spring
PPA –
• Sophomore Spring
PPA –
• Sophomore Spring
PPA and Cardiology –
• Fall Junior
PPA, Cardiology and Medical –
• Fall Junior
PPA, Cardiology,Medical, Psych/Behavioral Emergencies –
• Spring Junior
PPA, Cardiology, Medical and Trauma –
• Spring Junior
PPA, Cardiology, Medical, Trauma and Geriatrics
• Spring Junior
PPA, Cardiology, Medical, Trauma and OB –
• Spring Junior
PPA, Cardiology, Medical, Trauma, OB and Pedi (with
•
Spring Junior
PPA, Cardiology, Medical, Trauma, OB, Pedi, Tox
• Spring Junior
Successfully completed program of all clinical
objectives/hours approval by YNHSH Director
and/or Clinical Coordinator
Summer and Fall of Senior Year
Copyright Yale-New Haven Sponsor Hospital Program Paramedic Handbook, 2015 - 2016
CLINICAL SITES
The clinical experiences are designed to give the student an opportunity to apply knowledge and skills learned,
in a controlled setting with mentors and real patients prior to graduation and certification. To maintain the
educational focus of these experiences; no clinical or field internship time or objectives may be accomplished
while fulfilling a normal staffing crew role with any employer. Each clnical rotation has an associated
module which each student must pass prior to attending that clinical rotation. The completion of all
clinical experiences is required for successful graduation. Clinical experiences are scheduled at various times
and days at sites available in medical facilities around South Western and South Central Connecticut. Clinical
rotations are objective-based as well as hour-based. That is, the student must accomplish certain objectives
even if this takes longer than the minimum time requirement stated for each clinical area. See requirements
listed in the clinical section. The final portion of the program is the field internship. The minimum clinical
hours are 508 hours in various hospital areas and 200 hours in field internship. The minimum required hours
for clinical and field internship combined are approximately 709 hrs. A summary sheet of program time and
other requirements is at the end of this handbook. YNHSHP certificate paramedic program students must
complete all program requirements within two years of beginning the program unless an extension is granted
in writting.
Clinical sites for all of YNHSHP’s programs are located across South Central, North Central and South West
Regions of Connecticut. Hospital clinical rotations will be principally at Yale-New Haven Hospital and Yale
campus formerly known as Hospital of Saint Raphaels as well as other sites in the area. Clinical and Field
internship sites include a variety of busy urban and suburban locales to offer a broad-based education. For
field internship students will also be able to experience multiple models of EMS services including: hospitalbased, public utility, and third service. Students must ride with at least two types of systems and may not
complete more than one half of their ride time in any one type of basing system. Upon successful completion
and documentation of the entire didactic, clinical, and field portions of the program, students will be eligible to
sit for the National Registry of EMTs Paramedic Electronic Board Exam. All clinical scheduling is done
through the on line FISDAP system. YNHSHP will set up an account for each student with this on line
scheduling and tracking site. Students will be required to keep their log of clinical activity up to date on this
site. Failure to enter the records of your clinical experiences on FISDAP within forty eight hours of
completing a clinical experience is grounds for academic probation and ultimate dismissal from the program.
TEXTBOOKS
YNHSHP believes that everything that you need to know about Paramedicine cannot be contained in one
textbook. Therefore, for each module or “subject area” one or more textbooks and/or workbooks are required.
Required texts may be purchased through YNHSHP, others (non-required) may be purchased directly by the
student. Please call or check with your instructor before purchasing any texts because they are subject to
change. Some of these references are also supported by additional resources on line in the learning system JB
Learning. The listing for the 2014 program is in the appendix of this handbook. The textbook list is often
updated throughout the year as new editions become available and old ones become out-of-date or out-of-print
and therefore is subject to change. Textbooks must be paid for at the time of receiving them. No credit will be
extended for textbooks. See program expenses section.
National Registry of Emergency Medical Technicians
Upon completion of the didactic, laboratory and clinical requirements of the program, students are eligible to
sit for the National Registry of Emergency Medical Technicians® Paramedic electronic examination. However
upon completion of the didactic portion and YNHSHP final practical examination students are allowed to sit
for the National Registry Practical Examination. All NREMT exams are separate exams, not part of the
YNHSHP/UNH paramedic program and not administered by YNHSHP/UNH staff. The National Registry is a
not-for-profit, independent, non-governmental agency. Its free-standing structure is carefully guarded in order
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to preserve the integrity of the National Registration process. The National Registry certification is a widely
respected achievement used in many states (including Connecticut) in lieu of local testing as a prerequisite for
state licensure. The use of the National Registry exams compares the student to a national standard and
promotes reciprocity and mobility for EMTs and Paramedics. YNHSHP/UNH strongly supports the National
Registry process. The process consists of both a computer adaptive cognitive exam and a multi-station
practical examination. The National Registry requires that testing for registration be completed within two
years (24 months) of program completion and that each of the two part be successfully completed with one
year (12 months) of each other. Fees for this testing are not including in tuition. See more detail at end of
clinical section of this handbook.
PROGRAM ETHICS and PROFESSIONALISM
It is expected that YNHSHP/UNH students recognize that professionalism and ethics are very
important aspects of a Paramedic’s education and that any breach of these standards is very serious and may
initiate corrective action or immediate dismissal. YNHSHP/UNH Paramedic students are evaluated on their
affective domain skills as well their cognitive and psychomotor skills. Affective skills are as important as
cognitive or psychomotor skills. These areas include: Integrity, Empathy, Self Motivation, Appearance and
Personal Hygiene, Self confidence, Communications, Time Management, Teamwork and Diplomacy, Respect,
Patient Advocacy, Careful Delivery of Service. In the forms section at the end of this manual are examples of
a Professional Behavior Evaluation and a Professional Behavior Counseling Record which will be utilized on a
regular basis by YNHSHP/UNH faculty to evaluate the student’s affective domain abilities. The faculty will
highlight areas of strength as well as areas requiring growth. Failure to demonstrate competence in these areas
is sufficient reason alone for failure of the program or a module.
YNHSHP HONOR CODE
Personal integrity is key to the advancement of the Paramedic profession. We expect that our students will
hold high expectations of themselves and others. Cheating in any form, falsifying documents in any way, and
plagiarism will not be tolerated. Any student found cheating or falsifying program documents will be subject
to immediate dismissal from the program. This includes all papers, reports, homework, examinations, quizzes
and any other required work including on line work. A respectful attitude; and courteous and polite manor
towards faculty, preceptors, other students, colleagues, other agencies, and above all else, the patient and their
family, is part of professionalism. This respectful attitude is to be maintained at all times in the classrooms,
laboratory and during informal times. See section on Behavioral Standards on the page.
YNHSHP PARAMEDIC PROGRAM GRADE POLICY
As adult learners, test and quiz grades for didactic sections are viewed as a means for personal feedback on
strengths and weaknesses of the student’s learning and progress within the program. As instructors, quizzes
and tests show us where we are effective and where we need to spend more instructional time or change our
approach. You can expect an electronic quiz and/or written exercise every day and a written and practical
modular/course summary exam at the end of each “module” “course” or subject area. These quizzes will
usually be posted to the JB Learning system and must be completed prior to class time or in class. “POP”
quizzes may still be given in class. Discussion threads will also be posted to the JB Leaning site and
professional and academic participation in the discussion will count toward the quiz grade for the module. In
order to have successfully completed a module/course, you must submit the appropriate completed lab sheet
and achieve a grade of 80% or more on the modular/course exam and pass the practical portion. The practical
portion is graded only as pass or fail. National Registry type skill sheets will be used with objective grading
criteria. Practical portions that are not successfully passed must be retaken, by appointment, before the
module/course is considered to have been successfully completed. In addition you must maintain at least a
combined average of 70% on each of the class quizzes, discussion threads, and homework assigned for the
module. The modules stand alone and are not cumulative. Each module must be individually successfully
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completed to complete the program. All modules/courses must be successfully completed before a student may
take the final cumulative examinations. Final module/course grades will become part of your permanent
transcript. Nationally recognized courses with additional certification such as those of the American Heart
Association or the National Association of EMTs may have specific grade requirements and completion
criteria for successful completion of the course. When such courses are integrated into the program,
YNHSHP’s grading policy and course completion criteria will be in accordance with the national standards of
those organizations. Obtaining these certifications is considered a required part of successful completion of the
program.
RETESTING POLICY
Quizzes: Students who fall below a 70% average on modular/course class quizzes and assignments will be
expected to raise their average to above 70% (and pass the modular/course exam with an 80%) prior to
successfully completing the module. Students are expected to make arrangements with an instructor to
complete make-up quizzes (not retakes) and/or work packets or other learning assignment in order to raise
their average score to over 70% as needed.
Modular/Course exams: Students who do not achieve a grade of 80% or above on modular exams are
expected to make an academic counseling appointment with an instructor prior to taking a make-up exam. A
performance improvement plan (PIP) will be written by the student detailing the reason for the initial failing
grade as well as a plan of action to pass the make-up and a date that make-up will take place. This plan will be
evaluated by the didactic and education coordinators and will be agreed upon in order to sit for the make-up
exam. Failure to complete the performance improvement plan, which will include a retake examination, will
result in failure of the module. The student may be asked to complete remedial work prior to being permitted
to sit for the make-up exam. Make up exams will not be the same as the previous exam taken. Make-up exams
may not be taken on the same day as the initial exam and will be taken by making an appointment with the
instructor and on the student’s own time, not classroom instruction time. This process may be repeated once
more for a total of three attempts of a modular/course exam. The student has 30 days after the date of the
initial exam to retake and pass the module/course exam. Failure to pass the retake within this time will
constitute a failure of that module/course. If the module/course failed is a prerequisite to another
module/course this may set the students entire graduation back to another class or require the student to
withdraw and reapply to a later section.
Students, who miss a modular/course exam, due to any absence even if excused, will make it up by making an
appointment with the instructor and on the student’s own time, not classroom instruction time. Final transcript
grades will only reflect 80% for modular/course exams retaken or by appointment after the class no matter
what grade is achieved on the retake. Taking the modular exam late, has given you extra time to study that
your classmates did not get, so you can only achieve an 80% grade on transcripts.
MODULAR/COURSE GRADING POLICY
Grading Scale per Module/Course





29
Exam: 50%
Quizzes: 15%
Homework Assignments: 15%
Case Presentation: 10%
Participation: 10% (sliding scale based on students attendance and/or tardiness or lack
there of)
Copyright Yale-New Haven Sponsor Hospital Program Paramedic Handbook, 2015 - 2016
SEMESTER CUMULATIVE EXAMS FOR UNH DEGREE PROGRAM STUDENTS
During the first week of each academic semester, UNH Paramedicine students will take a written exam and
psychomotor assessment encompassiong material covered up to the current semester. Students must achieve at
least 80% on the written exam. The psychomotor assessment will be pass/fail and based on the National
Registry Physchomotor Examination Sheets for both paramedic and EMT. If the student fails either portion
they must present a performance improvement plan and retest within the semester for the failed portion.
Students will be given 3 attempts to restest each portion of the exam. Failure to pass both portions of the exam
after three attempts may result in dismissal from the program.
FINAL CUMULATIVE COGNITIVE EXAMINATION
The didactic program cumulative final examination will have two parts. A computer based cognitive
examination and a multi station practical similar to the NREMT exam. The practical exam will be scored pass
/fail with both a point minimum and critical criteria similarly to the NREMT practical. The computer exam
will be a final cumulative cognitive examination. This will be a computer based, proctored, in class
examination. The examination will be a validated, reliable and predictive computer based national exam. One
retake is allowed. If a passing grade is not achieved on the retake then the student may opt for a third attempt
but it will be at a student fee that is at their own expense. This will be a third and final attempt. The passing
score in all three cases will be set by the examination agency based on the reliability and validity parameters of
the exam. (Similar to NREMT) Final cumulative examinations may not be taken if the didactic portion (the
written and practical examination) of any module/course is incomplete. Final examination may not be taken if
any outstanding balance for any program fees is owed or if the student is on academic or administrative
probation. .
APPEAL OF DIDACTIC GRADES
Students may have access to their academic file at any time by appointment with YNHSHP. Students who feel
that they have received an unfair grade on a quiz or an exam must meet with an instructor to review the quiz or
exam. If a student is able to justify his/her answer using published reference documents, the appropriate
number of points will be awarded. Students must appeal grades within two weeks of taking the exam/retest.
Appeal of instructor decision may first be made to the Education Coordinator and then education medical
director. Decisions of the educational medical director on medical content are final. Case studies and papers
are always returned with an initial grade and instructor comments in the margins. To raise a grade the case
study or paper may be reworked with the comments in mind and resubmitted for a higher grade.
HOMEWORK POLICY
In addition to required reading for each class, some modules (such as Cardiology) may include homework
packets that must be completed prior to successful completion of that module. These packets must be turned
in to the instructor for a grade. Failure to complete homework as assigned is cause for failure of the module.
This includes discussions and other work that will be assigned on the JB learning system.
MODULE/COURSE COMPLETION
In order for the academic portion of a module/course to be considered “complete”, we must have a copy of
your modular/course exam (with at least an 80%), affective domain sheets that meet standard, and quiz
answer sheets, your homework packets and your original lab summary sheet (if applicable). Lab summary
sheets are only complete when an instructor has signed each skill. If lab sheets are not completed during the
lab time during the module, it is the student’s responsibility to make an appointment to complete them. See
Lab Section.
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SUCCESSFUL PROGRAM COMPLETION
Overall program completion requires a passing grade on all module exams (both cognitive, affective and
practical) , and the final cumulative exam, all lab practical sheets completed, all affective domain evaluations
meeting standard, all stations of a final practical exam passed, and all clinical and field internship objectives
met for both skills, affective domain and assessments with documentation properly on file. All case studies and
papers must receive at least a grade of C. All documentation must be completed with originals filed at
YNHSHP. Certificate students have a maximum of two years (24 months) from program start to complete the
program. UNH students must complete by their senor year.
It is the student’s responsibility to insure that all required FISDAP data entries have been made and the
documentation for completion of all aspects of clinical, field internship, laboratory and cognitive portions is
received by YNHSHP for program completion. When handing in documents as completed, it is suggested the
student keep a photocopy, however YNHSHP must receive original documentation.
ACADEMIC COUNSELING
Once every three months (quarterly), the Faculty will make a counseling appointment with each student (at a
mutually convenient time) currently enrolled in the Paramedic Program. The student must make themselves
available and attend this appointment. During this appointment, the faculty and student will explore the
student’s current progress in the program and discuss any pertinent educational issues. The review will
include all progress including cognitive and didactic issues, psychomotor skills and laboratory, clinical and
field internship progress. Affective domain and professionalism will also be discussed. If necessary, a
Performance Improvement Plan (PIP) will be developed to address any student or instructional concerns.
Appointments also be may be made at any time (in addition to quarterly meetings) by request from a student or
a faculty member with concerns about a student’s progress in the program. YNHSHP is interested in seeing all
its students succeed to become confident graduates; but it is ultimately the student’s responsibility to seek the
extra help all YNHSHP faculty are willing to give.
ACADEMIC PROBATION
Students who fail to successfully complete a module will be placed on academic probation. Failure to
complete a module includes failure to achieve 70% on quizzes and homework or failure to achieve 80% on
exams and pass the practical portion, or failure to complete a lab sheet if there is one for the module. Issues of
unprofessional behavior in or out of class may also result in probation. Once notified of your probation status
in writing, students must make a counseling appointment with the YNHSHP Education Director. An
individual Performance Improvement Plan (PIP) will be drawn up that indicates how you will proceed in the
program. The PIP will include performance objectives and an individual educational plan with a time frame to
meet the objectives. During which time the student will be suspended from clinical rotations to fulfill their
didactic requirements. If this contract is not fulfilled in a timely manner as agreed, dismissal from the program
is likely.
GRIEVANCE PROCESS
YNHSHP wishes to assist all its students to be successful and assist them to find fair and just solutions to
problems related to their education. As a general practice, problems can and should be resolved through the
normal administrative chain of command. The grievance process is not meant to circumvent the normal
channels of communications or to set aside the normal open door policy that all of the faculty and
administrators of YNHSHP maintain. Students should always first discuss issues with the faculty envolved.
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The grievance process may be utilized for resolving all issues that may arise during the course of the program
that cannot be resolved through the class government (see page 32) or open door policy described above.
Issues may include, but are not limited to, academic performance, educational or personal problems, complaint
resolution, and issue based problem resolution.
All complaints must be submitted in writing to the Educational Coordinator. A meeting between the student
and parties involved may be called by the Educational Coordinator. Based on the nature of the complaint the
Education Coordinator may involve the class president, Director of YNHSHP and the Education Medical
Director.
If the student does not believe the complaint has been addressed or re-mediated to their satisfaction, the
student will provide a written complaint to the Director of YNHSHP for review and discussion.
If the student still does believe the complaint has been addressed to their satisfaction, the student will provide a
written complaint to the Education Medical Director for review and discussion.
If the student still does not believe the complaint has been addressed to their satisfaction, the student may
submit written request to present the complaint to the Yale-New Haven Sponsor Hospital Program Operations
Committee. Due to the nature of the Operations Committee schedule, this process may take up to 2 months to
accomplish based upon the time the complaint was submitted. UNH paramedcine students may bring issues to
the UNH Fire Science Chair, Lee College Dean or Dean of Students only after they complete the program
grievance process.
ATTENDANCE POLICY
Time management is an area identified in the National Standard Curriculum as a skill necessary of
paramedics. Attendance and participation is mandatory for all classes, skills practice sessions, clinical and
field rotations unless students are notified to the contrary by the Program staff. A student is allowed a
maximum of 10, 4 hour classroom absences from the entire paramedic program. Anything over the
allotted time will be dealt with on a case by case base, including but not limited to, dismissal from the
program. Due to the intensity of our courses, students are expected to obtain their books and complete their
reading and quiz prior to class attendance. So that the class can explore questions and concepts in depth using
discussion and case studies; students should complete assignments and readings before coming to class so they
can be prepared to actively participate in discussions. Class sessions will not simply be a review of the
readings. Many things will be covered in class that is not in the texts and may appear on tests; therefore it is
prudent to attend all lecture sessions. The laboratory sessions are also very important – one on one feedback is
necessary to complete the laboratory skills and reinforce concepts. The Registry Examination will require this
practice and successful laboratory demonstration of skills to be able pass in an acceptable manner. Tardiness to
classes will not be tolerated. It is rude to peers and faculty. Late students will receive one written warning.
If the problem persists, students will be dismissed from the program. If a dire emergency occurs that
prevents a student from attending class (major illness, death in the family), the student is expected to e-mail
(preferred) or call the Education Coordinator or lead instructor as soon as possible to explain the
circumstances. The student is expected to call YNHSHP (203) 562-3320 and leave a message on the
answering machine or email the course faculty at their YNHSHP email address indicating the reason for
absence or tardiness to class; skills practice session, clinical or field rotations. If the student will be absent for
medical reasons, a doctor’s note must be submitted within one week of the absence from class. If the absence
is due to other reasons, such as mandated work shift, documentation must be submitted to YNHSHP within
one week of the absence. Following any absence, students are expected to get the day’s notes from a
classmate and make an appointment with an instructor to review the material that was covered and to take the
appropriate quiz. The student may be required to show mastery of the material by completing additional
remedial work. Questions or other material not made up will receive a zero grade and will count against
module cumulative grade.
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CANCELLATION OF CLASSES
Academic classes will be cancelled only in dire or extreme circumstances. In case of cancellation, students
will be notified by telephone, pager, email or fax as soon as the decision has been made. Students are required
to keep YNHSHP apprised of any change in their contact information. Make-up dates will be announced at
least 4 weeks in advance. Any material, quizzes or exams scheduled for the class that was cancelled will be
given on the next scheduled day of class. Weather cancellations are extremely rare, but if this happens notice
will be distributed to media outlets such as WFSB Channel 3 and WTNH Channel 8. Students enrolled through
UNH will not have classes if the Univerisity cancels classes.
LEAVE OF ABSENCE
In extenuating personal circumstances, the student may request a temporary leave of absence from the
Paramedic program. The student must submit a letter in writing describing the reason for their request and
duration of the leave. Following the submission of a letter, a meeting will be arranged with the student and the
Education Coordinator to discuss the matter. Decisions will be made on an individual case by case basis. A
leave of absence may or may not be granted. If granted it will be for a finite time period with a written
agreement on how the student may resume the program. The student may be asked to withdraw from the
program and may have to reapply for admission from the beginning or may have to repeat the module in
another class section. If the module is a perquisite for other modules, it may set back the student’s
progression. In addition to the policy, UNH Leave of Absence Policy Page 58 of UNH Student Handbook
applies to UNH enrolled students.
WITHDRAWAL
Students who decide to withdraw from the Paramedic Program for any reason must submit a letter in writing to
the Education Coordinator. Following receipt of the letter, a meeting will be arranged between the student and
the appropriate YNHSHP administrator to discuss the withdrawal and conduct an exit interview. Withdrawals
without an exit interview will be negatively noted on permanent transcripts and will affect any readmission
decisions or referrals. Any tuition refunds that may be due will be issued according to the CT. Code of
Administrative Rules or the applicable VA regulations. In addition to the policy, University of New Haven
Withdrawl Policy Page 58-59 of UNH Student Handbook applies to UNH enrolled students.
ADMINISTRATIVE PROBATION
A student may be placed on administrative probation for situations such as failing to make timely payments
towards their Paramedic Program tuition or for failing to keep their student file up to date with the necessary
current CPR cards, EMT cards and licenses, immunization and PPD records, or current phone numbers, email
and mailing addresses. If the student is placed on administrative probation, s/he will not be eligible for clinical
rotations including field internship or to receive grade reports, transcripts or other referrals until the problem is
satisfactorily solved. Certain severe circumstances may dictate suspension from attending class or dismissal
from the Paramedic Program.
REINSTATEMENT AFTER PROBATION
Students placed on either academic or administrative probation, will be sent a letter stating the specific reasons
for the probation. The student will contact the Education Coordinator and set up a meeting. At this meeting,
conditions to improve the academic performance (PIP) or resolve non academic issues will be put into writing
for the student to follow and complete. Once conditions are met, the student will be reinstated.
Administrative Probation reinstatement will be made once the student addresses those issues that led to the
probation whether they are financial, personal information, current records, etc. Once the conditions are met
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the student will be reinstated. Failure to fulfill academic or administrative agreement in a timely manner may
result in dismissal
TRANSCRIPTS
Student transcripts will be provided as follows:
The first copy will be enclosed with the graduation diploma if the student is graduating. All subsequent
transcript requests must be made in writing. The student must sign the letter with original signature and
specify the address to which the transcript will be sent. Transcripts will be sent in sealed, signed envelopes.
All official transcripts are embossed with a raised YNHSHP seal and printed with a colored watermark.
Any module for which any documentation part is not in this office, (exams, lab and clinical paperwork) will be
listed as incomplete if the student is still enrolled in the program. If the student is not longer in the program
any incomplete section will be listed as failed; any module exam below 80% will be listed as a failure.
Only original transcripts with signatures and a raised embossed seal will be issued. Transcripts will be issued
on paper that cannot be photocopied. The first copy of a transcript will be free; each subsequent copy will be
fifteen dollars ($15.00). Transcript requests will take a minimum of two weeks to process.
