Content Outline and Competencies:

I. Course Overview

A. Review of course outline and syllabus.

B. Review of course objectives and competencies.

II. Affirmation of Performance of CPR Sequences

A. Mastery performance of adult CPR sequences.

1. Demonstrate one-rescuer CPR

2. Demonstrate two-rescuer CPR

3. Demonstrate unconscious foreign body airway obstruction

4. Demonstrate conscious foreign body airway obstruction

5. Demonstrate rescue breathing

6. Demonstrate recovery position

7. Demonstrate FBAO on pregnant or obese

B. Mastery performance of child CPR sequences.

1. Demonstrate one-rescuer CPR

2. Demonstrate two-rescuer CPR

3. Demonstrate unconscious foreign body airway obstruction

4. Demonstrate conscious foreign body airway obstruction

5. Demonstrate rescue breathing

6. Demonstrate recovery position

C. Mastery performance of infant CPR sequences.

1. Demonstrate one-rescuer CPR

2. Demonstrate unconscious foreign body airway obstruction

3. Demonstrate conscious foreign body airway obstruction

4. Demonstrate rescue breathing

5. Demonstrate recovery position

D. Mastery performance of special procedures.

1. Demonstrate jaw thrust maneuver

2. Demonstrate cricoid pressure

3. Demonstrate AED usage

4. Demonstrate patient ventilation with a BVM

III. Cardiovascular and Respiratory Systems

A. Parts/functions of the cardiovascular system.

1. List the parts of the cardiovascular system

2. Explain the function/interrelationship of the parts of the cardiovascular system

3. Trace the path of blood through the body

4. Describe the process by which food and oxygen are delivered to cells

5. Describe the heart's electrical system

6. Explain the role of the brain in cardiac function

B. Parts/functions of the respiratory system.

1. List the parts of the respiratory system

2. Explain the function/interrelationship of the parts of the respiratory system

3. Explain the role of the brain in respiratory function

C. Role of cardiovascular and respiratory systems in basic life support.

1. Describe the interrelationship of the cardiovascular and respiratory systems in basic life support

2. Explain the use of CPR as basic life support

3. Correlate techniques used in CPR with structure and function of the cardiovascular and respiratory systems

a. Methods to open the airway

b. Artificial ventilation

c. Proper hand positioning

d. Rates and ratios for CPR sequences

e. Obstructed airway procedures

f. Step CPR sequence

IV. Diagnostic Signs

A. Identification of diagnostic signs.

1. List the seven diagnostic signs (level of consciousness, respiration, pulse, blood pressure, skin color, temperature and moisture, pupillary response).

2. Describe the normal value, range or condition for each diagnostic sign.

3. Describe techniques used to assess each diagnostic sign.

B. Relationship of diagnostic signs to patient assessment and CPR.

1. Describe the diagnostic signs for a patient in respiratory arrest

2. Describe the diagnostic signs for a patient in cardiac arrest

V. Medical and Environmental Emergencies

A. Prevention and treatment of medical emergencies.

1. Identify signs and symptoms of common medical emergencies

a. Heart attack

b. Stroke

c. Congestive heart failure

d. Diabetic emergencies

e. Seizures

f. Shock

2. Describe treatment procedures for common medical emergencies

a. Heart attack

b. Stroke

c. Congestive heart failure

d. Diabetic emergencies

e. Seizures

f. Shock

3. List the risk factors for common cardiovascular emergencies (heart attack, stroke).

4. Suggest prevention strategies for common cardiovascular emergencies (heart attack, stroke).

B. Prevention and treatment of airway obstruction.

1. Identify signs and symptoms of airway obstruction.

a. Anatomical obstruction (tongue)

b. Foreign body

c. Physiological (asthma, anaphylaxis, croup)

2. Describe treatment procedures for airway obstruction

a. Anatomical obstruction (tongue)

b. Foreign body

c. Physiological (asthma, anaphylaxis, croup)

3. List risk factors for airway obstruction.

a. Anatomical obstruction (tongue)

b. Foreign body

c. Physiological (asthma, anaphylaxis, croup)

4. Suggest prevention strategies for airway obstruction.

a. Anatomical obstruction (tongue)

b. Foreign body

c. Physiological (asthma, anaphylaxis, croup)

C. Prevention and treatment of environmental emergencies

1. Identify signs and symptoms of common environmental emergencies.

a. Drowning

b. Electric shock

c. Poisoning

d. Fracture, wounds and bleeding

e. Heat and cold emergencies

f. Burns

g. Shock

2. Describe treatment procedures for common environmental emergencies.

a. Drowning

b. Electric shock

c. Poisoning

d. Fracture, wounds and bleeding

e. Heat and cold emergencies

f. Burns

g. Shock

3. List risk factors for common environmental emergencies

4. Suggest prevention strategies for common environmental emergencies

VI. Patient Assessment, Triage and Treatment Simulations

A. Triage.

1. Define triage

2. Classify patients according to triage guidelines based on a list of presenting signs and symptoms

B. Simulations

1. Select appropriate treatment strategies for individual patients based upon assessment findings.

a. Maintain airway

b. Rescue breathing

c. CPR

2. Assess, prioritize and treat patients in a multiple person/injury scenario.

VII. Introduction to Emergency Medical Services System

A. EMS agencies.

1. Identify emergency care providers by level of training and responsibility

a. Bystander

b. First responder

c. EMT

d. Paramedic

2. Describe the types of emergency medical services available locally

B. Chain of survival.

1. Trace the "chain of survival" for victims of sudden illness or injury

2. Discuss the importance of early entry into the EMS system

Content Outline and Competencies:

I. Introduction to First Responder
   A. Define the roles and responsibilities of the First Responder.

II. Overview of the Human Body
   A. Introductory anatomy and physiology
      1. Label major body parts and systems (including regions, organs,
cavities, quadrants, etc)..
      2. Describe the function of major body parts and systems.
   B. Basic medical terminology
      1. Describe anatomical position.
      2. Use correct directional terms when referring to the human body
(medial, lateral, distal, proximal, etc.).

