EMS A151: Emergency Medical Technician Clinical

Course Outline of Record
Item	Value
Curriculum Committee Approval Date	12/06/2023
Top Code	125000 - Emergency Medical Services
Units	1 Total Units
Hours	54 Total Hours (Lab Hours 54)
Total Outside of Class Hours	0
Course Credit Status	Credit: Degree Applicable (D)
Material Fee	Yes
Basic Skills	Not Basic Skills (N)
Repeatable	No
Open Entry/Open Exit	No
Grading Policy	Pass/No Pass (B)

Course Description

Application and integration of skills and knowledge gained from EMS A150 in the emergency department of an acute hospital or other arranged clinical setting in accordance with California State Title 22, Section 9 regulations, and on a Basic Life Support ambulance unit. Formerly known as EMT A151. COREQUISITE: EMS A150 and EMS A150L. Transfer Credit: CSU.

Course Level Student Learning Outcome(s)

Demonstrate in the correct sequence, appropriate patient assessment including vital signs.
Adapt to various patient care settings, develop appropriate interventions, and communicate effectively with various healthcare professionals regarding patient presentation and care.

Course Objectives

I Behavioral objectives:
I. 1. Presents a neat, well-groomed, professional appearance
I. 2. Dresses in the approved clinical uniform with name tag visible
I. 3. Demonstrates dependability by reporting for duty on time, and stays the full scheduled time
I. 4. Performs tasks in a professional manner
I. 5. Practices standard precaution techniques
I. 6. Notifies the EMT Program Coordinator at least two hours prior to beginning of scheduled shift when unable to attend
I. 7. Demonstrates cooperation with clinical staff and preceptor, a willingness to learn, and the ability to follow directions
I. 8. Strictly follows all HIPAA regulations and practices appropriate patient confidentiality
I. 9. Demonstrates the ability to recognize both engineered and non-engineered sharps and properly disposes of all sharps in appropriate containers
I. 10. Communicates with healthcare workers of all disciplines in a clear, concise and effective manner
II Performance objectives:
II. 1. Appropriately documents evidence of performing a minimum of ten patient initial assessments, SAMPLE history interview, findings of the complete head-to-toe exam, including breath sounds, all pre-hospital or emergency department interventions and a brief summary of what this patient helped the student learn as it relates to the EMT 150 course objectives, using correct spelling and grammar on the provided ?Orange Coast College Patient Care Report? forms
II. 2. Demonstrates proper moves, lifts, and transporting of patients using correct body mechanics and appropriate use of both a pre-hospital gurney and equipment and a standard hospital gurney
II. 3. Demonstrates the ability to properly take vital signs on all available patients, to include the mental status, a manual blood pressure, a peripheral or central pulse as indicated, respiratory rate, temperature, capillary refill, and skin signs, and incorporates this information to help distinguish the patient?s priority status, recognizes hypoperfusion, or other conditions that require immediate intervention
II. 4. Recognizes situations in which the patient would require manual cervical stabilization and participates, at the discretion of the clinical personnel and under their supervision, participates in appropriate stabilization.
II. 5. Recognizes need for oxygen therapy and demonstrates correct choice and administration of appropriate oxygen delivery/ventilation device under the supervision of clinical personnel
II. 6. Recognizes need for airway management and demonstrates correct intervention, such as suctioning, use of adjunctive devices, and patient positioning, under the supervision of clinical personnel
II. 7. Contributes to the preparation of intravenous equipment, demonstrates the ability to assist clinical personnel in the initiation of intravenous therapy, and demonstrates proper recognition of intravenous site abnormalities requiring communication to the appropriate clinical personnel.
II. 8. Performs correct cardiopulmonary resuscitation at the discretion of the clinical personnel following up-to-date American Heart Association Healthcare Provider standards
II. 9. Completes the Emergency Department equipment check list
II. 10. Writes a one-page summary of application of program objectives and what the student learned during the BLS ambulance clinical experience
II. 11. Writes a one-page summary of application of program objectives and what the student learned during the emergency department clinical experience
II. 12. Participates in BLS ambulance daily equipment check and care of ambulance and equipment
II. 13. Participates in BLS ambulance daily equipment check and care of ambulance and equipment
II. 14. Completes a skill checklist documenting what skills were either performed, observed, or not observed for both the emergency department and the BLS ambulance setting
II. 15. Completes an evaluation of the ability of the ambulance company to meet the learning objectives of the student on the provided form
III Observation objectives: The student is to observe and be prepared to discuss:
III. 1. The patient assessment, priority decision or triage decision, including physical exam and history recording by the clinical personnel
III. 2. Compare and contrast the pre-hospital and hospital care in emergency situations including: airway maintenance, breathing assistance, oxygen therapy, control of bleeding, treatment of hypoperfusion, care of emotionally disturbed patients, pediatric patients, geriatric patients, obstetrical/gynecological patients and patients with traumatic and/or medical problems
III. 3. Aseptic techniques and care of wounds
III. 4. Applications of slings, basic dressings and bandages, pressure and elastic bandages, and application of splinting appropriate to clinical setting
III. 5. Methods of suctioning, including: oral, oropharyngeal, endotracheal, and tracheal
III. 6. Intravenous therapy