Transcripts will not be issued to anyone with any outstanding balance owed.
All UNH student transcipts are avalible form the UNH Registrar’s Office. See UNH Transcripts Policy Page
57 of UNH Student Handbook.
STUDENT GOVERNMENT
The faculty and instructors of YNHSHP have an open door policy for all students. We encourage all students
to have open and professional communications with the staff and faculty directly; however, we realize that
there are times that a student may feel uncomfortable in approaching a faculty member with a question,
complaint, concern, or constructive criticism directly. Due to this YNHSHP encourages that the paramedic
classes organize a student government. The student government usually consists of a president, vice-president,
treasurer, secretary and up to 3 trustees. The roles of each position are stated below. These positions are voted
for by the paramedic student body. Any individual may be removed from their position (see below) for cause.
President: The role of the president is to act as a liaison between the student body and faculty. If a student has
an issue arise but doesn’t want to approach faculty, they may do so through the president. This will include
any instructor imparities, building issues, safety concerns, etc. The president will, at times, be asked to
address the class or individuals in lieu of a faculty member in certain circumstances. The president is
responsible for ensuring that all equipment and rooms are straightened up and put away in their proper
locations after use. The president will sit on the YNHSHP Paramedic Program Advisory board or appoint a
class member to do so. The president, at anytime, may approach a faculty member with ANY concerns on
behalf of the class without repercussions from YNHSHP staff.
Vice President: The role of the vice president is to carry out the roles of the president, either in absence of or at
request of the president.
Treasurer: The role of the treasurer is to manage any funds that the class may collect for any events or
purchases the class may decide to make. This can include class trips, study events, condolence items,
recognition items, national registry hotel fees, etc. The treasurer must allow any student to examine financial
records, at written request by that student to both the president and treasurer, within 48 hours of receipt of
request. The president, treasurer, and student requesting to examine the records MUST be present when books
are examined in response to such request. YNHSHP exerts no oversight or responsibility for class collected
funds.
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Secretary: The role of the secretary is to record and forward any correspondence for the class at the president’s
or their appointee’s request. This may include notes of student government meetings, arranging sympathy
correspondence, etc.
Trustee: The role of the trustee is to act as a liaison between the student and the president if the student feels
their concerns are going unaddressed by the president.
Voting procedures: Each student gets to make 1 secret ballot during any voting process. There will be no
absentee votes. Should a vote (with exception of removal of officers) end in a tie, then the 7 elected officers
will (president, VP, Secretary, Treasurer, and 3 trustees) will vote by secret ballot to break said tie. Though
likely rare, any student body vote may be overruled by YNHSHP faculty if safety, education, or YNHSHP
reputation come into question. The decision made by YNHSHP is final unless defined as appealable as stated
elsewhere in this handbook.
Removal of officers: Should it be necessary, the student body can vote to remove any member of government.
To have a vote for removal, 10 percent of student body must petition, in writing, the education coordinator or
paramedic lead instructor for said removal. The education coordinator or paramedic lead instructor will then
start the removal process by having a secret ballot. In the event of a tie vote, due to a show of no confidence,
the officer being removed will indeed be removed from their position. With the exception of president (where
VP will succeed the president) all vacated offices will be re-voted for as originally done. In event of a tie, the
seated officers (with exception of the president, thus giving an odd number of votes) will cast 1 secret ballot to
determine winner.
Though very rare, YNHSHP faculty may remove any member of government from their positions without
vote. This decision will only be made by the concurrence of the Education Coordinator, YNHSHP Director
and the Medical Director. YNHSHP faculty decisions may not be appealed and their decision is final.
PARAMEDIC EDUCATION PROGRAMS
“MODULE” DESCRIPTIONS
The module descriptions below are solely meant to designate “modules” or subject areas that all YNHSHP
Paramedic students complete. It does not necessarily indicate the sequence in which the modules are taken.
ANATOMY AND PHYSIOLOGY I & II
This section is an introduction to the structure and function of the human body. We discuss all human
systems: respiratory, cardiac, skeletal, muscular, digestive, sensory, nervous, reproductive, excretory,
integumentary, immune and endocrine. An introduction to chemistry and biochemistry is included. The cell,
fluids and electrolytes and acid/base balancing will be an integral foundation of this module. Pathophysiology
will be referenced but not discussed in detail. Video tapes and cadaver lab will be utilized. The clinical
portion includes gross anatomy lab rotations (86 hours total plus 24 hrs clinical).
INTRODUCTION TO PARAMEDIC SKILLS
This is the introduction to the roles and responsibilities of Paramedics and their place in the Emergency
Medical Services System. This section will include ethical aspects of emergency care and out of hospital care,
safety and risk in EMS, legal aspects of providing care, cultural differences in patient groups, Emergency
Medical Service Systems and medical direction and communications. Included is (48 hours)
PHARMACOLOGY
This course is designed to lay the groundwork for drug administration. The students are introduced to drug
pharmacokinetics including absorption, distribution, biotransformation, excretion, elimination, tolerance, and
dependence. The basics of Pharmacology will also be learned in this module. Students practice medication
administration via oral, parenteral, and inhaled routes in the lab. This includes practicing IV and other access
routes in class and clinical experience. Dosage calculations are practiced in class, independently, and on an
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ongoing basis throughout the other modules. While an overview of major drug groups is included, the specific
drugs used in the prehospital setting will be covered in their respective modules. The clinical portion will
include time in the Pharmacy or paired with the Emergency Ward Pharmacist/IV and Airway portion of
clinical. (48 hrs. plus 116 hrs min. clinical)
TRAUMA EMERGENCIES
This comprehensive module covers both life-threatening and minor pre-hospital trauma care. It will include
advanced provider certification in Prehospital Trauma Life Support (PHTLS). The PHTLS provider
certification will be integrated with current advanced trauma management for all major body systems with
extensive coverage of multi-systems and musculo-skeletal trauma. YNHSHP presents the Pre-Hospital Trauma
Life Support Course as developed by the National Association of Emergency Medical Technicians in
cooperation with the Committee on Trauma of the American College of Surgeons. The clinical portion will
include time in the Emergency Department with the Trauma Team. (48 hrs. plus 16 hrs. min. clinical)
CARDIOLOGY I
This first segment of the three-part Cardiology series provides an in-depth look at cardiac anatomy, the
lymphatic system, vasculature, hemopoetics, hemodynamics, mechanical and electrical physiology and the
autonomic nervous system. Building on this deeper understanding of the body, students are given an
introduction to cardiac monitoring and rhythm interpretation including leads I, II, III, MCL1 and MCL6.
Assessment of the cardiac patient including heart and breath sounds and an introduction to cardiac
pharmacology are included in this module. (48 hrs)
CARDIOLOGY II
The second part in the Cardiology series focuses on resuscitation and the American Heart Association
Advanced Cardiac Life Support (ACLS) course. Our program teaches all of the “optional” sections and gives
students sufficient time to understand the foundation and concepts behind ACLS instead of just using
algorithms as “recipes” for various cardiac problems. This course looks at the whys and hows of ACLS
protocols: cardiac monitoring, rhythm recognition, chemical therapy (IV cannulation and medications), and
electrical (transthoracic pacing, cardioversion, defibrillation) interventions and airway management (oxygen
therapy and intubation), culminating in understanding the concepts in overall management of the patient in
severe cardiac distress. This module also provides ample time for practicing “megacodes”. Upon successful
completion of Cardiology I and II students are certified as ACLS providers. The clinical portion of this
program will be in the Intensive or Critical Care Units. (48 hrs)
CARDIOLOGY III
The third part of the Cardiology series centers on advanced techniques: obtaining and interpreting 12-lead
EKGs. This program also covers invasive cardiac monitoring (wedge pressures and arterial lines) for use in
inter-facility transfers. New concepts in AV and fascicular blocks will be discussed and all pertinent advanced
pharmacology will be covered. Clinical time will be spent in the Intensive or Critical Care Units. Upon
completion of the Cardiology series students are eligible for Basic Cardiac Life Support (BCLS) Instructor
certification. (48 hours plus 40 hrs min. clinical)
MEDICAL/GERIATRIC EMERGENCIES
This module includes identification, pathophysiology, and management of respiratory emergencies, endocrine
emergencies, anaphylactic reactions, alcoholism, acute abdomen, and genitourinary problems. The aging
process and medical emergencies of the geriatric patient will be discussed. The Geriatric Emergency Medical
Services (GEMS) course of the American Geriatrics Society in cooperation with the National Council of State
EMS Training Coordinators will be included. YNHSHP also presents the Advanced Medical Life Support
(AMLS) Course, as developed by the National Association of Emergency Medical Technicians in cooperation
with the National Association of EMS Physicians. The clinical portion will include time in the
Medical/Surgical, Geriatric, and Emergency departments (80 hrs. plus 32 hrs min. clinical)
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OBSTETRIC/GYNECOLOGICAL EMERGENCIES
Focusing on the anatomy and physiology of the male and female reproductive system and the assessment of a
woman with a suspected OB/GYN disorder, this module includes management of emergencies of the female
reproductive system, the management of an expectant mother, normal delivery procedures, and the care and
transportation of a mother and newborn. Abnormal deliveries such as multiple births, premature birth, breech
birth, and prolapsed umbilical cord are discussed. In addition, complications of labor and delivery including
postpartum hemorrhage, ruptured uterus, inverted uterus, and eclampsia are covered. Infant resuscitation
including IV techniques, intraosseous infusions, and tracheal intubations is reviewed. The clinical portion
includes time in the Labor and Delivery department. (52 hrs. 24 min. plus clinical)
PEDIATRIC EMERGENCIES
Exploring the unique aspects of dealing with and assessing pediatric patients, this module emphasizes growth
and developmental issues. This course concentrates on the appropriate means of communicating with,
assessing, and treating the pediatric patient in various stages of development. It also includes the
pathophysiology and management of problems that are primarily seen in pediatric patients including asthma,
bronchiolitis, croup, epiglottis, sudden infant death syndrome, and seizures. Students will gain a general
understanding of children with special needs and “high technology” children. The issues of abuse and
pediatric trauma are also covered. In addition, the module discusses the role of the Paramedic in a system that
provides neonatal transport. The specific skills included are pediatric resuscitation, IV techniques,
intraosseous infusions, tracheal intubation, and surgical airways in the child patient. Upon successful
completion of this module, students are certified in PALS (Pediatric Advanced Life Support) and PEPP
(Pediatric Emergencies for the Prehospital Professional). The clinical portion includes time in pediatric care
areas including the pediatric emergency room. (48 hrs. plus 40 min. clinical)
PSYCHIATRIC EMERGENCIES
This module discusses the various kinds of psychological problems the Paramedic might encounter. Emphasis
is placed on crisis-induced states that the Paramedic will confront when dealing with emergency situations.
Critical incident stress and effective handling of provider stress will be discussed. In addition, the student will
gain an understanding of various psychoses and neuroses and will learn how to differentiate between
psychiatric and organic causes of behavioral change. Procedures and techniques for handling psychiatric
emergencies are included. The Clinical portion includes time in a Psychiatric Facility and the psychiatric
crisis unit of the emergency department. (48 hrs. plus 24 min. clinical)
ENVIRONMENTAL EMERGENCIES
This module focuses on basic and advanced interventions in the treatment of patients injured as a direct result
of environmental influences. Included are the pathophysiology, symptomatology, and treatment of cold
injuries (hypothermia, frostbite), heat injuries (heat exhaustion, heat stroke), near-drowning, barotrauma,
altitude, lightning injuries, contact (plant) dermatitis and animal bites and stings. (48 hrs. this module does not
have a specific clinical requirement)
TOXICOLOGY
This module covers pre-hospital care of the poisoned patient. Building on your foundation of pharmacology,
we will examine overdose and side effects of drugs and drug overdoses. Assessment by recognizing
toxidromes will be central. Rational use of antidotes and field treatment of the poisoned patient will be a
principal focus of this course. Inhalation, injected, ingested, and contacted poisons will be discussed. The
clinical portion of this module includes time in Poison Control Center. (48 hrs. plus 8 hrs min. clinical)
HAZMAT for EMS
This multi-day certification course will expand upon the student’s prior hazardous materials background and
explore further the proper recognition and analysis of the hazardous materials incident. Students will gain a
broader knowledge base of how to safely handle the contaminated patient who has sustained injuries. Issues of
preplanning, utilizing resources effectively, and understanding both acute and chronic health hazards will be
explored. This course will fulfill NFPA 473 (EMS for Haz-mat) requirements and can also serve as the
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required yearly refresher for Hazardous Materials Operations. Prerequisite: Hazardous Materials Awareness
and Operations certification. If the student does not currently have Awareness and Operations certification,
individual arrangements will be made to obtain these certifications. (this course is part of the Toxicology
module)
THE ART OF PARAMEDICINE
This module is divided into two parts, the first is introduction into Paramedicine and will be at the beginning
of the year as part of Pharmacology and Paramedic skill section. This section will include ethics, Safety in
EMS, legal aspects of providing care, cultural differences in patient groups, Emergency Medical Service
Systems and medical direction. The second part of this module is at the end of the year and brings all parts of
the class room and laboratory year together. Going beyond the science of medicine, this section will
synthesize all of your paramedic education and focus on the non-medical aspects necessary to be a successful
“top-gun” paramedic in the 21st century. We will address techniques and principles necessary for effective
leadership and the art form of getting along with people in many EMS situations, including Paramedic
Intercept situations. Continuous Quality Improvement and Quality Assurance Management techniques will be
presented in a format that will identify factors affecting performance, prevention, and the role of leadership
and management in creating systems that ensure success. We will discuss where EMS has been and where it
is going and how expanded scopes of practice might affect you! Operational aspects of field EMS: for Mass
gatherings, EMS for Special Populations and “Street Sense” for the EMS provider will also be covered. (48
hrs plus 200 hrs Field Internship min. field time)
INCIDENT COMMAND SYSTEM FOR EMS PROVIDERS (NIMS)
This 16 hour intercurricular program adopted by the National Fire Academy covers procedures for controlling
personnel, facilities, equipment and communications utilized for any type or size of an emergency, ranging
from minor to major incidents. Multiple patient situations will be covered. The ICS/NIMS system is now
widely used by EMS agencies nationwide and is required by state and federal law in many interagency
responses such as hazardous materials responses. This particular ICS program will focus on using the
Incident Command System in EMS situations. ICS 100, 200, and 700 will be required. This course will fulfill
a Connecticut state requirement for graduation. A portion of this section will be computer based. (16
intercurricular hours)
YNHSHP reserves the right to adjust the modules or syllabus as necessary to meet objectives and student or
class needs.
Laboratory Section
Each module has skills to be mastered and demonstrated by the student in the lab. This is a required part of
competency based education. The two main types of laboratory practice will be skill based or scenario based.
Scenario based problem solving and critical thinking skills will be practiced and demonstrated by the student.
The laboratory provides a safe and realistic environment for experiencing and practicing those psychomotor
skills necessary to successfully carry out the job of a Paramedic without the pressures of the field setting.
YNHSHP faculty are experienced EMS educators with extensive experience in patient care. The faculty will
draw on real life situations to help make laboratory practice realistic. Scenario based training will start at a
simple level and increase in sophistication until it mirrors the complex decision making necessary in the field.
YNHSHP has a complete range of task trainers and sophisticated patient simulators and equipment for the
student to practice with in a manor realistic to the situations the student will face as a paramedic. Some skills
must be completed as designated on forms and/or under simulated field conclusions.
There will be some skills that must be practiced on live human beings as a preparation before entering the
clinical setting with real patients. The practice of patient assessments, for example, will be done on live and
sometimes moulaged (made up with realistic looking false wounds) patients in addition to the task trainers and
simulators. The practice of these and other skills will involve the touching of live model patients and other
students, including in the areas of the chest and pelvis under the direct supervision of the faculty. The program
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strongly believes in the importance of this practice but is aware of the risk of inappropriate behavior. All
students in any role in these situations including of rescuer or patient or observer are expected to display the
appropriate professionalism and tact expected of real patient care at all times. Students are also reminded of
the sexual harassment policy described in the first section of this manual. If at any time a student feels
uncomfortable it is the student’s responsibility to make that known to the faculty member present. Specific
skills which will be practiced in this program include the following but are not limited to:
1. Traction splinting and other splinting of the upper leg or pelvis
2. Patient assessment and physical examination including inspection, palpation, auscultation and
percussion
3. Dressing and bandaging of wounds
4. Auscultation of breath and heart sounds
5. Assessment of pulse and respirations
6. Application of ECG electrodes for monitoring and 12 lead chest electrodes
7. Spinal immobilization
8. Giving and receiving of various injections and IVs access.
The successful completion of the laboratory sections is evidenced by completed lab signature sheets and is an
inherent part of the program.
Laboratory Documentation
To ensure that minimum individual laboratory experience is obtained, a lab skill summary sign-off sheet will
be completed by every student for the following modules: Patient Assessment, Pharmacology, Cardiology,
Trauma Emergencies, Ob/Gyn, Pediatrics, and Medical. Substantially completed lab sheets are required prior
to beginning the clinical portion for that module. If a lab sheet is not entirely completed during a module, it is
the student’s responsibility to arrange an appointment with an instructor for completion. Modules are not
successfully completed until complete original lab summary sheet is in the student file.
To insure that no student monopolizes the time of instructors and to insure that each student can get a fair
share of individual lab time and to insure skills are retained over time the following rules will apply to
signatures on lab sheets. Each instructor or lab assistant may only sign-off on a specific skill, once per day for
each student. For example, instructor John may only sign off one critical trauma assessment today for student
Sally; however, John may watch Sally do an IV or a medical assessment on the same day. Further student
Sally may go to another instructor that same day for a skill already signed for by the first instructor (in this
example John). Students are encouraged to practice skills more often than the minimum number of return
demonstrations required on the lab sheet with or without an instructor, remembering that no live invasive
procedures may be practiced except under the direct observation of an instructor at all times. This procedure
ensures all students access to each station and confirms that all skills can be performed on multiple days. This
process also allows students to be evaluated from more than one instructor’s point of view. The laboratory
skill sheet will become part of the student’s permanent file and transcript. (See attached appendix)
There will be designated laboratory time in each didactic module that includes skill sheets. Students may use
the lab time as they wish to accomplish lab skills and scenarios or for other academic or non-academic needs
of the student. Instructors and assistants will also be available on an “as needed” basis or by appointment for
additional sign-offs or tutorial assistance. It is the student’s responsibility to ask instructors for lab assistance
either during designated “in class” lab time or additionally outside of class. It is an YNHSHP philosophy that
students must take responsibility for their own life-long learning needs. Therefore, YNHSHP staff will not
look for or chase students who need signatures. The student must take the initiative to request a lab
instructor’s assistance to meet his/her needs. This is also part of the affective domain skill of time management
listed in the NSC. Not every student demonstration of s skill will result in a signature from the instructor. It is
the instructor’s discretion to decide if a demonstration meets the standard to obtain a signature.
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Safety and Procedures in the Laboratory
Live invasive skills will only be practiced under an YNHSHP instructor’s direct supervision. While no
individual is required to undergo a live invasive procedure, YNHSHP encourages the student whenever
possible to practice some invasive skills (such as IV therapy) on healthy people in non-emergent settings under
direct supervision of a authorized preceptor prior to attempting skills on real patients. When practicing
airway, intravenous, or trauma skills, full infection control precautions will be used even in manikin practice.
This will include hand washing before gloving and then again after removing gloves, the use of gloves,
the use of eye protection and face masks (for respiratory procedures) and the proper disposal of all
contaminated materials in the provided red bags and sharps containers. Since most needle stick injuries result
from recapping needles, needles used on live subjects will not be resheathed. Clean needles used on
manikins may be resheathed if a one-handed technique is used. Much of the equipment used for manikin
practice is outdated. The student must check all equipment to be used for both manikin practice and live
procedures, just as they would in real patient care that the appropriate equipment is in dated when used on real
people and out dated for manikin use. Sharps containers will be placed within easy reach before starting a live
invasive procedure and sharps will be placed directly in them. Any needle-stick injury or other blood exposure
must be immediately reported to the lab instructor and the appropriate form (attached) will be filed. The area
of injury or exposure will be immediately washed with soap and water. Surfaces used for sterile procedures
such as injections, phlebotomy and intravenous cannulations will be scrubbed with 70% isopropyl alcohol or
dialdehyde solution before and after use and blue “chux” pads will be used under the patient for cleanliness.
The following excerpts are taken from the October 28, 1992 issue of JAMA (Journal of the American Medical
Association) regarding disease transmission via manikins. Please read the following carefully.
“The use of CPR training manikins has never been documented as being responsible for an outbreak or even
an isolated case of bacterial, fungal, or viral disease. Under certain circumstances, however, manikin surfaces
may present a risk of disease transmission. Therefore, manikin surfaces should be cleaned and disinfected
consistently to minimize risk.”
RECOMMENDATIONS
1. Purchasers of training manikins should thoroughly follow the manufacturer’s recommendations and
provisions for sanitary practice.
2. Students should be told in advance that the training sessions will involve “close physical contact” with
other students.
3. Students or instructors should postpone CPR training if they are known to be in the active stages of an
infectious disease, have reason to believe they have been exposed to an infectious disease, or have
dermatologic lesions on their hands, mouths or circumoral areas.
4. Chronic infections such as HBV and HIV persist over an extended period and can be transmitted even
when the carrier is asymptomatic. If an instructor wishes to train someone with a known chronic
infection or if the instructor has a known chronic infection, precautions should be taken to protect
other participants from exposure. This is best accomplished by providing the infected person with a
separate manikin not used by anyone else until it has been cleaned according to recommended end-ofclass decontamination procedures. Requests for individual manikins should be honored within reason.
Equitable accommodations for all participants are encouraged. In such instances the infected person
should have his or her personal physician review the circumstances carefully and indicate whether
participation is appropriate.
5. If more than one CPR manikin is used in a particular training class, students should preferably be
assigned in pairs, with each pair having contact with only one manikin. This would lessen the possible
contamination of several manikins by one person, therefore limiting possible exposure of other class
members.
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6. Instructors in CPR should practice good hygiene by washing their hands before handling manikins and
by avoiding eating during class. Procedures for cleaning and maintaining manikins and accessories
(e.g., face shields and resuscitation masks) should also be practiced. Manikins should be inspected
routinely for signs of physical deterioration, such as cracks or tears in plastic surfaces, which make
careful cleaning difficult or impossible. The manikins’ hair or clothing should be washed periodically
(perhaps monthly or if obviously soiled).
7. During two-rescuer CPR training, there is no opportunity to disinfect the manikin between students
when the switching procedure is practiced. To limit the potential for disease transmission during
manikin use, the students will simulate mouth to manikin procedures. As indicated, all external and
internal surfaces, as well as reusable protective face shields, should be washed thoroughly with warm
soapy water and brushes. All surfaces should be rinsed with fresh water. All surfaces should be
moistened with a sodium hypochlorite solution having at least 500 ppm free available chlorine (1/4
cup of liquid household bleach per gallon of tap water) for 10 minutes. This solution must be made
fresh for each class and discarded after each use. All external and internal surfaces are rinsed with
fresh water and immediately dried. Rinsing with alcohol will aid drying of internal surfaces, which
will prevent the survival and growth of bacterial or fungal pathogens if the manikins are stored for
periods longer than the day of cleaning.
