EMR 0002 - Emergency Medical Responder

Course Standards:

EMS Systems and Operations

1) Compare and contrast the types of Emergency Medical Services (EMS) systems and operations, including ground, water, and air services. For each type of service, discuss how the public accesses EMS systems, the advantages and disadvantages, special considerations, and safety issues. Discuss the roles played by the state departments of EMS and the National Highway Traffic Safety Administration.

2) Research the history of mapping, geographic information systems (GIS), global positioning systems (GPS), remote sensing, and other geospatial technologies. Examine how these technologies have evolved in the area of EMS, concentrating on their recent migration

toward online platforms, and evaluate their influence on present-day society, citing specific textual evidence from news articles and scholarly journals.

3) Differentiate between the careers in various types of EMS. Research and document educational requirements as well as state and national guidelines governing practicing professionals (such as licensing, initial certifications, re-certifications, training, and compliance). Identify personal and physical characteristics required of an EMS professional in a career portfolio.

4) Using texts from EMS professional journals or websites, evaluate concepts of quality improvement to provide safe, high quality, and appropriate patient care and the impact of research on EMR care. Cite examples of research that have been incorporated into improving emergency care for patients and/or victims of accidents/injuries.

5) Outline the risks and responsibilities facing the emergency response team during ambulance operations. Address at minimum the following: apparatus and equipment readiness; pre-arrival considerations, especially for high-risk situations; scene safety of personnel and patient(s); traffic; 360 degree assessments; and how to leave a scene.

6) Research and summarize the concepts surrounding vehicle extrication, including safe vehicle extrication, tools used, and patient considerations. Include in the summary common guidelines related to the following: roles of EMS; safety of staff, patients, and situation; vehicle stabilization; unique hazards; additional resources needed; and extrication considerations.

Safety and Wellness

7) Develop a reference toolkit of physical, mental, and personal requirements for personnel in emergency and public safety services. Document what the “profile of proficiency” looks like for professionals in these fields-for example, what scores are needed on a physical, mental, or emotional fitness test, and what guidelines must be followed for personal disease/disorder control.

8) Investigate stress management procedures for professionals in the emergency response and public service sectors. Identify stressors and stress-inducing situations through interviews with professionals in the field. Collaborate with a team to identify techniques and strategies for managing and alleviating stress. Communicate recommendations in the form of a toolkit, brochure, or fact sheet to support the use of these strategies, citing evidence drawn from the investigation.

9) Compare and contrast in a digital or written artifact the difference in Standard Precautions, personal protective clothing, and personal protective equipment (PPE) in EMS from other healthcare settings. Outline response steps if exposed to hazardous or bloodborne

pathogens. Demonstrate donning and doffing of all PPE and the care of soiled equipment or vehicles.

10) Interpret scene management and safety standards and/or protocols by writing a scenario for each of the following situations: (a) traffic or highway incidents, (b) violent encounters, (c) crowds, (d) nature of illness or mechanisms of injury, (e) number of patients and/or victims, and (f) personnel injury prevention. Identify the appropriate responses from EMS professionals and any additional resources that would be involved.

11) Complete the free FEMA Emergency Management Institute’s NIMS compliance courses ICS-200 (Single Resources and Initial Action Incidents) and IS-5A (Introduction to Hazardous Materials). Review content from the IS-700, IS-800, and ICS-100 tests. Create and role play scenarios that involve each of the situations described in the FEMA courses identifying the roles and responsibilities of the EMR and other team members.

EMS and Therapeutic Communications

12) Identify situations and locate agencies an Emergency Medical Responder (EMR) would call for additional assistance upon arrival at a scene. Practice scenarios that would require the transfer of care of the patient, incorporating pertinent information such as the patient’s condition, history of what happened, care given, etc.

13) Review the concepts of effective therapeutic communication. Examine interview techniques used during therapeutic communication and identify potential hazards of interviewing.

Legal/Ethical Guidelines

14) Interpret the rules, guidelines, and legal ramifications related to incident documentation by EMS staff. Complete a pre-hospital care report utilizing appropriate medical terminology and the acronyms SAMPLE, DCAP-BTLS, and OPQRST

15) Summarize the Health Insurance Portability and Accountability Act (HIPAA). Explain characteristics of consent, confidentiality, advanced directives, living wills, durable power of attorney, and other legal directives governing medical treatment. Using domain-specific language and accurate definitions of legal concepts, explain how the content of these legal documents impacts patients’ rights for all aspects of care.

16) Examine real-world situations that involve ethical dilemmas and the application of correct professional conduct as highlighted in recent news articles. Craft an argumentative essay making a claim about the importance of ethics and professional standards for persons working in Emergency Medical Services occupations. Cite examples from case studies to argue for the relevance of professional codes of conduct within scope of practice and how important it is to follow those guidelines.