Lecture Content

This course will integrate knowledge and skills learned in EMT A150 in a clinical setting. Emphasis will be placed on critical thinking that is necessary on the job. Students will be expected to perform under supervision on clinical patients at an assigned affiliated clinical site. The exposure of clinical patients will vary on location and scheduling. Students are to use the instructional objectives for direction on the level of expectations to be attained during this experience.

Lab Content

Students will apply the following skills they have learned in the lab course in a clinical setting: 1.Safe glove removal.2.Handwashing techniques.3.Review of standard precautions.4.Discussion and demonstration of proper body mechanics.5.Power lift.6.Direct ground lift.7.Extremity lift.8.Direct carry.9.Draw sheet method.10.Log rolling patients with and without suspected spinal injury.11.Establishing manual in-line stabilization.12.Moving patients into and from a wheelchair.13.Moving a patient on the Stair Chair.14.Gurney operations.15.Integration of gurney operations with the ambulance.16.Obtaining vital signs; manual blood pressure, respirations, pulse, skin signs.17.Capillary refill and pupil assessment.18.Pulse oximetry use.19.Orthostatic vital signs.20.Mental status assessment (AVPU and Orientation).21.Assisting with ambulation.22.Scene characteristics.23.Determining scene safety.24.Manual airway techniques.25.Nasal pharyngeal airway insertion.26.Oral pharyngeal airway insertion.27.Suctioning.28.Suctioning into the ETT and tracheostomy tube.29.Oxygen tank use and safety.30.Applying oxygen devices.31.Recognizing adequate and inadequate breathing.32.Patient ventilation techniques.33.Chest auscultation.34.Primary/Initial assessment.35.Rapid Exam (head-to-toe).36.D-C-A-P-B-T-L-S37.Secondary exam medical38.Secondary exam trauma39.Focused exam40.Detailed exam and reassessment.41.Neurological exams; Los Angeles Stroke Screen, Glasgow Coma Scale, and CSM checks42.Review of cardiopulmonary resuscitation per the most up-to-date American Heart Association guidelines.43.Using the semi automated AED.44.CPR resuscitation and AED use team integration.45.Use of cardiac monitoring devices.46.12-lead, 3- lead, and 5-lead ECG placement.47.Medication administration.48.Administering nebulized medications.49.Administering medication by a metered-does inhaler.50.Assisting a patient with Nitroglycerine.51.Administering aspirin for chest pain.52.Administering an epinephrine auto injector.53.Recognition of S-L-U-D-G-E-M response to organophosphate poisoning and chemical exposures.54.Self administration of an emergency rescue agent such as the Duo-dote kit.55.Administration of activated charcoal.56.Administration of oral glucose.57.Testing serum glucose levels with a glucose meter.58.Managing assaultive behavior.59.Restraining patients.60.Methods of bleeding control.61.Tourniquet application.62.Controlling nosebleed.63.Burn management techniques.64.Bandaging techniques.65.Special dressing and bandaging considerations.66.Dressing and bandaging an abdominal evisceration.67.Removing a foreign object in the upper eyelid.68.Caring for injuries of the Face, eye, mouth, jaw, cheek, and chin.69.Caring for injuries of the nose, ear, and neck.70.Care of amputated body parts.71.Stabilizing an impaled object.72.Discussion and demonstration of the PASG.73.General splinting techniques.74.Applying bipolar and unipolar traction splints.75.Applying air splints.76.Applying rigid splints and improvised splints.77.Splinting specific injuries and special situations.78.Stabilizing a flail segment.79.Stabilizing a suspected pelvic fracture.80.Assessing neurological, motor, sensory, and perfusion function.81.Cervical spine immobilization/extrication collars.82.Sizing and placing extrication collars to seated and supine patients.83.Use of various immobilization devices.84.Moving a patient to a long board.85.Seated immobilization techniques.86.Immobilizing a supin e patient to a long board.87.Rapid extrication techniques.88.Helmet removal.89.Child seat extrication.90.Special immobilization considerations and techniques.91.Pediatric immobilization.92.Childbirth: Delivery in the prehospital setting.93.Neonatal resuscitation.94.Assessment and care of the newborn.95.Pediatric primary/initial assessment.96.Pediatric rapid exam (Toe-to-head).97.Elements of the daily ambulance vehicle inspection.98.Multiple Casualty Incident triaging.99.Incident command and team leading.100.Assisting with advanced airway placement.101.Ventilation techniques with advanced airway placement.102.Nasogastric intubation.103.Assisting with intravenous therapy administration.104.Monitoring intravenous lines and intravenous sites.105.Care of urinary catheters, gastrostomy tubes, central lines and other permanent and semi-permanent devices on patients.