8. If used, the individual protective face shield should be changed each time a different student uses the
manikin in a training class. Between use by students and after demonstrations by the instructor, the
manikin’s face and the inside of its mouth should be wiped vigorously with a clean, absorbent material
(e.g., 4x4 inch gauze pad) wet with either the hypochlorite solution described above or with 70%
alcohol. The surfaces should remain wet for at least 30 seconds before they are wiped dry with a
second piece of clean, absorbent material. The use of alcohol is recommended in this instance as an
alternative since some persons object to the odor of sodium hypochlorite. Although highly
bactericidal, alcohols are not considered broad-spectrum agents, and use of alcohols here is
recommended primarily as an aid in mechanical cleaning. In a short contact period, alcohols may not
be as effective against pathogens, but in the context of vigorous cleaning with alcohol and absorbent
material, little viable microbial contamination of any kind is likely after cleaning.
9. Instructors in CPR should be encouraged not to rely solely on the use of a disinfectant to protect
themselves and their students from cross-infection during training. Thorough physical cleaning
(scrubbing and wiping) should be emphasized as the first step in an effective decontamination
protocol. Microbial contamination is easily removed from smooth, nonporous surfaces with
disposable cleaning cloths moistened with a detergent solution. There is no evidence that soaking
alone is as effective as soaking accompanied by vigorous scrubbing.
If these recommendations are consistently followed, students in each class should be able to use manikins
whose cleanliness equals or exceeds that of properly cleaned eating utensils. A higher level of surface
disinfection is not warranted, and the recommended disinfectant chemicals are safe, effective, inexpensive,
easily obtained, and well tolerated by students, instructors and manikin surfaces when used properly.
Neither HBV nor HIV is as resistant to disinfectant chemicals as previously thought. Studies have shown that
the retroviral agent that causes acquired immunodeficiency syndrome (AIDS), HIV, is comparatively delicate
and is inactivated in less than 10 minutes at room temperature by a number of disinfectants, including those
indicated for manikin cleaning. It is emphasized that to date there is no evidence that HIV/AIDS is transmitted
by casual personal contact, indirect contact with inanimate surfaces or the airborne route. The
recommendations adequately protect against transmission of either HBV or HIV as well as bacterial and
fungal infections.
Therefore it is the responsibility of every student to assist in the cleaning and decontamination of manikins,
simulators and equipment after every use.
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DISEASE TRANSMISSION & ACTUAL PATIENT PERFORMANCE OF CPR
No transmission of HBV (hepatitis B virus) infection during mouth-to-mouth resuscitation has been
documented. However, because of the theoretical risk of salivary transmission of HTLV-III/LAV during
mouth-to-mouth resuscitation, special attention should be given to the use of disposable airway equipment or
resuscitation bags and the wearing of gloves when in contact with blood or other body fluids. Resuscitation
equipment and devices known or suspected to be contaminated with blood or other body fluids should be used
once and disposed of or be thoroughly cleaned and disinfected after each use.
-reprinted from JAMA, June 6, 1986, vol. 255, #2.1 This is still true as of this edition (2010).
Laboratory Safety Contingencies
No food, beverages, or personal belongings other than laboratory materials will be permitted within the
laboratory space. Hand washing before and after lab procedures and before and after eating and drinking or
using the bathroom is the most important infection control procedure.
Since lab equipment and supplies are costly, conservation and reuse of supplies when performing procedures
on manikins is encouraged. Every effort is made to give each student the ability to practice procedures in a
safe and realistic manner with operational equipment as often as is necessary to ensure student comfort with a
procedure before using that technique in the clinical setting. Care and maintenance of equipment is part of the
Paramedic’s role and responsibility. Therefore, as a student is finished for the lab session, s/he will assist in
the organizing, cleaning, and maintenance of the lab equipment. Any broken or non-functional equipment
should be noted on a piece of paper and given to the instructor in charge of labs for the day if it cannot be
immediately repaired. Without this notification it is impossible to keep working equipment available for
student use. Appropriate equipment check lists will be maintained by students with an inventory list of
disposable equipment that needs to be replaced for the next lab session.
Many of the procedures that the students will be performing have potentially dangerous complications;
therefore, all directions must be followed without exception! Student horseplay or any behavior that may
jeopardize any students’ health or safety or equipment will not be tolerated.
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SECTION
III
Program
Educational
Objectives
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From
Department of Transportation; National Highway Traffic Safety
Administration
National Standard Paramedic Curriculum
And
National Education Standards
And
Updates and amendments by YNHSHP 2015
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ANATOMY AND PHYSIOLOGY MODULE EDUCATIONAL OBJECTIVES
Upon completion of this module, the student will be able to:
1.
Define anatomy, physiology, and pathophysiology.
2.
Name the levels of organization of the body and explain each.
3.
Name the organ systems of the body and give a function for each.
4.
Define homeostasis and give an example of a typical homeostatic mechanism.
5.
Describe the anatomical position.
6.
Describe and be able to label the sagittal, coronal, midsagittal, transverse and frontal planes.
7.
Use proper terminology to describe the location of body parts with respect to one another, include
distal propital, supior, inflor, caudal, cephiteal.
8.
Name the body cavities, their membranes and some organs within each cavity.
9.
Explain the four quadrants of the abdomen and name the organs in those areas.
10. Define matter, element, atom, proton, neutron, and electron.
11. Using common notational symbols, name some common elements found in the body.
12. Describe the purpose of ionic, covalent and hydrogen bonds in the body.
13. Describe what happens in synthesis and decomposition reactions.
14. Explain the importance of water to the function of the body.
15. Describe where water is found in the body and fluid components.
16. Explain the roles of oxygen and carbon dioxide in cell respiration.
17. Explain pH and state normal pH ranges in body fluids.
18. Explain how a buffer system resists major pH changes.
19. Describe the functions and types of sugars, fats, and proteins.
20. Explain how enzymes function as catalysts.
21. Describe the function of DNA, RNA and ATP.
22. Name the organic molecules that make up the cell membrane and state their functions.
23. State the arrangement of the molecules in the cell membrane.
24. State the five functions of proteins in the cell membrane.
25. Describe the cytoplasm.
26. Describe how the cell membrane regulates the composition of the cytoplasm.
27. Explain isotonic, hypotonic, and hypertonic solutions and their effects on the cell.
28. State the function of the nucleus and chromosomes.
29. Describe the function of the cell organelles and list 8.
30. Define each of these cellular transport mechanisms and give an example of the role of each in the
body: diffusion, osmosis, facilitated diffusion, active transport, filtration, phagocytosis and
pinocytosis
31. Describe what happens in mitosis and meiosis and describe the importance of each.
32. Describe the four major types of tissues and give general characteristics and function of each.
33. Describe the function of epithelial tissues depending on their location.
34. Describe the functions of connective tissue and relate them to the function of the body or an organ
system.
35. Explain the basic differences between smooth, skeletal and cardiac muscle.
36. Describe, in brief, nervous tissue.
37. Name the organs made of nerve tissue.
38. Describe the location of pleural membranes, pericardial membranes, and the peritoneum-mesentery.
39. State the location of mucous membranes and state the function of mucus.
40. Name some membranes made of connective tissue.
41. State the three functions of the integumentary system.
42. Name the two layers of skin.
43. State the location and function of the stratum corneum and the stratum germinativum.
44. Describe the function of melanocytes and melanin.
45. Describe the function of hair and nails.
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Describe the functions of the secretions of sebaceous glands, ceruminous glands and eccrine sweat
glands.
Describe how the arterioles in the dermis respond to heat, cold, and stress.
Name the tissues that make up the subcutaneous tissue and describe their functions.
Describe the function of the skeleton.
Explain how bones are classified and give an example of each.
Describe how the embryonic skeleton is replaced by bone
State the nutrients necessary for bone growth.
Name the hormones involved in bone growth and maintenance.
Explain what is meant by exercise for bones and explain its importance.
Identify the two major subdivisions of the skeleton and list the bones in each area.
Explain how joints are classified; give an example of each and describe the movements possible.
Describe the parts of a synovial joint and explain their function.
Describe muscle structure in terms of muscle cells, tendons and bones.
Describe the difference between antagonistic and synergistic muscles.
Name the energy sources for muscle contraction and state the simple equation for cell respiration.
Explain the importance of hemoglobin and myoglobin and oxygen debt and lactic acid.
Describe the neuromuscular junction and explain the function for each part.
Describe the structure of a sarcomere.
Explain polarization, depolarization and repolarization in terms of ions and charges.
Describe the sliding filament theory of muscle contraction.
State the major muscles of the body and their functions.
Name the divisions of the nervous system and state the general functions of each.
Name the parts of a neuron and the function of each.
Explain the importance of Schwann cells in the peripheral nervous system and neuroglia in the
central nervous system.
Describe the electrical nerve impulse and impulse transmission at the synapse.
Describe the types of neurons, nerves and nerve tracts.
Explain the importance of stretch reflexes and flexor reflexes.
Describe the reflex arc.
State the functions of the parts of the brain and locate each part on a diagram.
Name the meninges and describe their locations.
State the locations and functions of cerebrospinal fluid.
Explain the general purpose of sensations.
Name the parts of the sensory pathway and the general functions of each part.
Describe the characteristics of sensations.
Name the cutaneous senses and explain their purpose.
Explain referred pain and explain its importance.
Explain the importance of proprioception, or muscle sense.
Describe the pathways for the senses of smell and taste and explain how these senses are
interrelated.
Name the parts of the eye and explain their function in sight.
Name the parts of the ear and explain their function in hearing.
Describe the physiology of equilibrium.
Distinguish between endocrine and exocrine glands.
Define hormone and prostaglandin.
Identify the primary endocrine glands and list the major hormones secreted by each.
Explain the roles of positive and negative feedback mechanisms in hormone secretions.
Describe the relationship between parathyroid hormone and calcitonin.
Describe the relationship between insulin and glucagon.
Explain what prostaglandins are made of and state some of their functions.
Explain how protein hormones are believed to exert their effects.
Explain how steroid hormones are believed to exert their effects.
Describe the primary functions of blood.
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List the formed elements of blood and state the primary functions of each.
Name the hemopoietic tissues and the kinds of blood cells each produces.
Describe what happens to red blood cells at the end of their life span including the fate of
hemoglobin.
Explain the ABO and Rh blood types.
Name the five kinds of white blood cells and the functions of each.
State what platelets are and explain how they are involved in hemostasis.
Describe the three stages of blood clotting.
Explain how abnormal clotting is prevented in the vascular system.
Describe the location of the heart in terms of body cavities and relationship to other structures.
Name the chambers of the heart and the vessels that enter or leave each.
State the valves of the heart and their function.
State how heart sounds are created.
Trace the pathway of a blood cell throughout the body.
Describe coronary circulation.
Describe the cardiac conduction pathway and its relationship to a normal electrocardiogram.
Explain stroke volume, cardiac output and Starling's law of the heart.
Explain how the nervous system regulates the function of the heart.
Describe the structure and function of each of the blood vessels: arteries, veins and capillaries.
Describe the exchange of gases that occur at the capillary level.
Name the major systemic arteries and the parts of the body they nourish.
Name the major systemic veins and the parts of the body they drain of blood.
Define blood pressure and state the normal ranges for the systolic and diastolic indices.
Describe the functions of the lymphatic system.
State how lymph is formed.
Describe the system of lymph vessels and explain how lymph is returned to the blood.
State the location and function of lymph nodules and nodes.
State the location and function of the spleen.
Define immunity.
Explain the role of the thymus in immunity.
Explain the differences between humoral immunity and cell mediated immunity.
Compare and contrast the development and function of B cells and T cells.
Describe the differences between acquired immunity and genetic immunity.
Explain how vaccines work.
State the general function of the respiratory system.
State the pathway of the respiratory system including nasal cavities, pharynx and larynx.
State the function of the turbinates in the nasal cavity.
Describe the structure and function of the larynx and the speaking mechanism.
State the roles of the visceral and parietal pleura in respiration.
State the changes in air pressure within the thoracic cavity during respiration.
Explain the diffusion of gases in external and internal respiration.
Describe how oxygen and carbon dioxide are transported in the blood.
Explain the nervous and chemical mechanisms that regulate respiration.
Explain how respiration affects the pH of certain body fluids.
Describe the general function of the digestive system and name the major divisions.
Identify the accessory organs of digestion.
Explain the difference between mechanical and chemical digestion.
Describe the structure and function of the teeth and tongue.
Explain the function of saliva.
Describe the location and function of the pharynx and esophagus.
List and describe the four layers of the alimentary canal.
Describe the difference in absorption between the large and small intestine.
Describe the function of the normal flora in the colon.
Define peristalsis.
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Define chyme.
State the normal range of body temperature.
Define metabolism, catabolism and anabolism.
State the different ways heat is generated and lost in the body.
State why the hypothalamus is the thermostat of the body.
State what the products of cell respiration are and how the body disposes of them.
Describe the metabolic roles of fats, glucose and proteins.
Describe basal metabolic rate and the factors that affect it.
Define kilocalories.
Describe the water compartments and the name for the water in each.
Explain how water moves between the compartments.
Explain how water is taken in by the body and exits the body.
Describe the location and general function of each organ in the urinary system.
Name the parts of a nephron.
Define glomerular filtration rate.
Describe how the kidneys function in maintaining normal blood volume and pressure.
Describe how the kidneys help to maintain normal blood pH and electrolyte balance.
State the hormones that affect kidney function.
Explain the interaction between capillary blood pressure and blood protein
Describe the characteristics of normal urine.
Define diploid and haploid.
Describe the difference between spermatogenesis and oogenesis.
Define gametes.
Name the hormones necessary for the formation of gametes.
List the essential and accessory organs of the male and female, give the general function of each.
Identify and describe the structures that constitute external genitals in both sexes.
Name the parts of a sperm cell.
Define endometrium.
Briefly describe the life cycle of an oocyte.
Describe the menstrual cycle in terms of changes in hormone levels and the endometrium.
Beginning with fertilization, describe the major developmental changes during gestation.
Describe the structure and function of the placenta and umbilical cord.
Describe the difference between fetal circulation/respiration and adult circulation/respiration.
State the length of an average gestation period.
Describe the states of labor.
Describe the major changes that take place in an infant at birth.
Explain how microorganisms are named and classified.
Describe the distribution of and the benefits of normal flora.
Explain what is meant by infectious disease.
Describe the different methods by which infectious diseases are spread.
List some important infectious diseases.
Define genetic disease.
Explain how genes can cause disease.
Define homologous chromosomes, autosomes, sex chromosomes and genes.
Define alleles, genotype, phenotype, homozygous, and heterozygous.
Discuss the difference between dominant and recessive traits.
List some important genetic disease
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PHARMACOLOGY EDUCATIONAL OBJECTIVES
Upon completion of this module the student will be able to:
1. Name the major areas of concern in pharmacology.
2. Name and differentiate the sources of various drugs.
3. Name and contrast the various names of a drug (i.e., generic vs. trade name vs. official vs. chemical)
and demonstrate proper notation for each.
4. State why drug standards are necessary.
5. Identify those agencies both state and federal that are responsible for regulating drugs and provide
examples of each of their responsibilities.
6. State the 5 DEA drug schedules and give an example of a drug in each.
7. Define the following terms:
-capsules
-vials
-liniments
-fluid extracts
-powders
-lotions
-suppositories
-tinctures
-pastes
-pills
-ointments
-plasters
-spirits
-tablets
-creams
-lozenges
-suspensions
-aerosols
-ampules
-solutions
-colloids
-elixirs
8. Identify those pharmaceutical preparations used internally.
9. Identify and state the given dosage of prepackaged pharmaceutical preparations.
10. State the purpose and demonstrate the use(s) of the Physicians Desk Reference (PDR)and at least one
other drug reference.
11. Identify local and general or systemic effects of drugs.
12. List and compare the following factors on the action of drugs
-route of administration
-age of patient
-condition of patient
-dos
-absorption rate
-distribution
-elimination (excretion)
13. Rank the five methods of absorption from fastest to slowest.
14. Name the five routes in which drugs are absorbed.
15. Define the following terms with respect to Pharmacology:
-depressant
-cumulative effect
-physiological
-tolerance
-therapeutic
-synergism
-untoward
-potentiation
-initiation
-additive
-antagonism
-habituation
-idiosyncrasy
-hypersensitivity
-indication
-contraindication
-side effect
-placebo effect
16. Select the term that best describes a specific drug from the terms in number 15.
17. List 10 categories of drugs by major physiological effect or by body target system or organ. Give an
example from each.
18. Identify and discuss the following nine items as they relate to the administration of any drug:
-dose
-indications and use
-side effects
-dilution
-precautions
- contra-indications
-actions
-incompatibility
- route of malinstortion
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-side effects
-antidotes
List the two systems of weights and measures being used today.
Determine which weights and measures belong to the apothecary system or to the metric system.
State three advantages of the metric system.
Demonstrate the conversion of various measures between and within apothecary, common and metric
systems.
Given a drug dose in milligrams and its specific concentration in tablet form, calculate how many
tablets should be given to a patient.
Given a desired dose and concentration of a drug, calculate the volume of a drug to be administered.
Demonstrate the conversion of various measures from pounds to kilograms.
Given the weight of a patient in pounds and a drug dose in milligrams per kilogram, calculate the
appropriate drug dosage for the patient.
State the number of macro and micro drops/ml for IV fluid administration sets.
State the formula used to determine the flow rate for an IV infusion.
Given a rate of infusion for a IV fluid, determine the number of micro and/or macro drops/cc.
State six rights of drug administration.
Name at least eight safety considerations when administering drugs.
Identify and describe local guidelines for drug administration.
Describe the different types and sizes of syringes and needles and the advantages and disadvantages
and proper selection of each.
Identify four routes of parenteral drug administration.
Describe the proper approach and explanation that should be given to a patient prior to the
administration of a medication.
State what information should be elicited from a patient prior to administration of a medication.
State why ampule tops should be tapped before they are used.
State why air must be taken into the syringe when drawing a solution from a vial.
State why the IV tube is pinched off above the injection site when performing an IV push.
Demonstrate administering a proper dose of medication via piggyback and drip infusion.
State the advantages and/or disadvantages of:
-IV injections
-Subcutaneous injections
-Intramuscular injections
-Intraosseous administration
-Endotracheal administration
Describe why the skin is pinched when administering a subcutaneous injection.
Describe why the skin is stretched when administering an intramuscular injection.
Withdraw a given amount of solution, given the dose, from an ampule or vial.
Assemble a prepackaged syringe.
Perform an IV and IO push and inject a specified dose of medication into an already established IV
and IO line.
Perform safe subcutaneous and intramuscular injections at any one of several body locations.
Demonstrate the administration of aerosolized medication.
State which drugs may be given endotracheally and the limitations of the endotracheal route.
Demonstrate administering medication endotracheally.
Discuss the way in which suppositories are given and explain patient instructions.
Demonstrate administering sublingual medications.
Demonstrate using an IV pump.
Describe how LD50 and Therapeutic index are calculated.
Describe the guidelines and protocols for the use of the Poison Control Center.
Demonstrate how to identify unknown medications.
Perform an interdermal injection.
List the most common abbreviations and notations used on medication and prescription labels.
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CARDIOLOGY EDUCATIONAL OBJECTIVES
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Upon completion of this module, the student will be able to:
Describe the size, shape, and location /orientation (in regards to other body structures) of the heart
muscle.
Identify the location of the following structures on a diagram of the normal heart:
-Pericardium
-Pulmonary vessels
-Myocardium
-Coronary arteries
-Epicardium
-Tricuspid valve
-Right and left atria
-Mitral valve
-Interatrial septum
-Aortic valve
-Right and left ventricles
-Pulmonic valve
-Intraventricular septua
-Papillary muscles
-Superior and inferior vena cava -Chordae tendinae
-Aorta
Describe the functionof each structure listed above.
Describe the distribution of the coronary arteries and the parts of the heart supplied by each artery.
Relate to 12-lead with functional problems
Differentiate the structural and functional aspects of arterial and venous blood vessels.
Name and describe the location of 5 major arteries and 5 major veins.
Describe the structure and function of capillaries.
Describe the course of blood flow through the normal heart and lungs.
Describe the cardiac cycle in terms of mechanical function and relative position of heart valves.
Describe the effects of increased heart rate on the contraction and relaxation phases of the cardiac
cycle.
Describe the functional differences between the right heart and left heart pumps.
Define the following terms that refer to cardiac physiology:
-Stroke volume
-Afterload
-Starling’s Law
-Cardiac output
-Preload
-Blood pressure
-Ejection Fraction
-Dromotropy
-Chronotropy
-Inotropy
Describe innervation of the heart.
Name the chemical mediator of the sympathetic nervous system and describe the
mechanical, cardiac, and peripheral effects of:
-Alpha receptor stimulation
-Beta receptor stimulation
Name the chemical mediator of the parasympathetic nervous system and describe its primary effect on
the heart and the effect of:
- muscarinic receptor sites
- nicotinic receptor sites
Name major electrolytes that act on cardiac function and their effect. Including:
-Sodium
-Potassium
-Calcium
-Magnesium
Describe the electrical properties of the heart.
Describe the normal sequence of electrical conduction through the heart and state the purpose of this
conduction system.
Describe the location and function of the following structures of the electrical conduction system:
-SA Node
-Bundle of His
-Internodal and interatrial tracts
-Bundle branches & paciates or less bundles
-AV Node
-Purkinje fibers
Copyright Yale-New Haven Sponsor Hospital Program Paramedic Handbook, 2015 - 2016
20. Define cardiac depolarization and repolarization and describe the major electrolyte changes that occur
in each phase of process.
21. Name three areas of the heart possessing pacemaking capabilities and state the intrinsic (inherent)
rates of each area.
22. Describe an ECG.
Define the following terms as they relate to the electrical activity of the heart & the EKG:
-Isoelectric line
-PR interval
-P wave
-ST segment
-QRS complex
-Absolute and relative
-T wave
-Refractory period
23. Describe how electrical activity of the heart is affected by:
-Sympathetic stimulation
-Alpha receptors
-Beta receptors
-Parasympathetic stimulation
24. Name the common chief complaints of cardiac patients.
25. Describe why the following occur in patients with cardiac problems:
-Chest pain or discomfort
-Shoulder, arm, neck, or jaw pain/discomfort
-Dyspnea
-Syncope
-Palpitations/abnormal heart beat
26. Describe those questions asked during history-taking for each of the common cardiac chief
complaints.
27. Describe the four most pertinent aspects of the past medical history in a patient with a suspected
cardiac problem.
28. Identify, in a list of common prescription drugs, those that a patient may be taking for cardiovascular
problems.
29. Describe those aspects of the physical examination that should be given special attention in the patient
with suspected cardiac problems.
30. Describe the significance of the following physical exam findings in a cardiac patient:
-Altered level of consciousness
-Peripheral edema
-Cyanosis
-Poor capillary refill
-Cool, clammy skin
-Jugular vein distension
-Pulmonary rales/wheezes
-Carotid artery bruit
-Pulse irregularity
31. Describe the pathophysiology of atherosclerosis.
32. List the five major modifiable and four uncontrollable risk factors for atherosclerosis.
33. Describe the common characteristics of the pain/discomfort that occurs in angina pectoris and acute
myocardial infarction.