III. Cardiovascular and Respiratory Systems
   A. Parts/functions of the cardiovascular system
      1. List the parts of the cardiovascular system.
      2. Explain the function/interrelationship of the parts of the
cardiovascular system.
      3. Trace the path of blood through the body.
      4. Describe the process by which food and oxygen are delivered to
cells.
      5. Describe the heart's electrical system.
      6. Explain the role of the brain in cardiac function.
   B. Parts/functions of the respiratory system
      1. List the parts of the respiratory system.
      2. Explain the function/interrelationship of the parts of the
respiratory system.
      3. Explain the role of the brain in respiratory function.
   C. Role of cardiovascular and respiratory systems in basic life
support
      1. Describe the interrelationship of the cardiovascular and
respiratory systems in basic life support.
      2. Explain the use of CPR as basic life support.
      3. Correlate techniques used in CPR with structure and function of
the cardiovascular and respiratory systems.
         a. Methods to open the airway
         b. Artificial ventilation
         c. Proper hand positioning
         d. Rates and ratios for CPR sequences
         e. Obstructed airway procedures
         f. Ten step CPR sequence

IV. Patient Assessment: Diagnostic Signs, Assessment Components, Triage
   A. Identification of diagnostic signs
      1. List the diagnostic signs (level of consciousness, respiration,
pulse, blood pressure, skin color, temperature and moisture, pupillary
response, capillary refill).
      2. Describe the normal value, range or condition for each diagnostic
sign.
      3. Describe techniques used to assess each diagnostic sign.
      4. Describe abnormal states for each diagnostic sign.
         a. Respiratory arrest
         b. Cardiac arrest
         c. Other illnesses
         d. Selected injuries
   B. Components of patient assessment
      1. Perform a scene size-up while verbalizing key points.
      2. Perform an initial assessment, verbalizing any steps not readily
observable.
      3. Perform the appropriate focused assessment.
         a.  Trauma
         b.  Medical
      4. Perform a detailed assessment relating findings.
      5. Maintain ongoing assessment of the patient.
      6. Use "SAMPLE" history, "OPQRST" and "DCAP-BTLS" as an
organizational strategy.
   C. Triage
      1. Define triage.
      2. Classify patients according to triage guidelines based on a list
of presenting signs and symptoms.

V. Treatment of Respiratory and Cardiac Arrest
   A. Treatment for adult respiratory and cardiac arrest
      1. Demonstrate one rescuer CPR.
      2. Demonstrate two rescuer CPR.
      3. Demonstrate unconscious foreign body airway obstruction.
      4. Demonstrate conscious foreign body airway obstruction.
      5. Demonstrate rescue breathing.
         a. Without adjuncts
         b. Using oropharyngeal airways
         c. Using masks and supplemental oxygen
      6. Demonstrate recovery position.
      7. Demonstrate FBAO on pregnant or obese.
      8. Demonstrate airway management of a laryngectomy patient.
      9. Demonstrate use of suction equipment to clear the airway.
     10. Demonstrate use of automated defibrillation devices.
     11. Demonstrate jaw thrust maneuver.
     12. Demonstrate cricoid pressure.
   B. Treatment for children in respiratory and cardiac arrest
      1. Demonstrate one rescuer CPR.
      2. Demonstrate two rescuer CPR.
      3. Demonstrate unconscious foreign body airway obstruction.
      4. Demonstrate conscious foreign body airway obstruction.
      5. Demonstrate rescue breathing.
         a. Without adjuncts
         b. Using oropharyngeal airways
         c. Using masks and supplemental oxygen
      6. Demonstrate recovery position.
   C. Treatment for infants in respiratory and cardiac arrest
      1. Demonstrate one rescuer CPR.
      2. Demonstrate unconscious foreign body airway obstruction.
      3. Demonstrate conscious foreign body airway obstruction.
      4. Demonstrate rescue breathing.
         a. Without adjuncts
         b. Using oropharyngeal airways
         c. Using masks and supplemental oxygen
      5. Demonstrate recovery position.

VI. Treatment for Traumatic Injury
   A. Soft tissue and internal injuries
      1. Identify the signs and symptoms of soft tissue injury
         a. Closed injuries.
         b. Open injuries.
         c. Injury to internal organs.
      2. Demonstrate wound care procedures
         a. Bleeding control (internal and external bleeding).
         b. Dressing and bandaging wounds.
         c. Special wound care procedures (scalp, eye, face, nosebleed,
abdomen, genitalia).
      3. Apply treatments for shock
   B. Injuries to extremities
      1. Identify the signs and symptoms of extremity injuries.
      2. Describe the general principles of splinting (immobilization).
      3. Apply the principles of splinting (immobilization).
         a. Upper extremities
         b. Lower extremities
   C. Injuries to the spine, skull and chest
      1. Demonstrate emergency care for head injury.
         a. Identify the signs and symptoms of head injury.
         b. Demonstrate wound care.
         c. Apply immobilization principles.
      2. Demonstrate emergency care for spinal injury.
         a. Identify signs and symptoms of spinal injury.
         b. Select and apply a cervical collar.
         c. Select and apply a short spine board.
         d. Immobilize on a long spine board with strapping techniques.
      3. Demonstrate emergency care for chest injury.
         a. Identify types of chest injuries by signs and symptoms.
         b. Describe emergency care of chest injuries.