17) Research legal ramifications and responsibilities of the EMR associated with evidence preservation and mandatory reporting requirements within the EMS system. Identify the

process for reporting specific situations to the appropriate authorities, such as child abuse and/or crimes.

Patient Assessment/Evaluation and Treatment

18) Accurately perform the components of patient assessment to identify and manage immediate life threatening illnesses and injuries within the scope of practice of the EMR for pediatric, adult, and geriatric patients, utilizing rubrics from textbooks, National HOSA guidelines, or clinical standards of practice. Include the following areas:

a. Scene Size-up

b. Primary Survey or Assessment

c. History Taking

d. Secondary Assessment

e. Vital Signs

f. Reassessment

19) Identify and perform skills to manage life threatening illnesses based on assessment findings of a pediatric, adult, and geriatric patient with medical emergencies identifying anatomical structures involved. Utilize rubrics from textbooks, National HOSA guidelines, or clinical standards of practice in the following areas:

a. Altered mental status

b. Seizures

c. Stroke

d. Gastrointestinal bleeding

e. Anaphylaxis

f. Infectious diseases

g. Diabetes

h. Psychological emergencies

i. Chest pain

j. Poisoning

k. Respiratory distress/Asthma

l. Vaginal bleeding

m. Nosebleeds

20) Use assessment information to recognize shock, respiratory failure or arrest, and cardiac arrest based on assessment findings. Demonstrate the ability to manage the situation while awaiting additional emergency response.

21) Successfully perform American Red Cross or American Heart Association adult, child, and infant Basic Life Support (BLS) cardiopulmonary resuscitation (CPR) for Healthcare Providers or BLS for Prehospital Providers.

22) Research and evaluate National Trauma Triage Protocol. Identify and perform skills to manage life threatening injuries based on assessment findings of a patient with trauma emergencies, identifying anatomical structures involved. Utilize rubrics from textbooks, National HOSA guidelines, or clinical standards of practice in the following areas:

a. Internal and external bleeding

b. Chest trauma such as sucking chest wound and impaled objects in chest

c. Abdominal trauma such eviscerations and impaled objects

d. Orthopedic trauma such as fractures, dislocations, amputations

e. Soft tissue trauma, burns, dressings, and bandages

f. Head, facial, neck and spine trauma such as head injuries, scalp injuries, and injuries to spine

g. Environmental emergencies such as submersion and exposure to heat and cold

h. Multi-system trauma

23) Recognize and manage life threats based on simple assessment findings for special population patients such as children, the elderly, and maternity patients while awaiting additional emergency response. Utilize rubrics from textbooks, National HOSA guidelines, or clinical standards of practice for the following situations:

a. Vaginal bleeding in pregnant patients

b. Signs of labor and delivery

c. Steps in pre-hospital delivery

d. Initial care of neonates

e. Care of mother after delivery

f. Pediatric respiratory distress, seizures, and Sudden Infant Death Syndrome (SIDS)

g. Geriatric care

h. Child, elderly, and domestic partner abuse

24) Discuss developmental and psychological norms for all ages, including pediatric and geriatric patients relating normal vs abnormal psychological response to illness and injury.

Portfolio

25) Compile and continually update a portfolio of artifacts completed in this course. If pursuing EMR certification or dual enrollment/dual credit hours, document hours spent on activities such as job shadowing or classroom contact with an articulated institution. Upon completion of the course, prepare the portfolio in a professional style to present to appropriate EMS audiences.

The following artifacts will reside in the student’s portfolio:

• Career Exploration portfolio

• Skills performance rubrics

• Documentation of job shadowing hours

• Classroom contact hours, if applicable

• Examples of written, oral, or digital presentations

• Short research project documents

Standards Alignment Notes

*References to other standards include:

• National Highway Traffic Safety Administration National Emergency Medical Services Education Standards for Emergency Medical Responders (EMR).

All standards are aligned to the National EMS Educational Standards and EMR Instructional Guidelines and approved by the Tennessee Department of Emergency Medical Services.

Key for alignment: P-Preparatory, AP-Anatomy and Physiology, MT-Medical terminology, PT-Pathophysiology, LD- Life Span Development, PH-Public Health, Pharm-Pharmacology, AW-Airway Management, Respirations and Artificial Ventilation, A-Assessment, M-Medicine, S-Shock and Resuscitation, T-Trauma, SP-Special Patient Populations, EM-EMS Operations

Note: While not all standards are specifically aligned, teachers will find the framework helpful for setting expectations for student behavior in their classroom and practicing specific career readiness skills.