34. Describe the pathophysiology, signs and symptoms, and prehospital management including drug
therapy of:
- Valvular Heart Disease
- Congestive Heart Failure
- Cardiomyopathy
- Hypertensive crisis
- Cor Pulmonale
- Pericardial Disease
35. Describe six causes of cardiac arrest other than ASHD and describe how medical management of these
situations differs.
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36. Describe the contrast the etiology of cardiac arrest in infants and children from that of adult patients.
37. Describe the action, pre-hospital indications, side effects, adult and pediatric dosages,
contraindications, special considerations, and precautions for each of the following drugs:
Atropine sulfate
Adenosine
Lidocaine hydrochloride
Alteplase
Hydralazine
Verapamil
Anistreplase
Epinephrine
Diazoxide
Norepinephrine
Dobutamine
Isoproternol
Esmolol
Dopamine
Magnesium
Sodium bicarbonate
Naloxone
Calcium chloride/Gluconate
Nifedipine
Oxygen
Nitroprusside
Nitrous oxide
Pancuronium
Nitroglycerin preparations
Heparin
Morphine sulfate
Fentanyl
Furosemide
Rocuronium
Norepinephrine
Ethacrynic acid
Vecuronium
Hydromorphone
Succinylcholine
Labetalol
Diazepam
Meperidine
Metoprolol
Propanolol
Nalbuphine
Procainamide
Pentazocine
Fibrinolytics: TPA, etc.
Phenytoin
Haloperidol
Lorazepam
Midazolam
Vasopressin
Amiodarone
Diltiazem
Aspirin
Acetaminophen
Butorphanol
Phentolamine
Abciximab
Phenylephrine
Atenolol
Potassium Chloride
Eptifibatide
Tirofiban
Etomidate
38. Describe the action, uses, and side effects of the following drugs that are not used in the field but
commonly taken by cardiac patients:
39. Describe the basic concept of ECG monitoring.
40. Define a monitoring lead and describe how it differs from a 12-lead ECG.
41. Describe what type of information can and cannot be obtained from a monitoring lead.
42. Describe information obtained from the vertical and horizontal axes of the ECG graph paper.
43. For each axis, state the numerical values assigned to each small and large box on the ECG graph paper
at standard calibration.
44. Define ECG artifact; name and recognize the four major causes and how to correct each problem.
45. State the steps in the analysis format of ECG rhythm strips.
46. Describe the normal parameters for the following aspects of an ECG rhythm strip:
-Rate
-Rhythm
-P waves
-PR interval
-QRS complex duration
47. Describe two common methods for calculating heart rate on an ECG rhythm strip and the indications
for using each method.
48. Name 8 causes of dysrhythmias.
49. Describe the mechanisms of electrical impulses formation.
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50. Describe the etiology, Lead II ECG & 12-lead characteristics, clinical significance, and emergency
treatment of each of the following dysrhythmias:
-Sinus bradycardia
-Sinus tachycardia
-Sinus arrhythmia
-Sinus arrest
-Wandering pacemaker
-Premature atrial complexes
-Atrial tachycardia (PSVT)
-Atrial flutter
-Atrial fibrillation
-Premature junctional complexes
-Junctional escape complexes and rhythm
-Accelerated junctional rhythm
-Paroxysmal junctional tachycardia (PSVT)
-Ventricular escape complexes and rhythm
-Premature ventricular complexes
-Ventricular tachycardia
-Ventricular fibrillation
-Asystole
-Artificial pacemaker rhythms including: single chamber and dual chamber
-First degree AV block
-Second degree AV block, Type I and Type II
-Third degree AV block
-Bundle branch blocks, fascicular blocks and aberrant ventricular conduction
51. Describe the etiology, 12 lead EKG characteristics, clinical signs, and emergencytreatment of
AMI/ACS including use of fibrbrolytics.
52. Describe the indications for use of rotating tourniquets.
53. Describe the indications for use of a pericardial thump.
54. Describe the indications for use of synchronized cardioversion.
55. Describe energy recommendations for defibrillation of adult and pediatric patients for both biphasic
and monophasic defibrillators.
56. Describe the indications and complications of intracardiac injections.
57. Demonstrate the correct procedure for obtaining a history and performing a physical exam for cardiacrelated problems.
58. Demonstrate assessment techniques and emergency management of patients with any of the conditions
listed in objective #35.
59. Demonstrate preparation and proper administration of a prescribed dose of any of the cardiac drugs
listed in objective # 38.
60. Identify the following on any rhythm strip:
-P waves
-PR intervals -QT interval
-QRS complexes
-ST segments -PR segment
-P-P intervals
-T waves
-R waves and R prime
-R-R intervals
-Isoelectric line -Q waves
61. Recognize each of the dysrhythmias listed in objective #51 on Lead I, II, III, MCL1 rhythm strips or
ECG monitor.
62. Demonstrate appropriate clinical assessment and management of a cardiac patient having any of the
dysrhythmias listed in objective #51.
63. Demonstrate on an adult mannequin, the techniques for single and two-person CPR according to
American Heart Association standards.
64. Demonstrate on an infant mannequin, the technique for infant CPR according to American Heart
Association standards.
65. Demonstrate proper application of ECG chest electrodes and be able to use and obtain a sample of any
lead including a Lead II, right and left sided 12 lead or MCL1 rhythm strip.
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66. Demonstrate the proper use of the defibrillator paddle electrodes and multi function pads to
obtain a sample Lead II rhythm strip (Quick Look).
67. Demonstrate how to properly assess and correct the cause of poor ECG tracing.
68. Demonstrate the proper technique for administering a precordial thump.
69. Demonstrate on a mannequin the correct operation of a monitor-defibrillator to perform defibrillation
on an adult and infant and both pediatric with hands off/pads multifunction.
70. Demonstrate the correct technique for performing synchronized cardioversion.
71. Demonstrate on a mannequin the proper procedure for patient assessment and performance of carotid
massage.
72. Demonstrate the correct technique for performing non-invasive (external) cardiacpacing.
73. Demonstrate proper application and operation of a mechanical CPR adjunctive device.
74. Demonstrate team leadership and critical thinking in directing the resuscitation team.
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TRAUMA MODULE EDUCATIONAL OBJECTIVES
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Upon completion of this module, the student will be able to:
Identify and describe the function of the structures of the upper respiratory tract.
Identify and describe the function of the structures of the lower respiratory tract.
Define the terms respiration and pulmonary ventilation.
Define the physiology of the respiratory system.
Describe the pulmonary circulation.
Describe the process of gas exchange in the lungs.
Identify the normal partial pressures of oxygen and carbon dioxide in:
a. The alveoli
b. Venous blood
c. Arterial blood
Identify the systems involved in the process of regulation of respiration.
Describe the techniques of inspection, auscultation and palpation of the chest.
Identify the causes of upper airway obstruction, the pathophysiology, assessment and management
of each.
Discuss the pathophysiology, assessment and management of the following:
a. Toxic inhalation
b. Central nervous system dysfunctions
Demonstrate the techniques of direct laryngoscopy.
Demonstrate the techniques of inspection, auscultation and palpation in examining the thorax.
Demonstrate the ability to obtain an appropriate history when evaluating patients with respiratory
complaints.
Demonstrate the ability to perform an appopriate assessment when evaluating patients with
respiratory complaints.
Demonstrate the ability to appropriately administer the following drugs for the adult and pediatric
patient:
a. Oxygen
b. Epinephrine
c. Bronkosol
d. Racemic epinephrine
e. Aminophylline
f. Diphenhydramine
Define pathophysiology of shock based on aerobic and anaerobic metabolism.
Define pt management based on the Fick Principle.
Discuss the prevention of anaerobic metabolism.
Discuss red blood cell oxygenation in the lungs based on alveolar O2 levels and transportation
across the alveolar capillary wall.
Discuss tissue oxygenation based on tissue profusion and off-loading of oxygen.
Discuss the role played by respiration, inadequate ventilation in the management of shock.
Describe perfusion and the mechanisms of improvement of cardiac output based on thestrength
and rate of contractions.
Discuss the role of preload in improving cardiac output.
Discuss the fluid component of the cardiovascular system and the relationship between the volume
of the fluid and the size of the container.
Discuss the afterload (systemic vascular resistance), the relationship of diastolic pressure to the
SVR and the effect of diastolic pressure on coronary circulation.
Discuss the container size in its relationship to the fluid volume & pre-load.
Discuss body fluids based on total body water, intracellular fluid and extracellular fluid.
Identify the significant anions and cations in the body.
Describe the role of protein in the blood.
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Discuss osmosis. Define semi-permeable membranes and discuss their function.
Define isotonic fluids, hypotonic fluids and hypertonic fluids.
Define and discuss diffusion.
Define active transport.
Describe the mechanisms of concentration of electrolytes.
Define Acid-Base balancing.
Discuss Acid-Base balance on hydrogen ion concentration, pH, buffer systems.
Define and discuss the pathophysiology, assessment and treatment of the following:
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
Describe the mechanism of the body response to perfusion change.
Identify the role of the baroreceptor.
Describe how the actions of the baroreceptor affect blood pressure and perfusion.
Describe compensated shock.
Describe uncompensated shock, both cardiac and peripheral effects.
Describe how anaerobic metabolism at the cellular level can lead to death several days later.
Discuss the effects of decreased perfusion at the capillary level, both on the capillary lining as well
as the cell; include a discussion of increased interstitial fluid.
Describe the three phases in the capillary cellular relationship(ischemia, stagnant and washout).
Discuss the evaluation of the patient’s perfusion status based on physical observations within the
primary survey, including pulse, skin, temperature, capillary refill.
Discuss the relationship of the neurological exam to evaluation of hypoperfusion and oxygenation.
Describe the information provided by the following in physical examination: pulse, blood
pressure, diastolic pressure, systolic pressure, skin color, appearance, temperature and
respiration.
Discuss resuscitation of a shock patient, include red cell oxygenation, tissue ischemicsensitivity,
IV fluids, the Pneumatic Anti-Shock Garment.
Describe the beneficial and detrimental effects of the Pneumatic Anti-Shock Garment.
Describe the indication and contraindications for the Pneumatic Anti-Shock Garment.
Discuss fluid replacement, the types of fluid that are available, the benefits and detrimental effects
of each. Including:
a. Blood and blood products
b. Albumin
c. Hypertonic saline (3%)
d. PPF
e. Hetastarch, Hespan
Discuss how fluid replacement is monitored and controlled.
Discuss the routes of fluid replacement and the advantages and disadvantages of each.
Demonstrate in order of priority the steps of shock resuscitation.
Demonstrate the use of the Pneumatic Anti-Shock Garment.
Describe the indications and contraindications of the Pneumatic Anti-Shock Garment and how it
affects the patient in each.
Establish priorities of care based on threat to life conditions.
Describe the four phases of patient assessment.
Describe the primary survey and what areas are critical to evaluate.
Describe the methods of airway management.
Describe the methods and management of an obstructed airway.
Describe the mechanical methods of airway management of an obstructed airway.
Describe the mechanical methods of airway management including the benefits and limitations of
OPAs, NPAs, EOAs, EGTAs. LMAs, ETTs, PTLs, and Combi-tubes, and King Airways gum
bougie, SALT airways.
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66. Describe the trans-tracheal mechanisms of airway ventilation, including the benefits and
limitations.
67. Describe how the cervical spine is protected throughout airway maneuvers.
68. Describe the problems of ventilation in the trauma patient.
69. Define mouth to mask ventilation, its benefits and limitations.
70. Discuss the bag-valve mask, its benefits and limitations.
71. Discuss the techniques for evaluating the effectiveness of ventilation.
72. Describe the anatomy of the heart and the cardiovascular system.
73. Describe the problems that occur with decreased perfusion.
74. Describe the pathophysiology of cardiac arrest.
75. Describe the mechanisms of evaluating the effectiveness of perfusion, including pulse, skin color,
capillary refill.
76. Discuss ventilation with an EA, PTL, Combi-tube, EGTA, LMA, King Airways and
ETT include their benefits and limitations as well as methods of predicting difficulty in placing
each.
77. Describe the equipment and method of suctioning the airway, pharynx, and endotracheal
tube(optional).
78. Describe the anatomy of the skin, bones, vessels, subcutaneous tissue as it relates to hemorrhage
control.
79. Discuss the benefits and complications of hemorrhage control by the following means:
a. Direct pressure
b. Tourniquets
c. Hemostats
d. Elevation
e. Pressure points
f. hemostatic dressings
80. Define a mini-neurological examination (LOC).
81. Describe exposing the patient’s body for total evaluation.
82. Discuss when this should and should not be carried out.
83. Define shock.
84. Define the components of secondary survey and its benefits for patient evaluation.
85. Describe the assessment of the head, neck, thorax, abdomen, extremities and nervoussystem.
86. Describe the trauma score, define its usefulness and how it is accomplished.
87. Describe and demonstrate how a patient is packaged and stabilized for transportation to the
hospital, including airway ventilation, IV fluids pneumatic anti-shock garment, fracture
stabilization, bandaging.
88. Describe how the patient is immobilized on the backboard.
89. Describe how the patient is immobilized on the stretcher and in the ambulance.
90. Describe patient extrication and the medical considerations of extrication.
91. Describe how the patient is monitored enroute to the hospital.
92. Describe how the hospitals are selected for receipt of patients based on patient need and hospital
capability.
93. Perform a rapid assessment of the patient to identify priorities for care.
94. Demonstrate the assessment of the head, neck, thorax, abdomen, extremities and neurological
system in a trauma patient.
95. Describe laryngoscope, suction, endotracheal tube and bag-valve mask.
96. Discuss indications and contraindications of endotracheal intubation and methods to access and
predict the difficulty of placement.
97. Discuss alternatives to endotracheal intubation and their limitations.
98. Discuss need for rapid placement of ET tube, rapid sequence intubation, and chemically assisted
intubation.
99. Discuss methods of assuring and maintaining correct placement of ET tube.
100.
Demonstrate ventilation with bag-valve-mask.
101.
Demonstrate placement of ET tube, both oral and nasal (45 seconds).
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103.
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Demonstrate ventilation with bag valve and endotracheal tube.
Demonstrate method of assuring and maintaining correct placement of ET tube.
Demonstrate surgical airway technique.
Demonstrate reventilation for missed intubation.
Demonstrate skills described above both on manikin and live patient.
Describe the general needs of the trauma patient and the steps within each area of need which
must be addressed.
Describe the areas in which trauma care is rendered and a general overview of care in each of
those areas.
Define the priorities of trauma management.
Describe triage with multiple patients.
Describe the steps in the general assessment of patient care.
Describe the steps in the primary survey of patient care.
Describe the anatomy of the airway.
Describe the anatomy of the cervical spine.
Describe the physiology of the airway.
Describe the management of the airway in relationship to the individual pathophysiological
problems that occur.
Describe the relationship of the cervical spine to airway management.
Describe how the airway is managed protecting the cervical spine.
Describe the advantages and disadvantages of each.
Describe those steps in airway management that are hospitaltechniques and not pre-hospital
techniques and why.
Describe the anatomy of the chest.
Describe the physiology of pulmonary expansion.
Describe the assessment of ventilation and the various pathological conditions that can
compromise this ventilation.
Describe the management of compromised ventilations.
Describe the management of conditions that compromise pulmonary expansion.
Describe the advantages and disadvantages of the various ventilation techniques and devices.
Demonstrate two methods for decompressing a chest.
Describe a pneumothorax and its three variations.
Describe the management of circulatory and hemorrhage problems.
Describe the anatomy of the heart and cardiovascular system.
Describe the physiology of shock.
Describe the assessment of circulatory sufficiency vs. insufficiency.
Describe those components of assessment which are most easily obtained in the primary
survey and their individual significance.
Describe the management of perfusion problems.
Describe the pathophysiology of shock and its management in relationship to the Fick
Principle.
Describe the methods of hemorrhage control that should be used in the prehospital setting and
those that should not and why.
Describe the mini-neurological exam.
Describe the mini-neurological exam in relationship to perfusion and cerebral injury and the
management steps that must be taken to solve these problems.
Describe how a patient is exposed for examination.
Describe when a patient should and should not be exposed for such assessment.
Describe how assessment can be completed with only a partially exposed patient.
Describe resuscitation of the trauma patient based upon the Fick principle.
Describe the various steps in the assessment of the effectiveness of resuscitation techniques.
Describe the components of a complete prehospital history and the significance of each.
Describe the components of the history that are important prehospitally and those that are not.
Describe the general overview of a physical examination.
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149.
Describe the physical examination as it relates to the head.
Describe the anatomy of the head and face.
Describe those pathophysiologic conditions that require prehospital assessment and
management.
150.
Describe the management of the pathophysiologic conditions of the head.
151.
Describe the specific head injuries that compromise the airway and why.
152.
Describe specific head injuries that produce hemorrhage and how they are managed.
153.
Describe the physical examination of the neck.
154.
Describe the anatomy of the neck.
155.
Describe the pathophysiology of neck injuries.
156.
Describe the assessment of the neck.
157.
Describe the management of the neck.
158.
Describe the general examination of the thoracic cavity.
159.
Describe the anatomy of the thoracic cavity.
160.
Describe the physiology of the thoracic cavity including ventilation, respiration, and AcidBase balancing.
161.
Describe the assessment of the thoracic cavity.
162.
Describe the stethoscope, how it works and its uses in the physical examination.
163.
Describe how the physical examination of the thoracic cavity is conducted in steps, and the
various pathophysiologic processes that each step can identify.
164.
Describe the prehospital management of a pneumothorax, tension pneumothorax and an open
pneumothorax.
165.
Describe the management of a flail chest.
166.
Describe a hemothorax and the prehospital significance and management.
167.
Describe a pulmonary contusion and its prehospital significance and management.
168.
Describe cardiac tamponade based on anatomy, physiology and management.
169.
Describe the need/non-need of prehospital management of a cardiac tamponade.
170.
Describe cardiac contusion, including anatomy, pathophysiology, methods of assessment,
significance of dysrhythmias that occur and its management.
171. Describe the abdominal examination and the significance of the abdominal pathologyin the
prehospital phase.
172.
Describe the anatomy of the abdomen.
173.
Describe the physiology of the abdomen.
174.
Describe the pathophysiologic processes of the abdomen that affect prehospital care.
175.
Describe the assessment of the abdomen.
176.
Describe the management of these pathological processes.
177.
Describe the management of extremity injuries, both upper and lower.
178.
Describe the anatomy of the upper and lower extremities.
179.
Describe the pathophysiological processes that affect the upper and lower extremities.
180.
Describe the management of fractures and the treatment of each.
181.
Describe the management of dislocations, explaining which should be reduced prehospitally,
which should not, and why.
182.
Describe the management of lacerations.
183.
Describe the various types of splints which can be used for the immobilization of fractures,
and list the advantages and disadvantages for each.
184.
Describe in detail the short backboard, the various types on the market, and theprinciples of
immobilization of the cervical spine.
185.
Describe the management of pelvic fractures.
186.
Describe the significant pathophysiology of pelvic fractures.
187.
Describe the anatomy of the spine including the cervical, thoracic, lumbar and coccygeal
regions.
188.
Describe the anatomical differences in the various regions.
189.
Describe the construction of the vertebrae in the various regions.
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Describe the assessment of the spine including the differences in the bony assessment and
neurological assessment.
Describe continued monitoring of a patient.
Describe the various scores for assessing the severity of trauma injuries that haveprehospital
significance and those that do not.
Describe how a patient is monitored.
Describe transportation of a patient to a hospital.
Describe communication with a hospital.
Describe the procedure for the PARAMEDIC-to-Physician communication the steps and the
important information included in each step and the priority in each of the steps.
Demonstrate on a manikin or live patient:
a. Mouth to mask ventilation.
b. Mouth to mouth ventilation.
c. Bag-valve mask ventilation.
d. Demand-valve ventilation.
e. Oral airway insertion.
f. Nasal airway insertion.
g. Endotracheal tube.
h. Esophageal obturator airway.
i. PTL LMA, SAlT, King airways.
Assessment of adequate ventilation.
Management of an open pneumothorax.
Decompression of a tension pneumothorax.
Insertion of an IV line.
Application of MAST trousers.
Assessment of reestablishment of perfusion.
A mini-neurological exam.
Exposure of a patient for physical exam.
Physical examination of the head.
Physical examination of the neck.
Physical examination of the thorax.
Physical examination of the abdomen.
Physical examination of the upper extremities.
Physical examination of the lower extremities.
Physical examination of the pelvis.
Neurological examination.
Application of the short backboard.
Application of the long backboard.
Splinting techniques for the upper extremities.
Splinting techniques for the lower extremities.
Immobilization of the cervical spine.
Rapid extrication.
Application of a cervical collar.
Insertion of ET tube in the trauma patient including the use of medications to assist.
Insertion of an ET tube in the non-trauma patient including the use of medications.
Reduction of a knee dislocation.
Reduction of a shoulder dislocation.
Reduction of a finger dislocation.
Reduction of a fracture/dislocation of the ankle.
Describe four types of burns.
Describe the pathophysiology of rhabdomyolysis and treatment from crush, electrical and
compartment syndromes.
Copyright Yale-New Haven Sponsor Hospital Program Paramedic Handbook, 2015 - 2016
OBSTETRICS/GYNECOLOGY MODULE EDUCATIONAL OBJECTIVES
Upon completion of this module, the student will be able to:
1. Identify and describe the location and functions of the following:
a. Ovaries
b. Fallopian tubes
c. Uterus
d. Vagina
e. Cervix
f. Perineum
g. Labia
h. Endometrium
2. Describe the normal menstrual cycle.
3. Identify specific details of history that should be obtained in the gynecologic patient.
4. Identify specific physical findings that should be assessed in the gynecologic patient.
5. List the side effects of commonly used contraceptives.
6. Describe the typical signs, symptoms, and management of pelvic inflammatory disease.
7. Identify sources of non-traumatic abdominal pain.
8. Identify potential sources of trauma to the external genitalia and management of injuries.
9. Discuss the assessment of a sexual assault victim and identify the ways in which it differs from
usual assessment.
10. Identify principles of management for the sexual assault victim.
11. Identify the normal site of:
a. Ovum fertilization
b. Ovum implantation
12. Identify and describe the functions of the following:
a. Placenta
b. Umbilical cord
c. Amniotic sac and fluid
13. Describe fetal development and circulation.
14. Define the following terms:
a. Antepartum
b. Postpartum
c. Natal
d. Prenatal
e. Primigravida
f. Primipara
g. Multigravida
h. Multipara
15. Identify specific details of history that should be obtained in the obstetric patient.
16. Identify specific physical findings that should be assessed in the obstetric patient.
17. List early signs and symptoms of pregnancy.
18. Discuss the possible effects of trauma on both mother and fetus.
19. Discuss the effect of pregnancy on the following pre-existing diseases:
a. Diabetes
b. Essential hypertension
c. Neuromuscular disorders
d. Cardiac disorders
20. Define the following terms:
a. Spontaneous abortion
b. Criminal abortion
c. Therapeutic abortion
d. Threatened abortion
e. Missed abortion
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f. Septic abortion
21. Describe the pathophysiology, assessment, and management of the patient, who has had, or is
having an abortion.