VII. Treatment for Medical and Environmental Emergencies
   A. Prevention and treatment of cardiovascular emergencies
      1. Identify signs and symptoms of common cardiovascular
emergencies.
         a. Heart attack
         b. Stroke
         c. Congestive heart failure
         d. Shock
      2. Describe treatment procedures for common cardiovascular
emergencies.
         a. Heart attack
         b. Stroke
         c. Congestive heart failure
         d. Shock
      3. List the risk factors for common cardiovascular emergencies.
      4. Suggest prevention strategies for common cardiovascular
emergencies.
   B. Prevention and treatment of other medical and environmental
emergencies
      1. Identify signs and symptoms of other medical and environmental
emergencies.
         a. Diabetic emergencies
         b. Seizures
         c. Poisoning (ingested, inhaled, absorbed, injected)
         d. Substance abuse
         e. Burns
         f. Heat exhaustion
         g. Heat stroke
         h. Hypothermia
      2. Describe treatment procedures for other medical and environmental
emergencies.
         a. Diabetic emergencies
         b. Seizures
         c. Poisoning (ingested, inhaled, absorbed, injected)
         d. Substance abuse
         e. Burns
         f. Heat exhaustion
         g. Heat stroke
         h. Hypothermia
      3. Suggest prevention strategies for other medical and environmental
emergencies.
         a. Diabetic emergencies
         b. Seizures
         c. Poisoning (ingested, inhaled, absorbed, injected)
         d. Substance abuse
         e. Burns
         f. Heat exhaustion
         g. Heat stroke
         h. Hypothermia
   C. Emergency childbirth assistance
      1. Describe the stages of labor.
      2. Demonstrate procedures to assist delivery.
         a. Normal
         b. Abnormal (breech, prolapsed cord, excessive bleeding,
miscarriage)
      3. Rate newborns using the APGAR scale.
      4. Describe care after delivery.
         a. Newborn
         b. Mother
   D. Special considerations for pediatric patients
      1. Demonstrate examination of a child.
      2. Identify signs and symptoms specific to pediatric emergencies.
         a. High fever
         b. Seizures
         c. Asthma
         d. Croup
         e. Epiglottis
         f. Child abuse
         g. SIDS
         h. Trauma
      3. Demonstrate care for pediatric patient.

VIII. Gaining Access To and Moving Patients
   A. Gaining access to patients
      1. Use simple tools to gain access to patients in or under
vehicles.
      2. Demonstrate extrication techniques.
   B. Moving patients
      1. Determine the need for movement of the patient.
      2. Choose most effective lift and carry procedure for patient and
setting.
      3. Package patients in vehicles, using:
         a. Cervical collar
         b. Short board or KED
         c. Long board
      4. Remove packaged patients from vehicles.

Written exams:
Unit/Modular Exams      200-300 points
Final                   100-200 points
AHA Exam                40 points
Quizzes/Homework        50-150 points


Practical Exams*  
   Demonstration of all CPR sequences  pass/fail
   Patient Assessment                  pass/fail
   Airway Management                   pass/fail
   Trauma Management                   pass/fail
   Fracture Management                 pass/fail

Criteria for Grade:  
   90-100%  A
   80- 89%  B
   70- 79%  C
   60- 69%  D
    0- 59%  F

* If a student fails any portion of the practical exam, the student will
receive a grade no higher than D.

Attendance:
Due to the State Regulation (KAR 109-11-8), requiring 90% class
attendance, any student who does not meet this requirement will receive a
grade no higher than D.

Content Outline and Competencies:

I. Emergency Medical Services (EMS) Systems and the Role of the EMT

A. Differentiate the roles and responsibilities of the EMT-Basic from other pre-hospital care providers.

B. Describe the roles and responsibilities related to personal safety.

C. Discuss the roles and responsibilities of the EMT-Basic toward the safety of the crew, the patient and bystanders.

D. Define quality improvement and discuss the EMT-Basic's role in the process.

E. Define medical direction and discuss the EMT-Basic's role in the process.

F. State the specific statutes and regulations in your state regarding the EMS system.

G. Characterize the various methods used to access the EMS system in your community.

II. Personal Attitudes and Conduct of the EMS Provider

A. Assess areas of personal attitude and conduct of the EMT-Basic.

B. List possible emotional reactions that the EMT-Basic may experience when faced with trauma, illness, death and dying.

C. Discuss the possible reactions that a family member may exhibit when confronted with death and dying.

D. State the steps in the EMT-Basic's approach to the family confronted with death and dying.

E. State the possible reactions that the family of the EMT-Basic may exhibit due to their outside involvement in EMS.

F. State possible steps that the EMT-Basic may take to help reduce critical incident stress.

III. Well-being of the EMT

A. Explain the need to determine scene safety.

B. Discuss the importance of body substance isolation.

C. Describe the steps the EMT-Basic should take for personal protection from airborne and bloodborne pathogens.

D. List the personal protective equipment necessary for each of the following situations.

1. Hazardous materials

2. Rescue operations

3. Violent scenes

4. Crime scenes

5. Exposure to bloodborne pathogens

6. Exposure to airborne pathogens

E. Explain the rationale for serving as an advocate for the use of appropriate protective equipment.

F. Demonstrate the use and disposal of personal protective equipment and garments.

G. Explain the procedure for disinfection of all equipment.

H. Discuss reporting documentation.

IV. Medical and Legal Issues Confronting the EMT

A. Define the EMT-Basic scope of practice.

B. Discuss Do Not Resuscitate [DNR] (advance directives).

1. Local or state provisions regarding EMS application

2. Rationale for the needs, benefits and usage of advance directives

3. Rationale for the concept of varying degrees of DNR

4. Role of EMS and the EMT-Basic regarding patients with orders

C. Discuss the methods of obtaining consent.

1. Expressed

2. Implied consent

3. Consent of minors

D. Discuss the implications for the EMT-Basic in patient refusal of transport.

E. Discuss the issues around performance of duty.

1. Abandonment

2. Negligence

3. Battery

4. Conditions necessary for a duty to act

F. Discuss patient confidentiality including:

1. Importance

2. Necessity

3. Legality

4. HIPAA

G. Discuss the considerations of the EMT-Basic in issues of organ retrieval.

H. Differentiate the actions that an EMT-Basic should take to assist in the preservation of a crime scene.

I. State the conditions that require an EMT-Basic to notify local law enforcement officials.

V. Understanding the Human Body

A. Identify topographic terms: medial, lateral, proximal, distal, superior, inferior, anterior, posterior, midline, midclavicular, bilateral, midaxillary.