Method(s) of Instruction

Lab (04)
DE Live Online Lab (04S)
Directed/Independent Study (40)
Field Experience (90)
Non-Directed Clinical (NDR)

Instructional Techniques

Demonstration of various approaches to problem-solving Observation and participation in the routine in the emergency department and on the BLS ambulance unit Return demonstration of skills learned Discussion with clinical preceptors and during class sessions with online adjunct One four (4) hours clinical orientation prior to clinical participation led by the EMT Program Director/Clinical Coordinator Two (2) ten-hour emergency department shifts One (1) eight-hour emergency department shift One (1) eight-hour BLS ambulance shift And either one (1) additional eight-hour emergency department or BLS ambulance shift

Reading Assignments

Writing Assignments

Submission of a minimum of ten (10) completed patient care reports written legibly in ink using correct spelling, grammar, and medical terminology. One typed summary of BLS ambulance experience using correct spelling and grammar. One typed summary of emergency department experience using correct spelling and grammar. Completion of entire clinical packet.

Out-of-class Assignments

Demonstration of Critical Thinking

Observation/evaluation of skills performed; discussion of patient case histories and assessment/outcome; case presentations; final practical examination; evaluation of completed clinical packet to include a minimum of 5 10 patient care reports, an ambulance skill check list and an emergency department skill check list, an emergency department equipment checklist, student evaluations from each clinical visit, written summary of BLS ambulance experience, written summary of emergency department experience, student s evaluation of BLS ambulance s performance

Required Writing, Problem Solving, Skills Demonstration

Eligible Disciplines

Emergency medical technologies: Any bachelor's degree and two years of professional experience, or any associate degree and six years of professional experience. Nursing: Master's degree in nursing OR bachelor's degree in nursing AND master's degree in health education or health science OR the equivalent OR the minimum qualifications as set by the Board of Registered Nursing, whichever is higher. Master's degree required. Nursing science/clinical practice: Any bachelor's degree and two years of professional experience, or any associate degree and six years of professional experience.

Other Resources

1. EMS A151 Clinical Packet distributed and reviewed during clinical orientation, stethoscope with a bell and diaphragm, adult blood pressure cuff, penlight, student ID badge, trauma shears, and student-supplied

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