22. Describe the pathophysiology, assessment, and management of the following:
a. Ectopic pregnancy
b. Abruptio placenta
c. Placenta previa
23. Describe Braxton-hicks contractions and their significance.
24. Describe the pathophysiology, assessment, and management of eclampsia and preeclampsia.
25. Discuss pregnancy-induced hypertension including the administration of diazepam and
magnesium sulfate.
26. Describe the signs, symptoms, and management of supine hypotensive syndrome.
27. Define the stages of labor and the length of each.
28. Describe the progression of labor.
29. Define the following terms:
a. Effacement
b. Cervical dilation
c. Crowning
d. Presenting part
30. Discuss factors that influence transport decisions for the patient in labor.
31. List and describe steps for a normal delivery.
32. Describe the management during delivery when the cord is wrapped around the baby’s neck.
33. Describe the pathophysiology, assessment, and management of cephalopelvic disproportion
(CPD).
34. List factors that may cause a large fetus (LGA).
35. List and describe 5 abnormal positions or presentations of the fetus during delivery andthe general
management principles.
36. Describe the pathology and management of a prolapsed umbilical cord.
37. Describe the management of the multiple birth delivery.
38. Describe the occurrence, complications, and management of a precipitous labor.
39. Describe the pathophysiology, assessment and management of post-partum hemorrhage.
40. Discuss the indications for and technique of fundal massage.
41. Describe the pharmacology and actions, indications, precautions,administration, and side effects of
oxytocin.
42. Describe the pathophysiology, assessment, and management of uterine rupture.
43. Identify the pathophysiology, assessment, and management of uterine inversion.
44. Identify the pathophysiology, assessment, and management of pulmonary embolism during the
antepartum or postpartum period.
45. Describe the routine care of a newborn.
46. List 4 means by which heat loss occurs in infants.
47. Describe methods of heat conservation in the newborn.
48. Discuss the effects of hypothermia on the newborn infant.
49. Define the parameters of Apgar scoring and the numerical values utilized.
50. Describe resuscitation for the distressed infant.
51. Describe 2 methods of stimulating the distressed infant.
52. Describe the appropriate administration of oxygen to the newborn.
53. Describe methods of ventilatory assistance for the newborn infant.
54. Identify the rate of ventilation to be used in the non-breathing newborn.
55. Describe the technique for cardiac compressions on the newborn.
56. Identify the significance of meconium staining.
57. Identify the major problems that occur during transport of the neonate.
58. Identify heat sources that may and may not be utilized to warm the neonate.
59. Demonstrate the ability to properly assess the patient with a possible gynecologic disorder.
60. Demonstrate the ability to properly assess the pregnant patient.
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62.
63.
64.
65.
66.
67.
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Demonstrate the ability to obtain an appropriate history when evaluating an obstetricpatient.
Demonstrate the ability to appropriately administer oxygen.
Demonstrate the fundal massage.
Demonstrate the ability to use bulb syringe suction and De Lees suction.
Demonstrate the ability to clamp and cut an umbilical cord.
Demonstrate the ability to calculate an accurate Apgar score.
Demonstrate the ability to appropriately manage a newborn infant.
Copyright Yale-New Haven Sponsor Hospital Program Paramedic Handbook, 2015 - 2016
PEDIATRICS EDUCATIONAL OBJECTIVES
Upon completion of this module, the student will be able to:
1. Define the terms growth and development.
2. Identify the general goals of managing the pediatric patient.
3. Discuss the sources of historical information for the pediatric patient.
4. List the principles in the general approach to the pediatric patient.
5. Identify normal age-related vital signs in the pediatric patient.
6. Describe the normal and abnormal appearance of the anterior fontanelle in the infant.
7. For each of the following age groups, identify the relevant aspects of normal growth and
development, personality development, relationship to parents, history factors, commonillnesses
and accidents, and approach.
a.
Neonate
b.
1 to 5 months
c.
6 to 12 months
d.
12 to 36 months
e.
3 to 5 years
f.
6 to 12 years
g.
12 to 15 years
8. Define Sudden Infant Death Syndrome (SIDS)
9. Describe the incidence of SIDS.
10. Discuss the current theories on SIDS.
11. Describe the assessment and management of SIDS cases.
12. Identify the immediate needs of the SIDS family.
13. Describe the characteristics of the child abuser.
14. Describe the characteristics of the abused child.
15. Discuss the assessment of the potentially abused child including important historical information.
16. Describe the management of the victim and family in the child abuse situation.
17. Discuss legal requirements of health professionals to report suspected child abuse.
18. Describe the pathophysiology, assessment, and management of pediatric seizures.
19. Describe the pathophysiology, assessment, and management of dehydration in thepediatric patient.
20. Describe the pathophysiology, assessment, and management of the child with suspected
meningitis.
21. Describe the pathophysiology, assessment, and management of the child with suspected
septicemia.
22. Describe the pathophysiology, assessment, and management of the child with suspected Reyes
Syndrome.
23. List five public education items that help to prevent pediatric trauma.
24. Discuss pediatric trauma care including differences in shock, head injuries, fractures, and burns
from adult care.
25. List the top five causes of pediatric morbidity and mortality.
26. Identify the steps in relieving airway obstruction in the infant and child according to American
Heart Association standards.
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27. Discuss the pathophysiology, assessment, and management of the following respiratory disorders:
a.
Bronchiolitis/ASU
b.
Croup
c.
Epiglottitis
d.
Asthma
28. Using AHA ACLS/PALS Standards, identify the correct pediatric dosage for the following:
a.
Atropine sulfate
b.
Calcium chloride or gluconate
c.
Dopamine
d.
Epinephrine
e.
Epinephrine infusion
f.
Furosemide
g.
LidocaineI
h.
Lidocaine infusion
i.
Naloxone
j.
Sodium bicarbonate
k.
Amiodarone
29. Describe the technique for endotracheal intubation in the pediatric patient.
30. Identify appropriate blade sizes and endotracheal tube sizes for the pediatric patient.
31. Describe the site selection for intravenous infusions in the pediatric patients.
32. Describe the equipment selection for intravenous therapy in the pediatric patient.
33. Demonstrate the ability to assess vital signs in the pediatric patient utilizing the age appropriate
equipment.
34. Demonstrate the ability to obtain an age/developmental appropriate history when evaluating the
pediatric patient.
35. Demonstrate the ability to perform an age/developmental appropriate assessment when evaluating
the pediatric patient.
36. Demonstrate the ability to manage airway obstruction in the infant and child.
37. Demonstrate the ability to perform CPR on the pediatric patient according to the AHA standards.
38. Demonstrate the ability to perform endotracheal intubation in the infant and child.
39. Demonstrate the ability to perform intravenous therapy on the pediatric patient including selection
of appropriate equipment, solutions, and anatomical sites.
40. Describe and discuss the anatomical differences between adult and pediatric airways.
41. Demonstrate the ability to get intraosseous access in the infant and child.
42. Demonstrate the ability to defibrillate a infant and child including paddle placement and energy
selection.
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MEDICAL AND GERIATRIC EMERGENCIES MODULE EDUCATIONAL OBJECTIVES
Upon completion of this module the student will be able to:
INFECTIOUS DISEASE
1. Discuss assessment of the medical patient especially history taking and differential diagnosis.
2. Describe virus.
3. Describe bacteria.
4. Describe fungus.
5. Briefly discuss the body’s immune system.
6. Define antigen.
7. Define antibody.
8. Define antigenic determinants.
9. Define clone cells.
10. Define leukocyte.
11. Discuss the major components of the immune system.
12. Define lymph.
13. Define interstitial fluid.
14. Discuss composition of lymph and interstitial fluid.
15. Discuss the lymphatic system.
16. Discuss lymph circulation.
17. Discuss the function of:
a. Lymph
b. Antibodies
c. Thymus
d. Spleen
18. Discuss the formation and types of lymphocytes.
19. Discuss the development, activation and function of B cells.
20. Discuss the development, activation and function of T cells.
21. Identify and discuss the location of lymphocytes.
22. Describe the structure and types of antibodies.
23. Discuss gammaglobulinemia.
24. Define autoimmune disease.
25. Define infectious disease and the general cause.
26. List 12 examples of infectious disease and the general cause.
27. Discuss how infectious diseases are transmitted. Define: fomite, host, carrier, reservoir, vector
and subclinical infection.
28. Define communicable disease.
29. Give an example of a highly communicable disease caused by a virus.
30. Give an example of a communicable disease caused by bacteria.
31. Give an example of a communicable disease caused by fungi.
32. Discuss how stress may be related and affect infectous disease.
33. State how the anatomy and physiology of specific body systems are affected by specific diseases.
34. Identify the changes in signs and symptoms to be evaluated in a patient with an Infectious disease
including:
a. Primary survey, including LOC
b. Vital signs
c. Secondary survey (head-to-toe survey)
d. Neurological evaluation
35. Define tuberculosis.
36. Discuss the pathophysiology of tuberculosis, including:
a. Acute generalized form.
b. Chronic localized form.
37. Discuss the body systems commonly affected by tuberculosis.
38. Discuss signs and symptoms related to handling the patient with tuberculosis.
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Discuss EMS safety as related to handling the patient with tuberculosis.
Define hepatitis.
Discuss the pathophysiology of hepatitis.
Discuss the body symptoms related to the patient with:
a. Hepatitis acute anicteric
b. Hepatitis choloangiolitic
c. Hepatitis fulminant
d. Infectious hepatitis (include: how transmitted)
e. Serum hepatitis (include: how transmitted)
f. Toxic hepatitis
g. Viral hepatitis
Types A, B, C, D, E, etc.
Discuss assessment and management of the patient with hepatitis.
Discuss EMS safety as related to handling the patient with hepatitis.
Define meningitis.
Discuss the causes of meningitis.
List the signs and symptoms of pneumonia, Urinary tract infection, endocarditis, andpleurisy.
Discuss the pathophysiology of meningitis.
Discuss the body systems commonly affected by meningitis.
Discuss signs and symptoms related to the patient with meningitis.
Briefly discuss the following:
a. Acute meningitis
b. Cerebral meningitis
c. Cerebrospinal meningitis
d. Pneumococcal meningitis
e. Spinal meningitis
f. Traumatic meningitis
g. Tuberculous meningitis
Discuss assessment and management of the patient with meningitis.
Discuss EMS safety as related to handling the patient with meningitis.
Define syphilis.
Discuss the types of syphilis.
Discuss the pathophysiology of syphilis.
Discuss the body systems commonly affected by syphilis.
Discuss the signs and symptoms related to the patient with syphilis.
Define gonorrhea.
Discuss the pathophysiology of gonorrhea.
Discuss the body systems commonly affected by gonorrhea.
List two types of herpes simplex.
Discuss the pathophysiology of herpes simplex type 2.
Discuss the body systems commonly affected and incubation periodof herpes simplex type 2.
Discuss the signs and symptoms related to the patient with herpes simplex type 2.
Define Acquired Immune Deficiency Syndrome(AIDS).
Discuss the pathophysiology of AIDS.
Discuss the body systems commonly affected and incubation period of AIDS.
Discuss the signs and symptoms related to the patient with AIDS.
Discuss assessment and management of the patient with a sexually transmitted disease.
Discuss EMT safety as related to handling the patient with a sexually transmitted disease.
Define and discuss the pathophysiology of scabies.
Define and discuss the pathophysiology of lice.
Discuss the body systems commonly affected by scabies/lice.
Discuss assessment and management of the patient with scabies/lice.
Define measles.
Discuss the pathophysiology of measles.
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Discuss the signs and symptoms related to the patient with measles.
Define mumps.
Discuss the pathophysiology of mumps.
Define chickenpox.
Discuss the pathophysiology of chickenpox.
Discuss the signs and symptoms related to the patient with chickenpox.
Discuss the assessment and management of the patient with a childhood disease.
Discuss follow-up after exposure
a. Notification procedures by hospital
b. Notification procedures by EMS
Discuss EMS personnel hygiene.
Discuss vehicle cleaning procedures.
Demonstrate the ability to take a history from the patient with an infectious disease.
Demonstrate the ability to perform a complete physical assessment on the patient with an
infectious disease.
List types of isolation and precaution for each, including:
a. total body fluid
b. enteric
c. protective
d. respiratory
e. skin/wound
Discuss types of antibiotic and antivirals, their use and side effects.
ANAPHYLAXIS
1. Discuss antigens, including:
a. definition
b. examples
c. four ways antigens are introduced.
2. Define antibody and discuss production.
3. Define anaphylaxis vs. allergic reaction.
4. Describe the pathophysiology of anaphylaxis vs. allergic reaction.
5. Discuss the effects that anaphylaxis may have on the following body systems:
a. Respiratory
b. Cardiovascular
c. Gastrointestinal tract.
d. Central nervous
e. Skin
6. In a patient with anaphylaxis, identify signs and symptoms as related to:
a. Respiratory system
b. Cardiovascular system
c. Gastrointestinal system
d. Nervous system
e. Skin
7. Describe the assessment and management of anaphylaxis.
8. Describe the pharmacology/actions; indications;precautions;administration (adult and pediatric);
side effects/special notes for the following drugs for anaphylaxis, asthma and allergic reaction:
a. Oxygen
b. Epinephrine: 1:1000; 1:10,000
c. Diphenhydramine (Benadryl)
d. Aminophylline
e. Methlprednisolone
f. Albuterol
g. Hydrocortisone, dexamethasone
h. Ipratropium
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i. Ketamine
j. Terbutaline
9. Demonstrate the ability to take a relevant history from the patient with anaphylaxis.
10. Demonstrate the competency in effective assessment and management of the patient with
anaphylaxis, including drug therapy.
NERVOUS SYSTEM
1. Identify the parts of a neuron and describe their function.
2. Describe the process of impulse transmission for nerve cells.
3. Describe the types of nerve cells by function.
4. Identify and describe the protective mechanisms of the brain including the blood/brain barrier.
5. Describe the arterial and venous circulation to the brain.
6. Locate the following areas of specialization in the brain for:
a. Speech
b. Vision
c. Personality
d. Balance and coordination
e. Sensory
f. Motor
7. List the parts of the brain and the function of each.
8. Identify the anatomy and functions of the spinal cord.
9. Describe the protective mechanisms for the spinal cord.
10. Identify the divisions of the spinal cord.
11. Identify the divisions of the spinal column.
12. Identify the location of the brachial plexus and the lumbar-sacral plexus.
13. Identify the divisions of the autonomic nervous system and describe the functions and effects of
each.
14. Identify the historical factors to be elicited when evaluating the nervous system including traumarelated and non-trauma related problems.
15. Identify specific observation and physical findings to be evaluated in the patient with a nervous
system disorder including:
a. Primary survey
b. Vital signs
c. Neurological evaluation
d. Head to toe survey
e. Pupils
f. Extraocular movements
g. Spinal evaluation
16. Describe the rating system for the Glasgow Coma Scale.
17. Describe the pathophysiology, assessment and management of the following:
a. Coma
b. Seizures
c. Status epilepticus
d. Stroke
e. Transient ischemic attacks
f. altered LOC (vs. Coma)
18. For the following drugs, identify the pharmacology and actions, the indications, precautions,
administration and side effects, for the adult and pediatric patient.
Glucose 50%, 25%, 10%
Glucagon
Naloxone
RSI: Succinylcholine, Vecuronium, Pancuronium
Dexamethasone
Mannitol
Diazepam, Lorazepam
Phenobarbital
Methylprednisolone
Gabapentin
Carbamazepine
Fosphenytoin
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Phenobarbital
Phenytoin
List the possible causes of coma or altered LOC.
Differentiate between syncope and seizures.
Describe and differentiate the major types of seizures.
Describe the phases of a generalized seizure.
Demonstrate the ability to obtain an appropriate history when evaluating patients with nervous
system disorders.
Demonstrate the ability to perform an appropriate assessment when evaluating patients with
nervous system disorders.
Demonstrate a complete neurological exam.
Demonstrate the ability to appropriately evaluate a patient utilizing the Glasgow Coma Scale.
Demonstrate the ability to appropriately administer the following drugs for the adult and pediatric
patient.
a. Dextrose 50%, 25%, 10%
b. Naloxone
c. Diazepam, Lorazepam
Demonstrate the ability to appropriately manage a patient with a nervous system disorder.
List five causes for a headache and how to manage it.
ACUTE ABDOMEN
1. Describe and discuss the function of the primary gastrointestinal organs, including:
a. Mouth
b. Pharynx
c. Esophagus
d. Stomach
e. Intestines (large/small)
f. Rectum
g. Peritoneum
2. Describe and discuss the function of the gastrointestinal accessory organs, including:
a. Salivary glands
b. Teeth
c. Liver
d. Gallbladder
e. Pancreas
f. Veriform appendix
3. Name the organs that are located in the following quadrants and whether they are hollow or solid:
a. Right upper quadrant
b. Left upper quadrant
c. Right lower quadrant
d. Left lower quadrant
4. Describe the borders of the abdominal cavity.
5. Name the two major blood vessels in the abdomen and lesser supply vessels.
6. Discuss the following non-hemorrhagic causes of acute abdominal pain.
a. Local inflammation: edema, local obstruction.
b. Peritoneal inflammation: edema, pain secondary to edema.
c. General inflammation: edema, significant fluid loss.
7. List disease processes as related to nonhemorrhagic abdominal pain.
8. Define:
a. Hematemesis
b. Melena
9. List hemorrhagic causes of acute abdominal pain.
10. Discuss the specific question you would ask to obtain a history in a patient with abdominal pain.
11. Discuss signs and symptoms of:
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a. Local inflammation
b. Peritoneal inflammation
c. General inflammation
Describe signs and symptoms of:
a. Upper gastrointestinal bleed
b. Lower gastrointestinal bleed
Discuss management of the patient with acute abdominal pain.
Discuss general causes of genitourinary disorders.
Discuss pathophysiology, including causes and complications andsigns and symptoms of:
a. Acute renal failure
b. Chronic renal failure
c. Kidney stones
d. Urinary tract infection (pyelonephritis)
e. Inflammatory Bowel Disease
f. Pancreatitis
g. Gallbladder Disease
h. Hepatitis
Discuss pathophysiology of urinary assessment, including signs and symptoms of renal failure.
Describe management of renal failure.
Discuss assessment, including signs and symptoms of a kidney stone.
Describe management of the patient with a kidney stone.
Discuss assessment, including signs and symptoms related to a urinary tract infection.
Describe management of the patient with urinary tract infection.
Discuss types of dialysis.
Discuss complications related to dialysis.
Discuss the assessment and management of the dialysis patient.
Define:
a. Testes
b. Prostate
c. Penile urethra
d. Epididymis
e. Vas deferens
Discuss signs and symptoms of:
a. Epididymis
b. Torsion of testes
Discuss the assessment and management of the male patient with
i. Epididymis and Torsion of testes.
Demonstrate the ability to take a relevant history from the patient with:
a. Acute abdomen
b. Genitourinary disorder
c. Dialysis related disorders
d. Reproductive system disorders
Demonstrate the ability to perform a complete physical assessment on the patient with:
a. Acute abdomen
b. Genitourinary disorder
c. Dialysis related disorder
d. Reproductive system disorder
Demonstrate competency in effectively treating the patient with:
a. Specific acute abdominal emergency
b. Specific genitourinary disorders
c. Specific dialysis related disorders
d. Specific reproductive system disorders.
For the following drugs, identify the pharmacology and actions, the indications, precautions,
administration and side effects, for the adult and pediatric patient
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Activated charcoal
Dolasetron
Promethazine
Scopolamine
Thiamine
Dimenhydrinate
Prochlorperazine
Metoclopramide
Droperidol
Trimethobenzamide
ENDOCRINE EMERGENCIES
1. Define hormone.
2. Discuss hormone production, including function and the single-most important influencing
production.
3. Discuss the pituitary gland, including:
a. Location
b. Function
c. Anterior pituitary gland
d. Posterior pituitary gland
4. Discuss the thyroid gland, including:
a. Location
b. Function
c. Parathyroid gland
5. Discuss the adrenal glands, including:
a. Location
b. Function
c. Adrenal cortex
d. Adrenal medulla
6. Discuss the pancreas, including:
a. Structure
b. Location
c. Function
7. Discuss the ovaries, including:
a. Location
b. Function
c. Estrogen
d. Progesterone
8. Discuss the testes, including:
a. Location
b. Function
9. Discuss the function of insulin, including the cycle:
a. Absorption of glucose/insulin secretion to glucose
b. Insulin secretion
c. Glucose metabolism
d. Return to homeostasis
10. List and briefly discuss the two functions of the islets of Langerhans
11. Discuss the function of glucagon, including the cycle:
a. Lowering blood glucose concentration
b. Secretion of glucagon
c. Increase of blood glucose concentration
d. Return to homeostasis
12. Define diabetes mellitus
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Discuss juvenile onset of diabetes mellitus (type I)
Discuss adult onset of diabetes mellitus (type II)
Discuss osmotic diuresis in diabetes.
Discuss the mechanism of ketone body formation and ketoacidosis
Discuss kidney excretion of ketoacids and potassium
Discuss the pathophysiology of hypoglycemia, including:
a. Insulin and the relationship to serum glucose levels
b. Epinephrine and glycogen
Discuss the precipitation of hypoglycemia
List 8 signs/symptoms of hypoglycemia.
Describe the compensating mechanism in a hypoglycemic patient.
Describe the onset of hypoglycemia
Discuss the effects that low insulin levels have on the body.
Discuss the effects that increased glucose levels have on the body.
Discuss the pathophysiology of diabetic ketoacidosis, including:
a. Blood sugar level
b. Insulin level
Discuss the precipitation of diabetic ketoacidosis
List 8 signs/symptoms of diabetic ketoacidosis.
Discuss the body’s compensating mechanism of the patient with diabetic ketoacidosis.
Discuss the general management of the hypoglycemic patient or including:
a. Airway management
b. Intravenous fluid therapy
c. Drug therapy
d. Insulin, Potassium, Sodium Bicarbonate
e. Circulation
Discuss the general management of the hypoglycemic patient who is unconscious, including:
a. Airway management
b. Intravenous therapy
c. Drug therapy
d. Glucagon, Dextrose 50%, 25%, 10%
e. Circulation
Discuss the general management of the ketoacidotic patient who isunconscious, including:
a. Airway management
b. Intravenous therapy
c. Drug therapy
d. Circulation
Discuss the recognition and management of the patient with non-ketotic hyperglycemic
hyperosmolar acidosis.
GERIATRICS/GERONTOLOGY
1. Discuss statistics on aging, including increased life expectancy, percent of population over 65
years old, and leading causes of death in geriatric population.
2. Discuss at least 6 factors which contribute to the elderly being at high risk for increased medical
care.
3. Discuss general decline in organ systems, including:
a. Respiratory system
b. Cardiovascular system
c. Renal system
d. Nervous system
e. Musculoskeletal system
f. Gastrointestinal system
g. Response to emotions/stress
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4. List at least 12 diseases/disorders common in the elderly
5. List 4 factors that complicate clinical evaluation of the geriatric patient.
6. As related to the geriatric patient’s history, discuss the following considerations:
a. Common complaints of the geriatric patient (not specific to any one disorder).
b. 4 considerations which may mask the patient’s ability to communicate significant
signs/symptoms.