B. Describe the anatomy and function of the following major body systems.

1. Respiratory

2. Circulatory

3. Musculoskeletal

4. Nervous

5. Endocrine

VI. Patient Assessment - Vital Signs

A. Differentiate between a sign and a symptom.

B. Defend the need for obtaining and recording an accurate set of vital signs.

C. Explain the rationale of recording additional sets of vital signs.

D. Identify the components of the extended vital signs.

E. Explain the value of performing the baseline vital signs.

F. Demonstrate the skills involved in assessment of breathing including:

1. Methods to obtain a breathing rate

2. Attributes that should be obtained when assessing breathing

3. Differentiate between shallow, labored and noisy breathing

4. Pulse rate

5. Assessment of pulse oximetry reading

G. Demonstrate the skills associated with obtaining a pulse, including:

1. The information obtained when assessing a patient's pulse

2. Differentiating between a strong, weak, regular and irregular pulse

H. Demonstrate the skills associated with assessing the skin, including:

1. Color: differentiate between pale, blue, red and yellow skin color

2. Temperature: differentiate between hot, cool and cold skin temperature

3. Condition: identify normal and abnormal skill conditions

4. Capillary refill in infants and children: identify normal and abnormal

I. Demonstrate the skills associated with assessing the pupils, including:

1. Identify normal and abnormal pupil size

2. Differentiate between dilated (big) and constricted (small) pupil size

3. Differentiate between reactive and non-reactive pupils

4. Differentiate between equal and unequal pupils

J. Demonstrate the skills associated with obtaining blood pressure, including:

1. Defining systolic pressure

2. Defining diastolic pressure

3. Explaining the difference between auscultation, automatic and palpation methods for obtaining a blood pressure

K. Demonstrate the placement of monitoring electrodes and 12 lead electrodes.

L. Demonstrate the monitoring of a urinary catheter.

M. Demonstrate the use of glucometers to assess blood glucose, including:

1. Normal glucose levels

2. Levels reflecting hypoglycemia

3. Indications for testing

4. Limitations to accuracy

N. Demonstrate the skills that should be used to obtain information from the patient, family or bystanders at the scene.

O. Identify the components of the SAMPLE history.

P. Explain the importance of obtaining a SAMPLE history.

Q. Discuss how to respond to the feelings patients experience during assessment.

R. Discuss the need to search for additional medical identification.

VII. Lifting and Moving Patients

A. State three situations that may require the use of an emergency move.

B. Describe the guidelines and safety precautions for moving, carrying patients and/or equipment.

1. One-handed carrying techniques

2. Reaching

3. Log-rolls

4. Pushing and pulling

5. Carrying procedures on stairs

C. Explain the rationale for properly lifting and moving patients.

D. Demonstrate selection and safe use of each of the following devices:

1. Wheeled ambulance stretcher

2. Portable ambulance stretcher

3. Stair chair

4. Scoop stretcher

5. Long spine board

6. Basket stretcher

7. Flexible stretcher

E. Demonstrate techniques for the transfer of a patient from an ambulance stretcher to a hospital stretcher.

VIII. Managing the Airway

A. Explain the rationale for basic life support artificial ventilation and airway protective skills taking priority over most other basic life support skills.

B. Recognize the signs and symptoms of respiratory distress.

C. Explain the rationale for providing adequate oxygenation through high inspired oxygen concentrations to patients who, in the past, may have received low concentrations.

D. Demonstrate the steps in performing the head-tilt chin-lift, including:

1. Rationale for use

2. Techniques

3. Evaluating effectiveness

E. Demonstrate the steps in performing the jaw thrust, including:

1. Rationale for use

2. Techniques

3. Evaluating effectiveness

F. Demonstrate artificial ventilation technique, including:

1. Mouth to mask

2. Mouth to stoma

3. Infants

4. Children

5. Barrier shields

G. Demonstrate the indications and contraindications for, selection and placement of airways, including:

1. Oropharyngeal airways

2. Nasopharyngeal airways

3. Multilumen/supraglottic airways

H. Demonstrate the indications and contraindications for, selection and use of masks and ventilatory devices, including:

1. Pocket mask

2. Bag valve mask

3. Automatic transport ventilators

4. Manually triggered ventilator

I. Demonstrate the use of suction.

J. Demonstrate the use of supplement oxygen devices, including:

1. Bag valve mask

2. Oxygen powered ventilation

3. Nasal cannula

4. Nonrebreather mask

K. Given a handheld nebulizer, the student will demonstrate the ability to assemble and use the nebulizer, and state the appropriate indications, contraindications and oxygen flow rates.

L. The student should be able to correctly state the physiology, uses and limitations of end tidal CO2 monitoring.

M. The student should be able to correctly state the implications for airway management when given various end tidal CO2 readings.

N. Given a simulated patient with a supraglottic airway in place, the student will demonstrate the ability to perform gastric decompression using a nasogastric tube.

O. Given course information, the student will explain gastric distention and its effects on the ventilation of apneic patients.

P. The student should be able to state the indications for and demonstrate the proper use of Magill's forceps for foreign body airway obstruction.

IX. Assessing the Patient

A. Identify from various scenarios and identify potential hazards.

B. Identify need for additional help.

C. Summarize the reasons for forming a general impression of the patient.

D. Demonstrate the techniques for assessing mental status.

E. Demonstrate the techniques for assessing the airway.

F. Demonstrate the techniques for assessing if the patient is breathing.

G. Demonstrate the techniques for assessing if the patient has a pulse.

H. Demonstrate the techniques for assessing the patient for external bleeding.

I. Demonstrate the techniques for assessing the patient's skin color, temperature and capillary refill (infants and children only).

J. Demonstrate the ability to prioritize patients.

K. State reasons for management of the cervical spine once the patient has been determined to be a trauma patient.

L. Explain the reason for prioritizing a patient for care and transport.

M. Describe the areas included in the rapid trauma assessment and discuss what should be evaluated.

N. Demonstrate the rapid trauma assessment that should be used to assess a patient based on mechanism of injury.

O. Recognize and respect the feelings that patients might experience during assessment.

P. Discuss the reason for performing a focused history and physical exam.

Q. Describe the unique needs for assessing an individual with a specific chief complaint with no known prior history.

R. Differentiate between the history and physical exam that is performed for responsive patients with no known prior history and patients responsive with a known prior history.

S. Demonstrate the patient care skills that should be used to assist with a patient who is unresponsive with no known history.

T. Demonstrate the patient care skills that should be used to assist with a patient who is unresponsive or has an altered mental status.

U. Demonstrate the skills involved in performing the detailed physical exam.

V. Explain what additional care should be provided while performing the detailed physical exam.

W. Distinguish between the detailed physical exam that is performed the detailed physical exam.

X. Discuss the reasons for repeating the initial assessment as part of the ongoing assessment.

Y. Demonstrate the skills involved in performing the ongoing assessment.

Z. Explain the value of trending assessment components to other health professionals who assume care of the patient.

X. Communicating

A. Explain the importance of effective communication of patient information in the verbal report.

B. List the proper methods of initiating and terminating a radio call.

C. Perform a simulated, organized, concise radio transmission, including:

1. To the scene

2. At the scene

3. To the facility

4. At the facility

5. To the station

6. At the station

D. Describe the attributes for increasing effectiveness and efficiency of verbal communications.

E. Model the communication skills that should be used to interact with the family, bystanders and individuals from other agencies while providing patient care, and the difference between skills used to interact with the patient and those used to interact with others.

F. Perform a brief, organized report that would be given to an ALS provider arriving at an incident scene at which the EMT-Basic was already providing care.

G. Perform an organized, concise patient report that would be given to the staff at a receiving facility.

XI. Documenting

A. Describe what information is required in each section of the pre-hospital care report and how it should be entered.

B. Define the special considerations concerning patient refusal.

C. Explain the rational for using an accurate and synchronous clock so that information can be used in trending.

D. Discuss all state and/or local record and reporting requirements.

E. Explain the rationale for using medical terminology correctly.

F. Complete a pre-hospital care report.

XII. Understanding General Pharmacology

A. State the medications carried on the unit by the generic name.

B. Discuss the forms in which the medications may be found.

C. State the medications the EMT-B can assist the patient with by the generic name.

D. Discuss the forms in which the medications may be found.

E. Read the labels and inspect each type of medication.

F. Demonstrate general steps for assisting patient with self-administration of medications.

G. Discuss the indications, contraindications, side effects, precautions and methods of administration of all medications carried on the unit, including:

1. Activated charcoal

2. Aspirin

3. Atropine

4. Beta 2 bronchodilators

5. Nitroglycerin

6. Epinephrine

7. Glucagon

8. Pralidoxime chloride

9. Oral, non-aspirin analgesics

10. Mark 1 or Duodote injector kit

XIII. Providing Care for Respiratory Emergencies

A. Recognize the need for medical direction to assist in the emergency medical care of the patient with breathing difficulty.

B. Defend EMT-Basic treatment regimens for various respiratory emergencies.

C. Demonstrate the emergency medical care for breathing difficulty.

D. State the generic name, medication forms, dose, administration, action, indications and contraindications for the prescribed inhaler.

E. Perform the steps in facilitating the use of an inhaler.

F. Distinguish between the emergency medical care of the infant, child and adult patient with breathing difficulty.

G. Differentiate between upper airway obstruction and lower airway disease in the infant and child patient.

XIV. Providing Care for Cardiovascular Emergencies

A. Demonstrate the assessment and emergency medical care of a patient experiencing chest pain/discomfort.

B. Discuss the position of comfort for patients with various cardiac emergencies.

C. Predict the relationship between the patient experiencing cardiovascular compromise and basic life support.

D. Explain the importance of urgent transport to a facility with Advanced Cardiac Life Support if it is not available in the pre-hospital setting.

E. Demonstrate the application and operation of the automated external defibrillator.

F. Differentiate between the fully automated and the semi-automated defibrillator.

G. Demonstrate the assessment and documentation of patient response to the automated external defibrillator.

H. Explain the role medical direction plays in the use of automated external defibrillation.

I. Demonstrate the maintenance of an automated external defibrillator.

J. Demonstrate the skills necessary to complete the Automated Defibrillator Operator's Shift Checklist.

K. Perform the steps in facilitating the use of nitroglycerin for chest pain or discomfort.

L. Demonstrate the assessment and documentation of patient response to nitroglycerin.

M. Practice completing a pre-hospital care report for patients with cardiac emergencies.

N. Discuss the components that should be included in a case review.

O. The student will correctly demonstrate and explain the ECG patch placement, including: 1. 3/4 limb lead placement

2. 12 lead placement

P. The student will correctly explain the basic concept of how cardiac electrical activity is captured by the ECG monitor.

XV. Providing Care for Diabetes and Altered Mental States

A. Identify the patient taking diabetic medications with altered mental status and the implications of a diabetes history.

B. State the generic and trade names, medication forms, dose, administration, action and contraindications for oral glucose.

C. Demonstrate the steps in the emergency medical care for the patient taking diabetic medicine with an altered mental status and a history of diabetes.

D. Evaluate the need for medical direction in the emergency medical care of the diabetic patient.

E. Establish the relationship between airway management and the patient with altered mental status.

F. Demonstrate the assessment and documentation of patient response to oral glucose.

G. Demonstrate how to complete a pre-hospital care report for patients with diabetic emergencies.

H. The student should correctly identify the normal blood glucose level.

I. The student should correctly demonstrate the ability to measure a blood glucose level using a glucometer.

J. The student should correctly state the limitations when using a glucometer for glucose measurement.

XVI. Providing Care for Allergic Reactions

A. Differentiate between the general category of those patients having an allergic reaction and those patients having an allergic reaction and requiring immediate medical care, including immediate use of epinephrine auto-injector.

B. Describe the mechanisms of allergic response and the implications for airway management.

C. State the generic and trade names, medication forms, dose, administration, action and contraindications for the epinephrine auto-injector.

D. Evaluate the need for medical direction in the emergency medical care of the patient with an allergic reaction.

E. Demonstrate the emergency medical care of the patient experiencing an allergic reaction.

F. Demonstrate the assessment and documentation of patient response to an epinephrine injection.

G. Demonstrate completing a pre-hospital care report for patients with allergic emergencies.

XVII. Providing Care for Poisoning or Overdose

A. List various ways that poisons enter the body.

B. List signs/symptoms associated with poisoning and overdose.

C. Establish the relationship between the patient suffering from poisoning or overdose and airway management.

D. Demonstrate the steps in the emergency medical care for the patient with suspected poisoning or overdose.

E. State the generic and trade names, indications, contraindications, medication form, dose, administration, actions, side effects and reassessment strategies for activated charcoals.