7. As related to the physical examination of a geriatric patient, discuss the following considerations:
a. Fatigue
b. Excessive clothing
c. Disguised signs/symptoms
8. Define syncope
9. Define pre-syncope
10. Discuss the pathophysiology of syncope
11. Discuss the following types of syncope:
a. Vasodepressor syncope
b. Orthostatic syncope
c. Cardiac syncope
12. Define seizure and discuss the progression of events.
13. Define vertigo and discuss the progression of events.
14. Define dementia and list the causes:
a. Discuss the etiologies of chronic senile dementia
b. Discuss the etiologies of acute organic brain syndrome
15. Define delirium and list the causes.
16. Define Alzheimer’s Disease
17. Discuss 6 signs/symptoms of Alzheimer’s Disease and the progression of events.
18. Define:
a. Stroke
b. TIA
19. Discuss 4 causes of other focal neurological deficits.
20. List 4 drugs which may produce adverse reactions in the geriatric patient and that may culminate
in cerebral dysfunction.
21. Discuss the general management of neurological disorders.
22. Discuss signs and symptoms of cardiovascular conditions, specific to the geriatric patient.
23. Discuss syncope as related to cardiovascular conditions:
a. Vasodepressor
b. Orthostatic
c. Vasovagal
d. Cardiac
24. Discuss congestive heart failure as related to the elderly.
25. List 2 causes of dysrhythmias in the elderly.
26. Discuss the following as related to the geriatric patient:
a. Aortic dissection
b. Abdominal aortic aneurysm
c. Peripheral arterial and venous conditions
d. General management (refer to cardiac section)
a. List 4 conditions which may cause the physician to alter cardiac drugtherapy.
b. Discuss precautions as related to administration of fluids
27. As related to the elderly patient, list 6 conditions that may be associated withrespiratory distress.
28. Discuss findings which may be specific to the geriatric patient suffering from pulmonary
embolism.
29. Discuss findings that may be specific to the geriatric patient suffering from respiratory tract
infection.
30. Discuss chronic bronchitis with reference to the to the geriatric.
31. Discuss management of respiratory distress.
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32. Discuss the pathophysiology of carcinoma, in general.
33. List 4 kinds of cancer directly attributable to high mortality rate.
34. List 6 signs/symptoms of carcinoma and summarize the characteristics and warning signs of skin
cancer.
35. Discuss general management of the cancer patient
36. List 6 significant signs of blood loss.
37. Discuss cholecystitis/bilary disease as related to the elderly patient.
38. Discuss GI bleed as related to geriatric patients.
39. Discuss 2 causes of upper intestinal hemorrhage.
40. Discuss 4 causes of massive lower intestinal hemorrhage.
41. Discuss small bowel obstruction and 2 causes.
42. Discuss large bowel obstruction, including:
a. Main cause
b. Main signs/symptoms
43. Discuss diverticulitis, including signs and symptoms.
44. Discuss appendicitis, including:
a. Signs/symptoms
b. Complications
45. Discuss pancreatitis, including common cause and symptoms.
46. Discuss peptic ulcer disease/perforation, including:
a. Common cause
b. Signs/symptoms
47. As related to the elderly, list related signs and symptoms as associated with gastrointestinal
disorders.
48. Discuss the general management of critical GI bleed in the elderly.
49. Refer to Environmental Emergencies Section. Discuss tolerance of temperatures.
50. Discuss 6 predisposing factors for hypothermia common in geriatric patients.
51. Discuss 3 predisposing factors for hyperthermia common in geriatric patients.
52. Discuss general management of environmental emergencies.
53. List at least 6 reasons that the elderly are more prone to falls.
54. List 3 reasons that the elderly are more prone to head injuries.
55. List 3 reasons that the elderly are more prone to cervical spine injuries.
56. Prehospital priorities of care for trauma in elderly are similar to those for all traumapatients; list
two considerations.
57. Discuss trauma management considerations in the elderly for the following systems:
a. Cardiovascular system
b. Respiratory system
c. Renal system
58. Discuss positioning, immobilization and packaging of the elderly trauma patient (with
consideration of physical deformities).
59. List at least 6 factors which contribute to adverse drug reactions in the elderly.
60. List at least 10 drugs which commonly cause toxicity in the geriatric patient.
61. As related to digitalis intoxication, discuss:
a. Symptoms
b. Drug interactions
c. Management
62. As related to diuretic use, discuss:
a. Symptoms of adverse reaction
b. Drug interaction
c. Management
63. As related to antihypertensive drug use, discuss:
a. Symptoms of adverse reaction
b. Drug interaction
c. Management
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64. As related to antirrhythmic drug use, discuss:
a. Symptoms of adverse reaction
b. Drug interaction
c. Management
65. As related to psychotropic drug use, discuss:
a. Symptoms of adverse reaction
b. Drug interaction
c. Management
66. As related to antidepressant use, discuss:
a. Symptoms of adverse reaction
b. Drug interaction
c. Management
67. As related to salicylate use, discuss:
a. Symptoms of adverse reaction
b. Drug interaction
c. Management
68. Discuss geriatric abuse and factors which precipitate abuse.
69. Discuss signs and symptoms as related to geriatric abuse.
70. Discuss the profile of a potential geriatric abuser.
71. Discuss at least two considerations as related to obtaining a history from the abused geriatric.
72. Discuss, in general gerontology program services, including objectives of the program.
73. Discuss the following components of a gerontology program:
a. In-home assessment
b. Family conference
c. Patient conference
74. Compare and contrast osteoarthritis, rheumatoidarthritis, and gouty arthritis with respect to
population affected, causes, outcome and therapy.
75. Discuss osteoporosis as a cause of fracture.
RESPIRATORY SYSTEM
1. Describe the difference between the normal respiratory drive and the respiratory driveof the
patient with chronic obstructive pulmonary disease.
2. Define the following terms:
a. Hypoxia
h. Hyperpnea
b. Hypoxemia
i. Orthopnea
c. Hypercarbia
j. Apnea
d. Respiratory failure
k. Hypoventilation
e. Cyanosis
l. Hyperventilation
f. Dyspnea
m. Tracheal tugging
g. Tachypnea
n. Nasal flaring
3. Identify the historical factors to be elicited when evaluating the respiratory system.
4. Identify specific observations and physical findings to be evaluated in the patient with a
respiratory complaint.
5. Describe the techniques of inspection, auscultation, and palpation of the chest.
6. Define the following terms:
a. Snoring respirations
b. Stridor
c. Wheezing
d. Rhonchi
e. Rales
f. Friction rub
7. Identify the principles of basic airway management.
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8. For the following drugs, identify the pharmacology and actions, the indication, precaution,
administration and side effects for the adult and pediatric patient:
a. Oxygen
b. Epinephrine
c. Racemic epinephrine
d. Aminophylline
e. Diphenhydramine
f. Albuterol
g. Hydrocortisone
h. Methylprednisolone
i. Isoetharine
j. Metaproterenol
k. Terbutaline
l. Ipratropium
9. Identify the causes of upper airway obstruction, the pathophysiology, assessment and
management of each.
10. Discuss the pathophysiology, assessment, and management of the following:
a. Emphysema
b. Chronic bronchitis
c. Asthma
d. Pneumonia
e. Toxic inhalation
f. Pulmonary embolism
g. Hyperventilation syndrome
h. Central Nervous System respiratory dysfunctions
11. Demonstrate the technique of direct laryngoscopy
12. Demonstrate the upper airway obstruction protocol according to AHA standards.
13. Demonstrate the techniques of inspection, auscultation, and palpation in examining the thorax.
14. Identify the following abnormal lung sounds:
a. Stridor
b. Wheezes
c. Rales
d. Ronchi
14. Demonstrate the ability to obtain an appropriate history when evaluating patients with respiratory
complaints.
15. Demonstrate the ability to obtain an appropriate assessment when evaluating patients with
respiratory complaints.
16. Demonstrate the ability to appropriately administer the following drugs for the adult and pediatric
patient:
a. Albuterol
b. Aminophylline
c. Epinephrine
d. Racemic Epi
e. Isoetharine
f. Metaproterenol
g. Oxygen
PSYCHIATRIC MODULE EDUCATIONAL OBJECTIVES
Upon completion of this module, the student will be able to:
1. Define the term “Behavioral Emergency”.
2. List factors that may alter the emotional status of the ill or injured.
3. List those factors specific to the pediatric patient experiencing emotional crisis.
4. List the management techniques of emotional distress in all children.
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5. List the management techniques of emotional distress and crisis in the elderly.
6. Define the following terms:
a. Anxiety
b. Confusion
c. Anger
d. Emotional crisis
e. Conversion reaction
f. Fear
g. Depression
h. Transference
i. Guilt
j. Reality testing
7. List the proper verbal communication techniques useful in managing the emotionally disturbed
patient.
8. List the reasons for taking appropriate measures to insure the safety of the paramedic.
9. Describe the reason for reassuring the patient in emotional crisis and explain the techniques used
in this process.
10. Describe the circumstances when bystanders and relatives should be removed from thescene. Also
describe circumstances when their presence can be used to theparamedic’s advantage.
11. List those factors that increase the risk of suicide.
12. Describe those behaviors that are indirect indicators of an impending suicide attempt.
13. Describe those overt behavioral modifications associated with:
a. Rage
j.
Neurosis (inc. phobia, compulsive
b. Hostility
and panic disorders)
c. Suicide
k.
Psychoses
d. Violence
l.
Schizophrenia
e. Depression
m.
Substance abuse
f. Bipolar disorder
n.
Organic disorder
g. Paranoia
o.
Dementia
h. Delerium
p.
Hyperactivity
14. Dysphoria
15. Define the following terms:
a. Facilitation
b. Confrontation
c. Open-ended questions
d. Affect
e. Posture
f. Mental status
g. Delusion
h. Illusion
i. Hallucination
16. Describe the techniques that facilitate the systematic gathering of information from the disturbed
patient.
17. Describe the techniques that may be useful in redirecting anxietyin relatives and bystanders.
18. Describe the appropriate action of the EMT-Paramedic when confronted bythe uncontrollable
armed patient.
19. Describe the appropriate techniques used in restraining the patient.
20. Describe those techniques useful in protecting the EMT-Paramedic when attacked by a violent
patient.
21. List those situations in which the EMT-Paramedic is expected to restrain ortransport a patient
forcibly and against his will.
22. List the appropriate communications of significant findings to the resource hospital.
23. Describe the techniques that are useful in managing the effects of crisis situations on the EMTParamedic.
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24. Define the term “debriefing” as a technique for controlling EMT-Paramedicstress following a
stress situation.
25. Define the term stress.
26. Name the causes of stress.
27. Describe the three phases of the stress response.
28. Describe Post Traumatic Stress Syndrome.
29. Name and describe at least five defense mechanisms commonly usedto deal with stress and
identify those that are positive and those that are negative.
30. Describe factors that determine whether anxiety is a positive or a negative response.
31. Describe the common physiologic effects of stress.
32. Describe the behavior that is a manifestation of stress in:
a. the patient
b. the patient’s families
c. the EMT-Paramedic
33. Name common causes of job stress for the EMT-Paramedic.
34. Describe the techniques that are useful in managing the effects of crisis situations on
the EMT-Paramedic.
35. Define the term “debriefing” as a technique for controlling EMT-Paramedic stress following
36. a stressful situation.
37. Describe various techniques the EMT-Paramedic may use to help others manage stress in self or
others.
38. Describe the stages of the grief process.
39. Describe the common needs of a) the patient, b) the family, and c) the EMT-Paramedic in dealing
with death and dying.
40. Describe four (4) common management techniques used by the EMT-Paramedic whena patient is
dead or dying.
41. Identify issues of controversy in pre-hospital care involving death and dying.
42. Perform a mental status examination. Describe parts of MSE.
43. Discuss the effects of use and the side effects of the following psychotropic drugs:
A. Antipsychotics
i. Chlorpromazine
ii. Thioridazine
iii. Haloperidol
iv. Trifluoperazine
v. Fluphenazine
vi. Risperdone
vii. Aripiprazole
B. Antidepressants & Selective Serotonin Reuptake Inhibitors
1. Amitriptyline
6. Trazadone
2. Imipramine
7. Effexor
3. Doxepin
8. Wellbutrin
4. Nortriptyline
9. Celexa
5. Desipramine
10. Paxil
C. Lithium
D. Sedatives
i. Diazepam
ii. Chlordizepoxide
iii. Oxazepam
iv. Clorazepate
v. Lorazepam
vi. Alprazolam
vii. Hydroxyzine
E. Hypnotics
i. Flurazapam
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ii. Temazepam
44. List the signs, symptoms and treatment for acute dystonic reactions.
45. State the use and purpose of the DSM IV.
TOXICOLOGY EDUCATIONAL OBJECTIVES
Upon completion of this module the student will be able to:
1. Discuss the relative importance of toxicologic emergencies in prehospital care.
2. Describe the routes of entry of toxic substances into the body.
3. Discuss the role of Poison Control Centers in the EMS system and in the management of
a. patients with toxicological emergencies.
4. Describe the aspects of the patient’s history that are relevant in the management of a
b. patient with ingested poison.
5. Describe the general principles of management of a patient with ingested poison.
6. Discuss the factors affecting the decision to induce vomiting in a patient with ingested poison.
7. Describe the signs, symptoms and management of the following specific cases of ingested
poisons:
a. Strong acids or alkalis
b. Hydrocarbon products
c. Methyl alcohol or ethylene glycol
d. Cyanide
e. Food poisoning
f. Poisonous plants
8. Describe the general principles of management of a patient with in-haled poison.
9. Describe the signs, symptoms and management of the following specific cases of inhaled
poisons:
a. Carbon monoxide
b. Freon
c. Ammonia
d. Chlorinated hydrocarbons
e. Methyl chloride
10. Describe the general principles of management of a patient with injected poison.
11. Describe the general principles of management of a patient with surface contact poison.
12. Demonstrate the use of at least four toxicologic research sources to find: medical, personal
protective equipment and decontamination information.
13. Describe the general principles of management of a patient with a surface absorbed poison.
14. Describe the signs, symptoms and management of the following specific cases of surface absorbed
poison.
a. Organophosphate chemicals
b. Cyanide
15. Describe the general principles of management of a patient with an overdose includingacute toxic
drug reaction.
16. Describe the signs, symptoms, and management of the following specific cases ofoverdose:
a. Narcotics
b. Sedatives/depressants
c. Aspirin/salicylates
d. Acetaminophen
e. Antidepressants including TCA’s & MAO inhibitors
17. Describe signs and symptoms of untoward reactions to drugs including dystonic reactions and
their field management.
18. Discuss the incidence of drug abuse in the U.S.
19. Define the following terms:
a. Substance or drug abuse
b. Substance or drug dependence
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20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
30.
31.
32.
33.
34.
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c. Tolerance
d. Withdrawal
e. Addiction
List the most commonly abused drugs (Both by chemical name and “street”names) and describe
their physiological and psychological effects.
Describe the management of emergencies stemming from the use of the following:
a. Hallucinogens (LSD, mescaline, DMT, psilocybin)
b. Phencyclidine hydrochloride (PCP)
c. Cocaine
d. Cannabis (marijuana)
e. Amphetamines
f. Depressants
Discuss the incidence of alcoholism in the U.S..
Discuss the signs, symptoms and management of acute alcohol over-dose.
Discuss the signs and symptoms of chronic alcohol use.
Discuss the signs, symptoms and management of alcoholic withdrawal (deliriumtremens or
“DT’s”)
Describe the implementation of ICS at a Haz-Mat incident.
List the first standard actions to be taken at a Haz-Mat incident.
Define the following terms:
a. Hazardous material (DOT)
b. Hazardous substance (CERCLA)
c. Hazardous chemical (OSHA)
d. Extremely Hazardous substance (EPA)
e. Dangerous goods (CANADA)
f. Hazardous waste (RCRA)
List the nine United Nations hazardous materials classes and the major hazard of each.
Describe the purpose of CHEMTREC, how to contact and what
services areprovided.
Identify locations in the community where hazardous materials are transported, stored,
manufactured or disposed of.
Describe 3 methods hazardous materials can enter the body.
Identify respiratory hazards encountered at a HAZ-MAT incident.
Describe 3 types of protective breathing apparatus.
Define:
a.
Flash point
b.
Ignition temperature
c.
Flammable limits(upper and lower explosive units)
d.
Specific gravity
e.
Threshold limit value
f.
Emergency exposure limits
g.
ceiling limit
h.
vapor density
i.
boiling point
j.
lethal concentration
k.
lethal dose
l.
time weighted average
m.
TLV-short term exposure limit
n.
BLEVE
o.
melting point
p.
water solubility
q.
flammable rage
r.
radioactive materials
s.
alpha particles
t.
beta particles
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35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
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u.
gamma rays
v.
half-life
Describe the NFPA704 ID system
Describe military communication markings
Identify sources of specific information to help identify hazardous materialsand demonstrate their
use (include computer and on-line sources).
Identify the shipping papers including: proper names, individual responsible and thelocation
found.
List eight categories of information found on Material Safety Data Sheets.
Demonstrate the ability to use Material Safety Data Sheets.
Describe application, use and limitations of :
a. Structural fire-fighting personal protective equipment
b. Chemical protective clothing (levels A,B,&C)
c. High temperature/Explosive/Flash personal protective equipment
Describe the use of EPA pesticide labels and the special words used thereon.
Identify the purpose of consulting chemical compatibility charts for personal protective
equipment.
Identify the three ways in which chemicals impact the effectiveness of personal protective
equipment.
Identify how contamination occurs at Hazardous Materials incidents.
Identify the negative outcomes of failing to decontaminate, includingspreading the incident to the
hospital.
Explain the goal of decontamination.
Identify the elements crucial to a decontamination plan.
Identify when to use field decontamination.
Identify how to determine the appropriate level of decontamination to be utilized.
Explain the criteria to consider when establishing and equipping a decontamination corridor.
Identify the priorities for establishing and conducting decontamination.
Identify the specific decontamination procedures to be utilized at each level of decontamination.
Explain the process of decontaminating the decontamination team.
Identify the criteria for medical transport of contaminated patients.
List the phases of termination procedures.
Identify at least two goals of debriefing.
Identify at what point in an incident a debriefing should occur.
Identify at least 3 topics that should be addressed in a debriefing.
Explain the purpose of a critique.
Explain the influence of attitude on the safety level maintained at a HAZ-MAT incident.
Identify the possible multiple hazardous characteristics of a hazardous material in a single hazard
class.
Describe the use, dose, and contraindications of the following medications and specific antidotes
in toxicological emergencies:
a. activated charcoal
i. sodium nitrite
b. amyl nitrate
j. D50W
c. atropine
k. N-Acetylcysteine
d. calcium chloride
l. physostigmine
e. Ipecac
m. Diazepam
f. Naloxone
n. magnesium citrate
g. 2-pam chloride
o. calcium glutinate
h. sodium bicarbonate
p. sodium thiosulfate
q. cyanocobalamin
r. Flumazenil
Demonstrate the use of gastric lavage.
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ENVIRONMENTAL EMERGENCIES EDUCATIONAL OBJECTIVES
Upon completion of this module, the student will be able to:
1. Define steady-state metabolism and identify the oral and rectal temperatures associated with a
metabolic steady state.
2. List the two terms associated with bodily temperature extremes.
3. List and define the function of two structures in the body’s primary thermoregulatory mechanism.
4. List two mechanisms of thermal generation with the body and the basic mechanism associated
with each.
5. Describe the body’s compensatory mechanism for excess thermal gain.
6. Describe five ways in which the body dissipates heat into the external environment.
7. Describe the body’s compensatory mechanism for excess thermal loss.
8. State three common forms of systemic heat disorder. State three less common forms of systemic
heat disorder.
9. Define the roles of sodium, potassium and water in heat cramps.
10. List the signs and symptoms associated with heat cramps.
11. Describe the treatment of heat cramps.
12. Define the roles of sodium and water in heat exhaustion.
13. List the signs and symptoms associated with heat exhaustion.
14. Describe the treatment of heat exhaustion.
15. List the two environmental factors associated with heat stroke.
16. Describe the role of the body’s primary thermoregulatory mechanism in heat stroke.
17. State the critical upper range temperature at which cellular deterior-ation begins.
18. Differentiate the following parameters among heat cramps, heat exhaustion and heat stroke.
a. Pathophysiology
b. Cramping
c. Mental status
d. Skin condition
e. Internal temperature
f. Pulse
g. Blood Pressure
19. State the treatment modality that is common to heat cramps, heat exhaustion and heat stroke in
addition to the ABC’s of basic life support.
20. List predisposing factors and preventative measures associated with heat disorders.
21. Define fever (pyrexia) and identify the pathophysiological mechanisms of the disorder.
22. Define hyperpyrexia and identify pathophysiological mechanisms.
23. State the field treatment for pyrexia.
24. State the causative factor associated with acute systemic hypothermia.
25. State the temperature range, signs and symptoms associated with mild and moderate
65. systemic hypothermia.
26. State the temperature range, signs and symptoms associated with severe systemic hypothermia.
27. State the causative difference between acute, subacute and chronic hypothermia and state who is at
risk for each.
28. Describe the metabolic responses to mild, moderate and severe systemic hypothermia
66. and the implications of these responses to pharmocotherapy and defibrillation.
29. Discuss the treatment of hypothermia.
30. State conditions under which rewarming should be initiated in the field.
31. Define the “afterdrop phenomenon” and its prognostic implications.
32. List two metabolic factors that may be associated with chronic hypothermia. List five factors of
aging associated with chronic hypothermia.
33. List individuals who are at greatest risk for hypothermia.
34. Differentiate between frostnip, superficial frostbite and deep frostbite.
35. State the steps in the field management of frostbite.
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36. State the immersion rewarming temperature for frostbitten extremities and the rationale for this
temperature.
37. State the importance of near-drowning as a leading cause of accidental death in the U.S..
38. Describe the usual physiologic sequence of events in a near-drowning episode and differentiate
drowning from near-drowning.
39. Describe the pulmonary and systemic pathophysiology in near-drowning patients.
40. Describe the differing physiology of dry vs. wet and salt vs. Fresh water drowning.
41. State the factors affecting survival times and probability of successful resuscitation in neardrowning patients.
42. Describe the management of the near-drowning patient.
43. Identify the common types and sources of ionizing radiation.
44. Identify sources of normal background radiation.
45. Describe the pathophysiology of ionizing radiation received over acute and/or chronicexposure.
46. Describe the signs, symptoms and management of the irradiated patient.
47. Describe the relative risks to the paramedic in handling the radiated patient.
48. Describe the physiology of breathing gas under pressure, and include an explanation of gas
pressure laws.
49. List the common medical problems associated with diving accidents.
50. Describe the various major physiologic factors which may predispose a diver to decompression
sickness.