F. Perform the necessary steps required to provide a patient with activated charcoal.

G. Discuss the emergency medical care of bites and stings.

H. Explain the rationale for contacting medical direction early in the pre-hospital management of the poisoning or overdose patient.

I. Demonstrate the assessment and documentation of patient response.

J. Demonstrate completing a pre-hospital care report for patients with a poisoning/overdose emergency.

XVIII. Providing Care for Environmental Emergencies

A. List the signs and symptoms of exposure to cold.

B. Demonstrate the assessment and emergency medical care of a patient with exposure to cold.

C. Recognize the signs and symptoms of water-related emergencies.

D. Describe the complications of near-drowning.

E. Demonstrate the assessment and emergency medical care of a near-drowning patient.

F. List the signs and symptoms of exposure to heat.

G. Demonstrate the assessment and emergency medical care of a patient with exposure to heat.

H. Demonstrate completing a pre-hospital care report for patients with environmental emergencies.

I. Demonstrate the assessment and documentation of patient response.

XIX. Providing Care for Behavioral Emergencies

A. Define behavioral emergencies.

B. Discuss the general factors that may cause an alteration in a patient's behavior.

C. State the various reasons for psychological crises.

D. Explain the rationale for learning how to modify your behavior toward the patient with a behavior emergency.

E. Discuss the special considerations for assessing a patient with behavioral problems.

F. Discuss the characteristics of an individual's behavior which suggests that the patient is at risk for suicide.

G. Discuss the general principles of an individual's behavior which suggest that he is at risk for violence.

H. Discuss special medical/legal considerations for managing behavioral emergencies.

I. Discuss methods to calm behavioral emergency patients.

J. Demonstrate various techniques to safely restrain a patient with a behavioral problem.

XX. Providing Care for Obstetric or Gynecological Emergencies

A. Identify the following structures: uterus, vagina, fetus, placenta, umbilical cord, amniotic sac, perineum.

B. Identify pre-delivery emergencies.

C. Explain the rationale for understanding the implications of treating two patients (mother and baby).

D. Establish the relationship between body substance isolation and childbirth.

E. State indications of an imminent delivery.

F. Differentiate the emergency medical care provided to a patient with pre-delivery emergencies from a normal delivery.

G. Identify and explain the use of the contents of an obstetrics kit.

H. Demonstrate the steps to assist in the normal cephalic delivery.

I. Demonstrate the procedures for the following abnormal deliveries: vaginal bleeding, breech birth, prolapsed cord, limb presentation.

J. Demonstrate post-delivery care of infant.

K. Summarize neonatal resuscitation procedures.

L. Demonstrate the post-delivery care of the mother.

M. Demonstrate the steps in the emergency medical care of the mother with excessive bleeding.

N. Discuss the emergency medical care of a patient with a gynecological emergency.

O. Demonstrate completing a pre-hospital care report for patients with obstetrical/gynecological emergencies.

XXI. Providing Care for Traumatic Injuries

A. Establish the relationship between body substance isolation and bleeding.

B. Establish the relationship between airway management and the patient with chest injury, burns, blunt and penetrating injuries.

C. Establish the relationship between mechanism of injury and internal bleeding.

D. Establish the relationship between airway management and the trauma patient.

E. Explain the sense of urgency to transport patients who are bleeding and show signs of shock (hypoperfusion).

F. State the types of open soft tissue injuries.

G. List the types of closed soft tissue injuries.

H. List the functions of dressing and bandaging.

I. Describe the steps in applying a pressure dressing.

J. Describe the classifications of burns.

K. List the signs of internal bleeding.

L. Demonstrate direct pressure as a method of emergency medical care of external bleeding.

M. Demonstrate the use of diffuse pressure as a method of emergency medical care of external bleeding.

N. Demonstrate the use of tourniquets as a method of emergency medical care of external bleeding.

O. Demonstrate the care of the patient exhibiting signs and symptoms of internal bleeding.

P. Demonstrate the care of the patient exhibiting signs and symptoms of shock (hypoperfusion).

Q. Demonstrate the steps in the emergency medical care of closed soft tissue injuries.

R. Demonstrate the steps in the emergency medical care of open soft tissue injuries.

S. Demonstrate the steps in the emergency medical care of a patient with an open chest wound.

T. Demonstrate the steps in the emergency medical care of a patient with open abdominal wounds.

U. Differentiate the care of an open wound to the chest from an open wound to the abdomen.

V. Demonstrate the steps in the emergency medical care of a patient with an impaled object.

W. Demonstrate the steps in the emergency medical care of a patient with an amputation.

X. Demonstrate the steps in the emergency medical care of an amputated part.

Y. Demonstrate the steps in the emergency medical care of a patient with superficial burns.

Z. Demonstrate the steps in the emergency medical care of a patient with partial thickness burns.

AA. Demonstrate the steps in the emergency medical care of a patient with full thickness burns.

BB. Demonstrate the steps in the emergency medical care of a chemical burn.

CC. Demonstrate completing a pre-hospital care report for patients with soft tissue injures.

DD. State the reasons for splinting.

EE. List the general rules of splinting.

FF. List the complications of splinting.

GG. Differentiate between an open and a closed painful, swollen, deformed extremity.

HH. Explain the rationale for splinting at the scene vs. load and go.

II. Demonstrate the emergency medical care of a patient with a painful, swollen, deformed extremity.

JJ. Demonstrate completing a pre-hospital care report for patients with musculoskeletal injuries.

KK. Relate mechanism of injury to potential injuries of the head and spine.

LL. Describe the method of determining if a responsive patient may have a spine injury.

MM. Establish the relationship between airway management and the patient with head and spine injuries.

NN. Relate the airway emergency medical care techniques to the patient with a suspected spine injury.

OO. Describe the implications of not properly caring for potential spine injuries.

PP. Demonstrate log-roll for a patient with a suspected spinal cord injury, including:

1. Four person

2. Two person

QQ. Demonstrate securing a patient to a long spine board.

RR. Demonstrate using the short board immobilization technique.

SS. Demonstrate procedure for rapid extrication.

TT. Demonstrate knowledge of helmet management, including:

1. When and how to remove

2. Types of helmets

UU. Differentiate how the head is stabilized with a helmet compared to without a helmet.

VV. Demonstrate completing a pre-hospital care report for patients with head and spinal injuries.

WW. Demonstrate the use of the pelvic wrap for pelvic fractures.

XXII. Providing Care to Infants and Children

A. Identify the developmental considerations for the following age groups, including:

1. Infants

2. Toddlers

3. Pre-school

4. School age

5. Adolescent

B. Describe differences in anatomy and physiology of the infant, child and adult patient.

C. Differentiate the response of the ill or injured infant or child (age-specific) from that of an adult.

D. Differentiate between respiratory distress and respiratory failure.

E. Indicate various causes of respiratory emergencies.

F. State the usual cause of cardiac arrest in infants and children vs. adults.

G. Describe the methods of determining end organ perfusion in the infant and child patient.

H. Summarize the indicators of possible child abuse and neglect.

I. Describe the medical/legal responsibilities in suspected child abuse.

J. Demonstrate the assessment of the infant and child.

K. Discuss the field management of the infant and child trauma patient.

L. List the common causes of seizures in the infant and child patient.

M. Describe the management of seizures in the infant and child patient

N. Demonstrate the techniques of foreign body airway obstruction removal in the infant.

O. Demonstrate the techniques of foreign body airway obstruction removal in the child.

P. Demonstrate oxygen delivery for the infant and child.

Q. Demonstrate bag-valve-mask ventilation for the infant.

R. Demonstrate bag-valve-mask ventilation for the child.

S. Identify the signs and symptoms of shock (hypoperfusion) in the infant and child patient.

T. Attend to the feelings of the family when dealing with an ill or injured infant or child.

U. Understand the provider's own response (emotional) to caring for infants or children.

V. Recognize need for EMT-Basic debriefing following a difficult infant or child transport.

W. The student will correctly explain the process of monitoring urinary catheters.

XXIII. Understanding and Performing Basic Operations

A. Discuss the medical and nonmedical equipment needed to respond to a call.

B. List the phases of an ambulance call.

C. Describe the general provisions of state laws relating to the operation of the ambulance and privileges in any or all of the following categories, including:

1. Speed

2. Warning lights

3. Sirens

4. Right-of-way

5. Parking

6. Turning

D. List contributing factors to unsafe driving conditions.

E. Describe the considerations that should be given to escorts, intersections.

F. Discuss "Due Regard for Safety of All Others" while operating an emergency vehicle.

G. Summarize the importance of preparing the unit for the next response.

H. Distinguish among the terms: cleaning, disinfection, high-level disinfection and sterilization.

I. Identify what is essential for completion of a call.

J. Describe the purpose of extrication.

K. Discuss the role of the EMT-Basic in extrication.

L. Identify what equipment for personal safety is required for the EMT-Basic.

M. Define the fundamental components of extrication.

N. State the steps that should be taken to protect the patient during extrication.

O. Evaluate various methods of gaining access to the patient.

P. Distinguish between simple and complex access.

XXIV. Understanding Overview Information

A. Discuss the various environmental hazards that affect EMS.

B. Describe what the EMT-Basic should do if there is reason to believe that there is a hazard at the scene.

C. Explain the EMT-Basic's role during a call involving hazardous materials.

D. Describe the actions that an EMT-Basic should take to ensure bystander safety.

E. State the role the EMT-Basic should perform until appropriately trained personnel arrive at the scene of a hazardous materials situation.

F. Break down the steps to approaching a hazardous situation.

G. Explain the methods for preventing contamination of self, equipment and facilities.

H. Summarize the components of basic triage.

I. Describe the criteria for a multiple-casualty situation.

J. Evaluate the role of the EMT-Basic in the multiple-casualty situation.

K. Define the role of the EMT-Basic in a disaster operation.

L. Describe basic concepts of incident management.

M. Review the local mass casualty incident plan.

N. Given a scenario of a mass casualty incident, perform triage.

Content Outline and Competencies:

I. ALS BLS Interface

A. Explain the various roles the EMT-B can play in supporting ALS operations.

B. Provide examples of support activities the EMT-B can perform with ALS units.

C. Explain the way that ALS and BLS units interact in the local communities of interest.

D. Define the role of medical direction in the interaction of ALS and BLS personnel.

II. EMS Communications

A. Define and explain the concept of System Status Management in an EMS system.

B. Explain the role of Emergency Medical Dispatch in the local EMS system.

C. Demonstrate how to write a complete pre-hospital care report using the SOAP format on the JCCC Patient Report form.

D. Explain the importance of thorough documentation in a pre-hospital care report.

E. Describe the types of biocom reports an EMT may give to a hospital.

F. Demonstrate a complete biocom report for a simulated EMS call.

G. List the information that must be collected for insurance billing.

H. Demonstrate proper use of mobile and portable radios.

III. Map Reading and Navigation

A. Explain the procedures for using the map book of the local EMS system.

B. Demonstrate how to find a given location using the dispatch information and map book.

IV. Patient Assessment

A. List the components of a history of an adult and a pediatric patient.

B. Elicit an accurate history from a patient using a variety of techniques.

C. Demonstrate the techniques used when performing a physical exam.

D. Review the procedures used in taking vital signs.

E. Demonstrate a complete physical assessment for each of the following types of patient:

1. Significant mechanism of injury trauma

2. Non-significant mechanism of injury trauma

3. Alert medical patient

4. Decreased LOC medical patient

F. Differentiate between safe and unsafe scenes.

G. Value the need for maintaining a professional, caring attitude when performing a focused history and physical exam.

H. Differentiate between critical life-threatening, potentially life-threatening and non-life-threatening patient presentations.