51. Describe the pathophysiology of decompression sickness.
52. Describe the signs, symptoms and management of decompression sickness.
53. Describe the pathophysiology of pulmonary overpressure accidents.
54. Describe the signs, symptoms and management of pneumomediastinum.
55. Describe the signs, symptoms and management of subcutaneous emphysema.
56. Describe the signs, symptoms and management of gas embolism.
57. State how to access dive medical information.
58. Describe how to access hyperbaric treatment.
59. Describe the signs, symptoms and management of the following specific cases of
67. injected poisons:
a. Bees, hornets, wasps or yellow jackets
b. Brown recluse spider
c. Black widow spider
d. Scorpion
e. Rattlesnakes, copperheads or cotton-mouth water moccasins
f. Coral snakes
g. Marine animals
68. Describe the general management principles of a patient with a surface absorbed poison,
specifically a plant poison.
69. Describe effects of altitude on changes in barometric pressure.
70. Describe the effects of changing barometric pressure on alveolar gas diffusion.
71. List the five major high altitude diseases and state which are most likely .
72. Describe the signs and symptoms, pathophysiology and treatment for: HAPE, HACE, HARH,
HAFE, and HAMR.
73. Describe the prevention for high altitude illnesses.
74. List the high altitude drugs commonly used and the advantages and disadvantages of each
approach.
75. State two uses for portable pressure bags at altitude.
76. Describe the physics of lightning.
77. Describe the types of lightning.
78. List preventions and treatments for lightning strikes.
79. Be able to calculate the distance of a storm.
80. Describe the signs and symptoms of:
a. Direct lightning strike
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b. Lightning splash
c. Lightning ground strike
81. Describe the pathophysiology and treatment of rhabdomyolysis as it relates to a lightning strike.
82. Describe the pathophysiology of rabies and its prevention.
PARAMEDIC MODULE EDUCATIONAL OBJECTIVES
Upon completion of this module, the student will be able to:
MEDICAL ETHICS AND PROFESSIONALISM
1. Identify and describe those activities performed by an EMT-PARAMEDICaramedic in the field.
2. Define the role of an EMT-PARAMEDICaramedic.
3. Describe and contrast the difference between an EMT-Ambulance, EMT-Intermediate and EMTPARAMEDICaramedic training program.
4. Define the terms “ethics” and “professionalism”.
5. Describe the differences between ethical behavior and legal requirements.
6. State specific activities that are most appropriate to ethical behavior.
7. Identify whether a particular activity is unethical and/or illegal, given certain patient care
situations.
8. Identify whether a particular activity is ethical or unethical given certain patient care situations.
9. Define the term “professional.”
10. Define the term “health care professional.”
11. Identify whether a particular activity is professional or unprofessional given certain patient care
situations.
12. State certain activities that are most appropriate to professional behavior.
13. List current state requirements for EMT-PARAMEDIC continuing education.
14. Define and discuss at least three reasons why continuing education is important for the EMTARAMEDIC.
15. Define the terms “certification, licensure, and registration.”
16. Name and describe current state legislation outlining the scope of pre-hospital Advanced Life
Support.
17. State the reason that it is important to keep one’s EMT-PARAMEDIC certification current.
18. State the major purposes of a national association.
19. State the major purposes of a national registration agency.
20. State the major benefits of subscribing to professional journals.
21. State the benefits of EMT-PARAMEDICS teaching in their community.
22. State the importance and benefits, and model the following professional behaviors: Integrity,
Empathy, Self Motivation, Appearance and Personal Hygiene, Self Confidence, Communications,
Time Management, Teamwork and Diplomacy, Respect, Patient Advocacy, Careful Delivery of
Service.
EMS SYSTEMS
1.
2.
3.
4.
5.
6.
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Discuss citizen access and the various mechanisms of obtaining it.
Discuss pre-hospital and out-of-hospital care as an extension of hospital care.
Define stabilization of patients.
Define and describe Medical Control.
Describe physician responsibility for Medical Control.
Describe the relationship between the physician on the scene, the EMT-PARAMEDIC and the
physician on the radio.
a. Physician who is with patient when the EMT-PARAMEDIC arrives.
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8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
b. The physician who arrives on the scene after the EMT-PARAMEDIC’s have started
evaluating and treating the patient.
Describe the benefits of EMT-PARAMEDIC follow-up on patient condition, diagnosis and
retrospective review of prehospital care.
Describe KKK 1822-x Ambulance standards.
Define the American College of Surgeons Essential Equipment List and how it relates to local
state laws.
Define the national standard levels of prehospital provider as defined by curriculum, respectively.
a. Discuss ambulance placement and the parameters that should be utilized in its development,
include the differences in urban, suburban and rural settings.
Discuss the medical community role in overseeing prehospital care.
Discuss the Paramedic’s role in overseeing prehospital care.
Define protocols and standing orders.
Describe the development of protocols.
Define local training standards.
Describe the legislation in the EMT-PARAMEDIC’s state as regards prehospital care.
Describe integration of prehospital care into the continuum of total patient care with the
Emergency Department phase of hospital care.
Discuss replacement of equipment and supplies.
Discuss the EMT-PARAMEDIC’s initial responsibilities when arriving on the scene.
Describe the relationship between the physician on the radio and the EMT-PARAMEDIC at the
scene.
Describe the relationship between the attending physician not on the scene and the EMTPARAMEDIC at the scene.
Discuss the varying philosophies between the management of medical patients and trauma
patients, prehospital.
Describe the transition of patient care from the EMT-PARAMEDIC, including:
a. Transfer of responsibility (legal and medical).
b. Reporting of patient status to physician or nurse.
Describe the ability of physician run critique based on documentation.
Describe retrospective evaluation of patient care including run report review, continuing
education, skill practice and skill deterioration.
Describe the total system quality improvement vs. quality assurance.
MEDICAL / LEGAL CONSIDERATIONS
1. Discuss the significance and scope of the following in relationship to EMT practice:
a. State Medical Practice Act
b. Good Samaritan Act/Civil Immunity
c. State EMS Statutes
d. State Motor Vehicle Codes
e. State and local guidelines for “Do Not Resuscitate”
2. Define the following:
a. Negligence
b. Medical Liability
c. Tort
d. Duty to Act
e. Battery
f. Slander
g. Informed Consent
h. Expressed Consent
i. Implied Consent
j. Abandonment
k. Liable
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3.
4.
5.
6.
7.
8.
9.
l. Assault
m. False imprisonment
n. “Borrowed servant” doctrine
o. Civil vs. criminal law
p. Legislative vs. case law
q. Kidnapping
Describe the significance of accurate documentation and record keeping in substantiating incident.
Identify those situations that require the EMT-PARAMEDIC to report those incidents to
appropriate authorities.
Describe the four elements to prove medical liability.
Describe the significance of obtaining expressed consent.
Describe the extent to which force and restraint may be used to protect the EMT, the patient and
the third party.
List the top four causes of EMS/Legal entanglements and the ways to protect against each.
Describe the issues of equipment liability.
EMS COMMUNICATIONS
1. Describe the phases of communications necessary to complete a typical EMS event.
2. Name the possible components of an EMS communications system and explain the function of
each.
3. Define base station.
4. Name factors that affect the coverage of mobile transmitter/receivers.
5. Describe the position of the antenna on a portable transmitter/receiver that will deliver maximum
coverage.
6. Describe an advantage of a repeater system over a non-repeater system.
7. Describe the vehicular repeater system.
8. Describe the purpose of a remote console.
9. Describe the function of a satellite receiver.
10. Describe the function of an encoder and decoder.
11. Define hertz, kilohertz and megahertz.
12. Define the terms UHF and VHF and distinguish between the two.
13. Describe the most common causes of interference in biotelemetry communications.
14. Describe the simplex, duplex and multiplex radio systems.
15. Describe functions and responsibilities of the FCC.
16. Describe the responsibilities of an EMS dispatcher.
17. Name information items that must be gathered from a caller by the dispatcher.
18. Describe the ten-code used in the local community.
19. Describe three communications techniques that influence the clarity of radio transmissions.
20. Describe three communications techniques that influence the content of radio transmissions.
21. Describe the importance of written medical protocols.
22. Describe two purposes of verbal communication of patient information to the hospital.
23. Describe information that should be included in patient assessment information verbally reported
to the physician.
24. Organize a list of patient assessment information in the correct order for radio transmission to the
physician according to the format used locally.
25. Name five uses of the written EMS run form.
26. Demonstrate the proper use of a portable transmitter/receiver to receive and transmit information.
27. Demonstrate the proper use of a mobile transmitter/receiver to receive and transmit information.
28. Demonstrate the proper use of a digital encoder.
29. Demonstrate the proper use of a mobile or portable transmitter in a real or simulated patient
situation to:
a. Organize and transmit patient assessment information, using a standardized format; and;
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b. Transmit an ECG.
30. Properly complete a written EMS form based on a real or simulated patient situation.
31. Describe the use and limitations of cellular communications in EMS.
32. Describe the use of portable and mobile computer terminals and “pen-based” systems in EMS.
RESCUE
1. List the equipment utilized for personal and patient safety during a rescue and in different rescue
situations.
2. Identify safety hazards that may be encountered in a rescue operation.
3. Describe the pre-planning phase of a safe rescue.
4. Describe the elements and resources involved in the assessment phase of a rescue operation.
5. Define safe patient access.
6. List the types of equipment available to access an entrapped patient.
7. Describe the EMT-PARAMEDIC’s patient assessment and management responsibilities during a
rescue operation.
8. Identify the expertise for special rescue resources available in the EMT-PARAMEDIC’s response
area or as would be necessary for unusual rescues.
9. Identify the difficulties that maybe encountered in the patient removal phase of a rescue operation.
10. Explain the need for a coordinated effort during the removal phase of rescue operation.
11. Discuss removal of the patient from the rescue scene.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
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MAJOR INCIDENT RESPONSE
Define the term “major incident”.
Identify the local “communication” system.
Describe when a major “incident” should be declared.
Describe the “pre-planning phase” function.
Describe area “response planning”
Describe the components of special resources.
Describe the function of “scene command”.
Describe the function of “scene triage”.
Describe the “transferring command function”.
Describe section and staging management.
Describe a system for patient identification.
Describe scene medical control.
Identify “who’s in charge”
Describe the Medical sector and it’s functions.
Describe the rehabilitation sector and it’s functions.
Name and describe the major functional areas in the NIMS system.
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SECTION V
AGREEMENTS & FORMS
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HANDBOOK AGREEMENT
I verify that I have carefully read, understand and am responsible for all of the following :
• I acknowledge that email is a prime means of communication for the program. I am responsible for
correcting problems and reviewing messages throughout the program. I acknowledge that I am responsible for
using YNHSHP email accounts for all school-related communication and must check my email and course JB
LEARNING site for announcements at least every day.
• I acknowledge that it is my responsibility to regularly meet with my faculty mentor for academic planning.
• I acknowledge I am responsible for knowing and following the requirements and policies of the Yale-New
Haven Sponsor Hospital Program Paramedic Student Handbook, the Clinical Manual and all paramedic
program course syllabi and the University of New Haven Policies if enrolled as a degree student.
• I acknowledge that clinical agencies with which I work as a student may have policies including, but not
limited to, drug testing, immunizations, criminal background checks and manner of dress or appearance. I am
responsible for knowing and following these policies.
• I have never been charged or convicted of any crime in the past, excluding minor traffic violations which did
not involve bodily injury to others. I understand that if I am arrested I must report that arrest to the Paramedic
Program Director prior to returning to class.
My Signature below signifies that I have read the Yale-New Haven Sponsor Hospital Paramedic
Education Program handbook, understand the contents, and agree to abide by the policies and procedures
contained therein.
Printed
Name___________________________________Signature_____________________________________
Date______________________________
Release of Liability
I understand that experiences in both real and simulated patient care as part of this program in settings
including classroom, laboratory, clinical and field internship may expose me to various risks including but not
limited to: infectious diseases, violence, emotional trauma, physical injury and motor vehicle accidents and
legal liability. I assume all responsibility for these risks and therefore release and indemnify the Yale-New
Haven Sponsor Hospital, its affiliate agencies, employees, faculty, preceptors, and board of directors. I also
understand that Yale-New Haven Sponsor Hospital, its affiliate agencies; employees, faculty, preceptors, and
board of directors do not provide or cover me with workers compensation or any other type of medical,
disability or other insurance.
Signed____________________________________________Date_______________________________
Photograph Release
I give permission for the Yale-New Haven Sponsor Hospital Program to use photographs and video of me
participating in this course for promotional, educational, research or other purposes.
Signed_____________________________________________Date______________________________
RIGHT OF CHANGE
I understand that Yale-New Haven Sponsor Hospital Program reserves the right to change or modify the
continents and provisions of this handbook and the Paramedic program as it deems it necessary to achieve the
goals or objectives of the program and Yale-New Haven Sponsor Hospital Program.
Signed________________________________________Date_________________________
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Medical Forms
Name
Birthdate
M/F
Address
City
State/Zip
Phone (Day)
Phone (Evening)
Email Address
Social Security Number
Health Information
For safety reasons, we need to be aware of any special health concerns you may have. Please attach a separate note
if you need more room. This information is confidential and will not be released to anyone other than the directors
and primary instructors without your permission. Please list any accommodations you may need and discuss with the
program director.
Do you have any sensory, mental, or
If so, list and state how they affect you:
physical limitations? Yes No
Do you have any learning limitations
If so, please list:
or disabilities or special needs?
Yes No
Are you currently on any medication
Please list all medications and dosages:
(prescription or over-the-counter)
for your medical condition(s)?
Yes No
What is your weight?
What is your height?
Immunization History: UP-TO-DATE VACCINATIONS REQUIRED Vaccinations – date of last dose:
Vaccine
OPV
MMR
MENINGITIS
HBV
TDAP
CHICKENPOX
PPD
Date
Do you have any of the following: Please mark EACH Yes or No
Hemophilia
Hernia/Ruptures
Diabetes
Arthritis
Lung Disease/Asthma
Ulcer/GI disorder
Allergy to Bee Stings
Any other Allergy
Anxiety/Panic Disorder
Any other conditions we need to be aware of?
If you answered yes to any of the above, please describe exact diagnosis and treatment:
Your health insurance Company/HMO
Name
Address
Phone (Day)
92
Knee Condition
Back Condition
Heart Defect/Disease
Seizures/CNS Disorder
Emergency Information:
Policy #/Group#
Person to Notify in case of Emergency:
Relationship
City
Phone (Evening)
State/Zip
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INFLUENZA
Name
Birthdate
M/F
Address
City
State/Zip
Phone (Day)
Phone (Evening)
Phone (Cell)
Other#
Email address
Person to Notify in case of Emergency:
Birthdate
City
Phone (Evening)
Name
Address
Phone (Day)
M/F
State/Zip
Phone (Cell)
Other#
Email address
Current Medical Problems
Past Medical History
Past Surgical History
Allergies
Medications
Social History:
Tobacco Yes/No
Drugs/Alcohol: Yes/No
Instructions: Below is to be completed in full and signed by the student and by the examining physician, physician
assistant or nurse practitioner.
Physical Exam: Check if normal; describe if abnormal:
Head
Normocephalic/atraumatic
Eyes
PERRL, EOMI, conjunctiva clear, fundi benign
Ears
EAC’s patent, TM’s clear
Nose
Nares patent, turbinates pink
Throat
Tongue & uvula midline, tonsils normal, non-erythematous
Neck
Negative lymphadenopathy, negative thyromegaly
Lungs
Clear to auscultation bilaterally, negative wheezing
Heart
Regular rate and rhythm, negative murmur
Abdomen
Soft, non-tender, negative organomegaly
Extremities
Motor & strength intact, negative clubbing or cyanosis; circulation intact in
all four extremities
Neurological
DTR’s intact and equal bilaterally
Labs: Urine Dip
Sugar:
Protein:
PPD: date read:
And results:
SIGNATURES REQUIRED: At the time of this exam, this individual is physically cabable of performing the physical
duties required of an EMT and is free of any evidence of communicable disease.
Student signature
Date:
Examiner’s signature:
93
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Date:
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Yale-New Haven Sponsor Hospital Paramedic Program
Lab Sheet
Student Name_________________________________________________
SKILL
Airway/Intravenous Labs p.1
SCENARIO
INSTRUCTOR
DATE
COMMENTS
DATE
COMMENTS
AIRWAY ADJUCNTS
NPA
OPA
Nasal cannula
Nasal cannula
Non-rebreather
Non-rebreather
BVM
CPAP
CPAP
Nebulizer TX
Nebulizer TX
Nebulizer TX to BVM
Nebulizer TX to CPAP
SUCTION
Suction- Yankauer
Suction- French
Suction- French
Suction-French
Suction- handheld
SKILL
AIRWAY MNGT
ETT, table
ETT, table
ETT, table
ETT, table
Bougie
Combi-tube
LMA, table
LMA, table
King, table
Surgical
ETT
Trach
SCENARIO
INSTRUCTOR
NREMT Sheet
NREMT Sheet
NREMT Sheet
NREMT Sheet
NREMT Sheet
NREMT Sheet
NREMT Sheet
NREMT Sheet
I_______________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________
Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheet
Student Name: __________________________________________________
SKILL
PREPARATION
Airway/IV/Pharmacology p.2
MEDICATION
INSTRUCTOR
DATE
COMMENTS
Multidose vial
Multidose vial
Multidose vial
Ampule
Ampule
Ampule
Dilutent
Dilutent
Dilutent
Pre-filled syringe
Pre-filled syringe
Pre-filled syringe
ADMINISTER (LIVE)
Sublingual
Sublingual
PO
PO
Intramuscular
Intramuscular
Subcutaneous
Subcutaneous
Intradermal
Intradermal
Nebulizer
Nebulizer
Neb to BVM
M.D.I.
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________
Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheet
Student Name: ____________________________________
SKILL
MANIKIN
Airway/IV/Pharmacology p. 3
MEDICATION
INSTRUCTOR
----------------------------
DATE
----------
COMMENTS
---------------------
INSTRUCTOR
DATE
COMMENTS
IV Bolus
IV Bolus
IV Bolus
IV Drip
IV Drip (Calc)
IV Drip (Calc)
IV Drip (Calc)
IV Drip (Calc)
IV Piggyback
IV (Pump)
IV (Pump)
Buratrol IV
Rectal
ETT drug admin
Intranasal
Intranasal
INTRAVENOUS
Manikin, Full set up
Manikin, Full set up
Manikin, Full set up
Manikin, Full set up
NREMT 6min
NREMT 6min
NREMT 6min
NREMT 6min
Manikin, Blood draw
Live
Live
Live, Seated on Stretcher
Live, Supine floor
Live, Straight eedle
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________ Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheet
Student Name: _________________________________________
SKILL
SCENARIO
Electrical
(cont)
Lifepak 12
Overview
4-lead
12-lead
ETCO2 lead
“Paddles” lead
Defibrillation
Defibrillation
Defibrillation
Cardioversion
Cardioversion
Cardioversion
Pacing
Pacing
Pacing
Synch
Synch
Asynch
Cardiology/ACLS p. 1
INSTRUCTOR
DATE
COMMENTS
12 Lead
Acquisition
LP-10
LP-12
LP-12
Other
12 Lead
Interpretation
12 lead static
12 lead static
12 lead static
12 lead static
12 lead static
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________
Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheet
Student Name: ___________________________________
SKILL
VAGAL
Cardiology/ACLS p. 2
SCENARIO
INSTRUCTOR
DATE
COMMENTS
Carotid massage
Valsalva
Occluded straw
BLS CODE
AED-solo
AED-partner
AED- LP 12
Heart sound simulator
TWO MEDIC code
Two medic, leader
Two medic, 2nd medic
Four person code
Leader
Leader
Airway
Airway
Drugs/IV
Drugs/IV
CPR
CPR
EKG recognition
Dynamic
Dynamic
Dynamic
NREMT sheet
NREMT sheet
NREMT sheet
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheet
Student Name: _______________________________________
SKILL
ASSESSMENT
Medical
Medical
Medical
Medical
Medical 1
SCENARIO
INSTRUCTOR
DATE
COMMENTS
NREMT sheet
NREMT sheet
NREMT sheet
NREMT sheet
SKILLS
Cranial Nerve Exam
Cinn. Stroke Scale
LA Stroke Sclae
Abdominal Ass.
LUNG SOUNDS
Lung sound simulator
Lung sound simulator
Breath sounds-live
Breath sounds- live
Breath sounds- live
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________ Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheet
Student Name: _____________________________________________
SKILL
Medical 2
SCENARIO
INSTRUCTOR
DATE
COMMENTS
AiRWAY/BREATHING
Nasal intubation
Nasal intubation
CPAP
Retrograde ET
Nebulizer
Surgical Airway
Surgical Airway
ETCO2 recognition
ETCO2 recognition
ETCO2 recognition
ETCO2 recognition
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete________________________ Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program
Student Name: _________________________________________________
SKILL
Medical 3
SCENARIO
INSTRUCTOR
VASCULAR ACCESS
INTRAVENOUS
Manikin, full set-up
Manikin, full set-up
NREMT sheet
NREMT sheet
Medication infusion
Medication infusion
NREMT sheet
NREMT sheet
DATE
COMMENTS
PICC access
Subcutaneous port
Tunneling cath
Assessment tools
Blood pressure
Pen light
Glucometer
Oral interviews
Oral interview
Oral interview
Oral interview
Oral interview
NREMT sheet
NREMT sheet
NREMT sheet
NREMT sheet
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________ Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheet
Student Name: _________________________________________________
SKILL
OB/GYN p.1
SCENARIO
INSTRUCTOR
DATE
COMMENTS
ASSESSMENT
Leopold’s Maneuver
Measure fundal height
Estimate gestational age
DELIVERY TYPE
Cephalic
Frank Breech
Prolapsed cord
Shoulder dystocia
Arm presentation
Foot presentation
Delivery
Clamping/cutting
Leaking clamp
Nuchal cord
Sterile gloving
APGAR
Suction type
Meconium
Delee
Vascular access
Umbilical catheter placement
Scalp vein
Airway
BVM
Newborn ETT
Newborn ETT
FBAO-BLS
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________ Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheet
Student Name: _______________________________________
SKILL
OB/GYN p. 2
SCENARIO
INSTRUCTOR
DATE
COMMENTS
NEONATE MEGACODE
One medic
One medic
Two medic
Two medic
Broslow tape
Pediatric wheel
OB/GYN wheel
Gynecological
GYN assessment
GYN assessment
GYN assessment
Fundus massage
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________
Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheet
Student Name: ______________________________________
SKILL
SCENARIO
Patient assessments
Live
Live
Live
Broslow tape
Pedi Wheel
AGE
One rescuer CPR
Infant
Child
Infant
Child
Responsive
Unresponsive
Magill’s
Responsive
Unresponsive
Magill’s
Infant
child
Two rescuer CPR
FBAO-infant
FBAO-child
OPA insertion
Vascular access
Jamshidi needle
EZ-IO Gun
I/O full set up
I/O full set up
I/O full set up
Pediatrics p.1
INSTRUCTOR
------------------
DATE
---------
COMMENTS
--------------------------
Infant
Child
Infant
Child
NREMT sheet
NREMT sheet
NREMT sheet
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________ Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheets
Student Name: ___________________________________
Pediatrics p. 2
SCENARIO
INSTRUCTOR
Megacode
DATE
COMMENTS
AGE
One medic
One medic
Two medic
Two medic
Pepp-“1 pill killers”
Pals scenarios
Child ET
Child ET
1
2
3
4
5
NREMT sheet
NREMT sheet
Manikin used:
Manikin used:
Trauma
Infant Car Seat
Infant Board Immob
Papoose Board
Child Car Seat
Child Board Immob
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________
Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheet
Student Name: ________________________________________
SKILL
ASSESSMENTS
SCENARIO
NREMT Sheet
Critical patient
Critical patient
Critical patient
Critical patient
Critical patient
Critical patient
Non-critical
Non-critical
NREMT Sheet
NREMT Sheet
NREMT Sheet
Sensory overload
Sensory deprived
In Vehicle
Trauma p.1
INSTRUCTOR
-----------------
DATE
-------
COMMENTS
----------------------------
AIRWAY
Intubations
ETT w/ c-spine
ETT w/ C-spine
ETT w/ C-spine
Digital
Digital
In Vehicle
Face to face
Cricothyrotomy
Needle cric
Needle cric
TTJI
TTJI
Surgical-knife
Surgical-knife
Nu-trach
Quik-trach
Melker
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________
Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheet
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Student Name: ______________________________
SKILL
Trauma p. 2
SCENARIO
INSTRUCTOR
DATE
COMMENTS
Pharmacological
Assisted intubations
R.S.I. scenario
R.S.I. scenario
R.S.I. scenario
Conscious sedation
Conscious sedation
Difficult airway
Difficult airway
Difficult airway
Breathing
Open Pneumo Care
Open Pneumo Care
Chest decompression
Chest decompression
Chest decompression
Vascular access
External jugular
INTRAOSSEOUS
EZ-IO
Humeral Head
Proximal Tiba
SMART Triage
SMAR Triage
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________ Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheet
Student Name: _______________________________________
SKILL
Splinting
Extremity fixation
Extremity fixation
Joint fixation
Joint fixation
Femur traction
Femur traction
Dislocation care
Dislocation care
Tourniquet
Tourniquet
Trauma p. 3
SCENARIO
INSTRUCTOR
DATE
COMMENTS
NREMT sheet
NREMT sheet
Hare
Sager
Commercial
Improvised
Extrication
Vehicle
Vehicle
Log roll- Pt prone
Log roll- Pt supine
BEAM -multi-person lift
Short board
Helmet Removal
Helmet Removal
Rapid Extrication
Rapid Extrication
Rapid Extrication
KED
KED
3 Rescuer
3 Rescuer
Pt supine
Pt full fowlers
1 Rescuer
2 Rescuer
3 Rescuer
NREMT sheet
NREMT sheet
Cardiac
Trauma Mega Code
Trauma Mega Code
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________
Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheet
Student Name: _______________________________________
SKILL
TOX/HAZMAT
SCENARIO
INSTRUCTOR
DATE
COMMENTS
Oral Board
Tox Oral Board
HAZMAT Oral Boar
Cardiac
TOX Mega Code
HAZMAT Mega Code
SKILLS
HAZMAT Suit
NIOSH Guidebook
NRG Guidebook
NRG Interpretation
NRG Interpretation
NRG Interpretation
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________
Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheet
Student Name: _______________________________________
SKILL
Enviromental
SCENARIO
INSTRUCTOR
DATE
COMMENTS
Oral Board
Tox Oral Board
HAZMAT Oral Boar
Cardiac
Environmental Mega Code
Environmental Mega Code
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________
Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheet
Student Name: _______________________________________
SKILL
SCENARIO
Behavioral
INSTRUCTOR
DATE
COMMENTS
Mental Status Exam
GEMS Skills
Sight Deprivation
Dexterity Deprivation
Mobility Deprivation
De-escalation
De-escalation
De-escalation
De-escalation
Restraints
2-Point
4-Point
Verbal
Verbal
Physical
Physical
Behavioral Oral Board
NREMT sheet
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________
Rev 2013
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Yale-New Haven Sponsor Hospital Paramedic Program Lab Sheet
MEDICATION
Student Name: __________________________________
Airway/IV/Pharmacology p. 3
INDICATIONS/ROUTE/DOSE
INSTRUCTOR DATE
CORRECT OR INCORRECT
COMMENTS
Adenosine
Albuterol
Amiodarone
Asprin
Atropine
Dextrose
Digoxin
Diltiazem
Dopamine
Epinephrine
Etomidate
Fentanyl
Fibrinolitic Therapy
Lidocaine
Magnesium
Midazolam
Morphine
Naloxone
Nitroglycerine
Oxygen
Propofol
Rocuronium
Succinylcholine
Thiopental
Verapamil
Vecuronium
Verapamil
I____________________ have completed the above, myself, appropriately according to directions and the
student handbook.
(signed) ____________________________________Date Complete_________________________ Rev 2013
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EVALUTAION
FORMS
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YNHSHP Clinical Interaction Evaluation Form
Student’s Name:_______________________________Date____________________________
Preceptor’s Name:______________________________Date____________________________
Hospital:_________________________________Department:_________________________
Preceptors: Please check all that apply and feel free to make specific comments in each area. When complete
you may either return to student or mail directly back to us at YNHSH 77-D Willow Street New Haven CT
06511 If you have any concerns or comments you may call the program director at (203) 562-3320 Your
input is a most valued part of the education of these future providers. Thank you.
1. Punctuality and Attendance:
_____ On time
_____ Early
_____ Late
2. Appearance:
_____Professional
_____Acceptable
_____Needs improvement
3. Attitude:
_____Outstanding in enthusiasm
_____Interested
_____Average
_____Somewhat indifferent
_____Uninterested
4. Response to instruction and direction:
_____Learns and responds quickly, carrying out requests efficiently
_____Responds satisfactorily
_____Often lacks the ability to carry out requests
5. Relations to others:
_____Works well with others
_____Congenial and helpful
_____Seems to get along well with others
_____Difficult to work with at times
_____Causes friction with in a group
6. Approach to patients:
_____Excellent
_____Capable
_____Lacks confidence
_____Does poorly
7. Ability to learn:
_____Exceptional
_____Learned work readily
_____Average
_____Slow in learning
_____Very slow to learn
8. Acceptance of suggestions and criticisms:
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_____Acts promptly on suggestions and criticism
_____Graciously accepts criticism or suggestions
_____Accepts suggestions and criticism satisfactorily
_____Reluctantly accepts suggestions and criticism
_____Resents suggestions and criticism
9. On a scale of 1-10, please rate the student on the following:
(10-outstanding; 9-8 very good; 7-6 good; 5-4 average; 3-2 marginal; 1-unsatisfactory)
_____Initiative
_____Maturity
_____Ability to work well under pressure
_____Dependablility
_____Accepts responsibility
_____Communication skills
_____Listening ability
_____Attendance/Punctuality
_____Dress/Appearance
_____Overall performance
Overall Comments:
Signature of Preceptor______________________________________Printed Name___________________
Date_____________________________Institution_______________________________________________
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Patient Contact Log
Date Location
Time Age Sex of Patient
Chief Complaint
Patient Interaction
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Student Name_______________________________________Date______________________
Student Signature____________________________________________ By signing above, I certify this
document is true and correct
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YNHSHP MODULAR PARAMEDIC PROGRAM
CLINICAL INCIDENT REPORT FORM
DIRECTIONS: PLEASE DESCRIBE THE SITUATION CLEARLY AND WITHOUT BIAS.
DATE OF INCIDENT________________________________________________________
INSTRUCTOR/PRECEPTOR_________________________________________________
Location___________________________________________________________________
INCIDENT DESCRIPTION:
(PLEASE INCLUDE SETTING, PERSON(S) INVOLVED, ETC.)
STUDENT/PRECEPTOR ACTION OR BEHAVIOR:
INSTRUCTOR/PRECEPTOR COMMENTS:
STUDENT COMMENTS:
___________________________
_____________________________________
STUDENT’S SIGNATURE
INSTRUCTOR/PRECEPTOR SIGNA
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PROFESSIONAL BEHAVIOR EVALUATION
Student’s Name:
Date of evaluation:
1. INTEGRITY
Competent
Not yet
competent
Competent
Not yet
competent
Competent
Not yet
competent
Competent
Not yet
competent
Competent
Not yet
competent
Competent
Not yet
competent
Competent
Not yet
competent
Examples of professional behavior include, but are not limited to: Consistent
honesty; being able to be trusted with the property of others; can be trusted with
confidential information; complete and accurate documentation of patient care and
learning activities.
2. EMPATHY
Examples of professional behavior include, but are not limited to: Showing
compassion for others; responding appropriately to the emotional response of
patients and family members; demonstrating respect for others; demonstrating a
calm, compassionate, and helpful demeanor toward those in need; being
supportive and reassuring to others.
3. SELF - MOTIVATION
Examples of professional behavior include, but are not limited to: Taking initiative
to complete assignments; taking initiative to improve and/or correct behavior;
taking on and following through on tasks without constant supervision; showing
enthusiasm for learning and improvement; consistently striving for excellence in
all aspects of patient care and professional activities; accepting constructive
feedback in a positive manner; taking advantage of learning opportunities
4. APPEARANCE AND PERSONAL HYGIENE
Examples of professional behavior include, but are not limited to: Clothing and
uniform is appropriate, neat, clean and well maintained; good personal hygiene
and grooming.
5. SELF - CONFIDENCE
Examples of professional behavior include, but are not limited to: Demonstrating
the ability to trust personal judgment; demonstrating an awareness of strengths and
limitations; exercises good personal judgment.
6. COMMUNICATIONS
Examples of professional behavior include, but are not limited to: Speaking
clearly; writing legibly; listening actively; adjusting communication strategies to
various situations
7. TIME MANAGEMENT
Examples of professional behavior include, but are not limited to: Consistent
punctuality; completing tasks and assignments on time.
Not yet
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8. TEAMWORK AND DIPLOMACY
Competent
competent
Competent
Not yet
competent
Competent
Not yet
competent
Competen
Not yet
competent
Examples of professional behavior include, but are not limited to: Placing the
success of the team above self interest; not undermining the team; helping and
supporting other team members; showing respect for all team members; remaining
flexible and open to change; communicating with others to resolve problems.
9. RESPECT
Examples of professional behavior include, but are not limited to: Being polite to
others; not using derogatory or demeaning terms; behaving in a manner that brings
credit to the profession.
10. PATIENT ADVOCACY
Examples of professional behavior include, but are not limited to: Not allowing
personal bias to or feelings to interfere with patient care; placing the needs of
patients above self interest; protecting and respecting patient confidentiality and
dignity.
11. CAREFUL DELIVERY OF SERVICE
Examples of professional behavior include, but are not limited to: Mastering and
refreshing skills; performing complete equipment checks; demonstrating careful
and safe ambulance operations; following policies, procedures, and protocols;
following orders.
Use the space below to explain any “not yet competent” ratings. When possible, use specific behaviors, and
corrective actions.
Faculty signature
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PROFESSIONAL BEHAVIOR COUNSELING RECORD
Student’s Name:
Date of counseling:
Date of incident:
_
Reason for Counseling
Explanation (use back of form if more space is needed):
Integrity
Empathy
Self - Motivation
Appearance/Personal Hygiene
Self - Confidence
Communications
Time Management
Teamwork and Diplomacy
Respect
Patient Advocacy
Careful delivery of service
Follow-up (include specific expectations, clearly defined positive behavior, actions that will be taken if
behavior continues, dates of future counseling sessions, etc.):
-Faculty signature
I have read this notice and understand it.
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Student Contact Form
Regarding: ________________________________________________ Date: _________________
Page _______of Pages ______
Time: ________
Location: ___________________________________________________
People Present: ______________________________________________
People on phone: _____________________________________________
Email or other attachments: _____________________________________
Who initiated: ________________________________________________
Reason for Contact:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
________________________________________________________________________________________
Plan (PIP):
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_______________________________________________________________________________________
Signed:
(By all parties present)
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Yale-New Haven Sponsor Hospital Paramedic Program
Student Progress Report
Student Name: __________________________
Date: ____________________
Academics:
Sectional Exam Grades
___________________
___________________
___________________
___________________
Quiz Average –
Administrative:
Tardy – _____________
Absent – ____________
Financial – ___________
Affective Domain:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
____
Students Response:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
___________________________
Student Name
______________________________
Educational Coordinator and/or
Lead Instructor
* Reviewed by Dr. Waltman _______________________ Date ________________________
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Section
VI
APPENDICES
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YALE-NEW HAVEN SPONSOR HOSPITAL PROGRAM STAFF
YNHSHP DIRECTOR and
MOBLE INTENSIVE CARE MEDICAL DIRECTOR
Sandy Bugucki , MD, PhD
EDUCATION PROGRAMS MEDICAL DIRECTOR
Adam Waltman, MD, NR-PARAMEDIC
EDUCATIONAL COORDINATOR
David M Tauber, BS, NR-PARAMEDIC, CCEMT-PARAMEDIC,FP-C, NCEE, EMS-I
[email protected]
(203) 562- 3320
UNIVERSITY OF NEW HAVEN PROGRAM COORDINATOR
Peter Struble, MPA, NR-PARAMEDIC, CT EMS-I
[email protected]
(203) 479-4232
EMT PROGRAMS COORDINATOR
David Acker, NR-Parameedic, EMS-I
[email protected]
(203) 562- 3320
PARAMEDIC DIDACTIC COORDINATOR
Michael Torino, EMT-Paramedic, EMS-I
[email protected]
(203)562-3320 ext203
CLINICAL COORDINATOR
Jason Ucci, BS, NR-Paramedic, EMS-I
[email protected]
(203) 562- 3320
AHA and CERTIFICATION PROGRAMS COORDINATOR
Don Corey, NR-Paramedic, EMS-I
[email protected]
SECRETARY AND ADMINISTRATIVE ASSISTANT
Enid Annunziata
[email protected]
(203) 562- 3320
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YALE-NEW HAVEN SPONSOR HOSPITAL
FACULTY BIOGRAPHIES
David Acker, Sr., NR-PARAMEDIC, EMS-I, has been a Paramedic since 2000. He is an EMS-I, NAEMSE
INSTRUCTOR, AHA BCLS, ACLS and PALS Instructor and a PHTLS Instructor. David has been an
instructor in first aid, water safety and survival in the U.S. Marine Core. He is a Senior Paramedic Field
Instructor in the YNHSHP system and is a retired career Fire Fighter Paramedic from the West Shore Fire
Department and the East Haven Fire Department.
Kevin Burns, BA, BS, MSPA, PA-C, EMT-PARAMEDIC, is the EMS Coordinator for Yale-New Haven
Hospital and a Clinical Lecturer for the Yale School of Medicine. He has been involved with EMS since 1993
and a Paramedic since 1997 working multiple basing modes in NY and CT with urban, suburban and rural
services. He has worked in emergency medicine as a PA since 2002. He has co-authored several articles,
participates in research and received several awards. He still maintains his paramedic licensee. He is a
graduate of the NAEMSP Medical Direction course, holds post graduate certificate in Critical Care and is a
NAED EMD provider. He is a member of the Paramedic Advisory Committee and a clinical instructor for
YNHSHP. He is a member of the SHARP team.
Jeremiah Carrier, NREMT, EMS-I, has been the Lead Instructor at Yale-New Haven Sponsor Hospital
since January 2012. Jeremiah has an extensive criminal justice background, however in 2010 decided on a
career change in EMS, at which point he joined the New Haven Sponsor Hospital Programs Emergency
Medical Technician class and earned his NREMT-B certification. Professional memberships include the
National Association of EMS Educators and the National Association of EMT’s. Jeremiah recently joined
Yale-New Haven Sponsor Hospital where he has actively been teaching EMS students since 2012. Jeremiah
enjoys teaching and preparing others to enter the ever changing and exciting world of EMS. Jeremiah currently
works part-time for the New Haven division of AMR. Jeremiah is a NAEMSE Level One Instructor in
addition to an AHA Healthcare Provider. Jeremiah is currently working on his NREMT-Paramedic license.
When Jeremiah is off-duty he enjoys camping, hiking, and spending time with his family.
David Cone, MD, EMT is the Chief of the EMS Division and attending physician in the emergency
department of Yale-New Haven Hospital. He is Associate Professor of Emergency Medicine and Public
Health at Yale University School of Medicine. He is residency trained and board certified in Emergency
Medicine and fellowship trained in EMS. Dr. Cone is the immediate past president of NAEMSP. He is the
editor of Prehospital Emergency Care and Senior Associate Editor of Academic Emergency Medicine and has
innumerable publication credits. He was an author of the 1998 NHTSA National Standard Paramedic
Curriculum. He serves as medical director of New Haven CMED and is the service chief of the SHARP team.
He is also a member of the Paramedic Advisory Committee and a clinical instructor for NHSHP.
Paul Januszewski, BS, NRP, EMS-I is the Clinical Coordinator and AHA Training Center Administrator for
Yale-New Haven Sponsor Hospital. He has been involved with Fire/EMS since 1996 and a Paramedic since
2009. Paul has been a career firefighter with the North Haven FD since 2002 and currently holds the rank of
Lt. which serves as a shift commander with the FD. Paul holds a degree in Public Safety Administration and is
currently enrolled in an M.S.
Lewis Kaplan, MD, FACS, FCCM, FCCP, is the director of the surgical ICU at YNHH and an Associate
Professor of Surgery, Section of Trauma Yale Medical School. He is a USAF Special Operations Flight
Surgeon and has experience in emergency medicine and ECC. Lew is a lecturer and clinical instructor for
YNHSHP.
Melissa Langhan, MD, is the Director of Pediatric Emergency Medicine at Yale-New Haven Hospital. She is
fellowship trained in pediatric emergency medicine from Yale University School of Medicine. She is an AHA
PALS Instructor and ATLS certified. She is a member of the Paramedic Advisory Committee and lead
instructor for the paramedic pediatrics module and a clinical instructor for YNHSHP.
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Scott Martus, BS, NR-PARAMEDIC, EMS-I, He is AHA Training Center Faculty for PALS, ACLS, and
BCLS and Regional Faculty for ACLS. He is a PHTLS, GEMS, PEPP and AMLS instructor. Scott is a Fire
Lieutenant for the Town of North Haven Fire Department.
Jeffery McGovern, BS, NR-PARAMEDIC, CCEMT-Paramedic, FP-C, EMS-I, He is a graduate of
YNHSHP 2000 paramedic program. Jeff is AHA Training Center Faculty for PALS, ACLS, and BCLS. He is
a GEMS, PEPP, AMLS and PHTLS instructor. Jeff holds certifications in tactical EMS, Advanced Hazmat
Life Support, and various other WMD courses. He is a Paramedic for the Town of North Branford Ambulance
Service and a member of the Yale-New Haven Hospital Pediatric Critical Care Transport Team.
Seth Powsner, MD, is a Professor of Psychiatry and Emergency Medicine at Yale University School of
Medicine. He is the Director of the Crisis Intervention Unit at YNHH. He is the President elect for the
American Association for Emergency Psychiatry and has many published peer reviewed articles. Seth is the
course director for behavioral and emergency psychiatry module and clinical instructor at YNHSHP. He is
also a member of the Paramedic Advisory Committee.
Joseph Schindler, MD, is Medical Director of the Yale-New Haven Hospital Stroke Team and lecturer for
YNHSHP.
William Seward III, NR-PARAMEDIC, Chief, North Branford Fire Department is lecturer and lab
instructor, subject expert in Hazardous Materials, vehicle rescue and WMD. He retired after 25 years as
Captain and training officer of the New Haven Fire Department.
William B Stewart, Ph.D., is the Chair of Anatomy at Yale School of Medicine. Bill is a lead investigator for
the National Institute of Health. He has authored over 60 peer reviewed articles and 10 book chapters. He
directs the YNHSHP Paramedic Anatomy and Physiology program and leads the cadaver dissection labs as
part of that section.
David M. Tauber, BS, NR-PARAMEDIC, CCEMTP, FP-C, NCEE, is the Educational Coordinator of the
Yale-New Haven Sponsor Hospital. He retired after 20 years as member of Conway Fire/Rescue in NH.
Involved in EMS since 1971 first as a dispatcher and an instructor since 1976, he has worked in urban,
suburban, rural and Wilderness EMS. He is the Executive Director of the Advanced Life Support Institute of
Conway NH. He spent 4 and a half years as paramedic on a critical care transport team and holds certifications
as a flight paramedic and pediatric neonatal and adult critical care paramedic. Tauber has been Director of
Education and Continuous Quality Improvement for a service that averaged 180 emergency calls per day. A
former member of the Wilderness Medical Society’s Prehospital Care Committee and the NASAR Medical
Advisory Committee, and a lifetime member of NAEMT and NASAR. He is an active member of the
National Ski Patrol System receiving several awards. In 1993, he became the medical team leader of the
FEMA USAR Task Force MA-1. He was deployed to the 1996 Olympics and to NYC on 9-11- 2001. Until
January 2008 he was cross rostered as a medical spec and haz-mat tech. He is an instructor trainer for PEPP
and GEMS. He also is an ACLS Experienced Provider Instructor. He has authored several book chapters and
articles and been an instructor for over 26 paramedic classes.
Anthony Tomassoni, MD, MS, FACEP, Prior to coming to Yale-New Haven Hospital he was Director of the
Maine Poison Control Center and served as the medical director for the Advanced Life Support Institute of
Conway NH. Before attending medical school he was a high school chemistry teacher. A board-certified
Emergency Medicine Physician and Toxicologist, he was an attending physician in the Emergency Ward of
Maine Medical Center (a level 1 trauma center) and he serves as Medical Team Manager of the FEMA USAR
Task Force MA-1.He is a former member of the Red Cross Medical Assistance and HAZMAT Response
Team. Tomassoni has been a flight physician for University AirCare and a member of the Wilderness Medical
Society. Tony is course leader for Paramedic Toxicology and a clinical instructor for YNHSHP.
Mike Torino, FIREFIGHTER/PARAMEDIC, EMS-I, is the ALS Programs Coordinator. Mike is a
graduate of the 1993 NHSH Paramedic Program and is currently a paramedic field instructor and affiliate
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faculty for YNHSHP. Mike is a retired firefighter-paramedic with the East Haven Fire Department. He was
deployed to Ground Zero in NYC September of 2001 as part of a search and rescue team. He holds
certification as a tactical medic assigned to East Haven Police Departments ESU, EMS-I, NAEMSEINSTRUCTOR, AHA BCLS-I, ACLS-I, ACLSEP-I, PALS-I, PEPP-I, PHTLS-I, AMLS Instructor and is
certified in Advanced Hazmat Life Support.
Adam R. Waltman, MD, NR-PARAMEDIC, FACEP, is the Educational Medical Director of YNHSH and
is an attending physician in the emergency department of the Yale campus of the former Hospital of Saint
Raphaels in New Haven. He is a board-certified Emergency Medicine Physician and completed an EMS
Fellowship in special operations at Johns Hopkins University, School of Medicine serving with the U.S. Secret
Service on several overseas assignments including a presidential protection detail. Prior to medical school Dr.
Waltman was a paramedic for 11 years in Hartford and West Hartford providing 911 services. He maintains
his paramedic licenses and is an AHA PALS and ACLS Instructor and CT. EMS clinical skills examiner. He is
a graduate of the NAEMSP Medical Directors Course and is ATLS certified.
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