V. Ambulance Operations

A. Demonstrate the safe operation of an ambulance in a non-emergency mode.

B. Demonstrate the ability to back an ambulance using a backer.

C. Identify potentially dangerous situations while operating an ambulance.

D. Describe the principles of defensive driving.

VI. Basic Electrocardiogram Use

A. Explain the basic principles of electrocardiography.

B. Demonstrate how to apply limb leads and precordial leads to a patient.

C. Demonstrate how to acquire a 12 lead ECG.

D. List the potential sources of interference in obtaining a 12 lead ECG.

E. Explain methods by which an ECG can be transmitted to a base hospital.

F. Justify the importance of obtaining an ECG during an EMS call.

VII. Mass Casualty Incidents

A. Explain the principles of MCI management.

B. Define Mass Casualty Incident.

C. Explain the concept of triage and its application to MCI management.

VIII. Field Internship (Field Laboratory) (144 hours: 12-12 hour shifts)

A. Demonstrate the ability to serve as team leader on at least 5 BLS level calls.

B. Demonstrate an understanding of the concepts of scene management.

C. Demonstrate appropriate compassion and empathy for patients while on calls.

D. Demonstrate the proper use of BLS ambulance equipment on calls.

E. Demonstrate proper checkoff procedures of a BLS ambulance.

F. Demonstrate the ability to transmit an appropriate biocom to the receiving facility.

G. Demonstrate the proper procedure for passing the care of an ill or injured patient from the EMS crew to the receiving facility.

H. Explain the appropriate use of patient restraints and demonstrate their use on a simulated patient.

Content Outline and Competencies:

I. Cardiology
   A. Identify and state the relevant parameters, clinical significance,
treatment, and etiology for the major cardiac dysrhythmias and infarct
patterns.
   B. State the topographic anatomical location of all of the electrode
positions for a 12 lead ECG.
   C. Demonstrate the procedures for electrical therapies.
   D. Identify all ACLS and BCLS algorithms and explain the rationale for
treatments.
   E. Given a description of a patient, write the appropriate treatment.

II. Cardiovascular System
   A. Label anatomic features of the human heart and circulatory system.
   B. Identify the normal physiological limits, components of, and factors
influencing:  cardiac output, myocardial oxygen demand, stroke volume,
afterload, preload, blood pressure.
   C. Define Starling's law and state its implications for cardiac
output.
   D. Identify and define the phases of the cardiac cycle and the function
and position of the heart valves during each phase.
   E. Label the parts of the heart's conduction system and state the
intrinsic firing rate of each part.

Unit quiz (3 at 100 points each)    300
Class work, homework, attendance    100
Final exam                          200
Total points possible               600

Grading Scale:
   Cognitive:
      90 -100% A
      80 - 89% B
      70 - 79% C
      60 - 69% D
       0 - 59% F

Content Outline and Competencies:

I. Preparatory

A. Stress and the MICT

1. List the physiological and psychological manifestations of stress.

2. List the common causes of job stress for the MICT, and activities that could be utilized to reduce stress.

B. EMS systems

1. List the components of an EMS system, and outline various system designs and funding methods.

2. Define medical control, and differentiate between on-line and off-line medical control.

3. List the components of a quality improvement system.

C. Role of the MICT

1. When given a list of activities performed by all levels of pre-hospital personnel, the student should be able to correctly identify the activities performed exclusively by the MICT.

2. Utilizing the concepts of restorative vs. supportive care, the MICT should be able to contrast the roles of the MICT in each situation.

II. Anatomy and Physiology

A. Acid/Base balance; fluids and electrolytes

1. Identify normal pH and outline the function of the three physiological systems which maintain pH.

2. Write a chemical equation that expresses the physiology of acid/base balance.

3. Given a set of blood gases, identify what abnormality is represented and list a common cause.

4. Given a list of anions and cations, state which are chiefly extracellular and which are intracellular.

5. Explain the kidney's role in blood pressure maintenance, urine formation, and acid/base regulation.

B. Cardiovascular system

1. Label anatomical features of the human heart and circulatory system.

2. Identify the normal physiological limits, components of and factors influencing: cardiac output, myocardial oxygen demand, stroke volume, afterload, preload, blood pressure.

3. Define Starling's law and state its implications for cardiac output.

4. Identify and define the phases of the cardiac cycle and the function and position of the heart valves during each phase.

5. Label the parts of the heart's conduction system and state the intrinsic firing rate of each part.

6. List the functions of blood, and define: hematocrit, hemoglobin, universal donor and universal recipient.

C. Cellular physiology

1. Identify the role of oxygen in cellular respiration and specify the differences in resultant energy production when oxygen is absent.

2. Identify the processes involved in the sodium pump and specify any changes in cellular metabolism when the pump is inactive.

D. Central and autonomic nervous systems

1. Identify the autonomic neurotransmitters and their effects on the body systems.

2. List the processes of nerve impulse transmission.

3. Label the anatomic parts and identify the function of the central and peripheral nervous system.

4. Identify the blood supply to the various regions of the brain, and factors influencing cerebral blood flow.

E. Musculoskeletal system

1. Identify the sequence of events necessary for muscle contraction.

2. Describe the location of the major muscles.

3. Describe the electrical phenomena which result in neuromuscular excitation.

F. Respiratory system

1. Given a diagram, identify structures of the upper and lower respiratory system.

2. Write the primary stimulus for breathing and list five causes of a change in respiratory rate.

3. Identify the normal PaCO2 and PaO2, and given an increase or decrease, name this condition and describe its effect on respiratory activity and on blood pH.

4. Given a PaO2, state the percent O2 saturation, and given a percent O2 saturation, state the PaO2 using the oxygen hemoglobin dissociation curve.

G. Topographical anatomy

1. Identify major topographic landmarks.

2. Match definitions with terms denoting movement.

3. Define anatomical terms that denote location with respect to a reference point.

III. General Pharmacology, Patient Assessment and Communications

A. EMS radio communications

1. List and describe seven communication phases that occur in an EMS event.

2. List and describe EMS communications hardware.

3. Describe the inherent differences in EMS communication radio frequencies.

4. Given a scenario, select the correct biocom format and content.

B. General pharmacology

1. Perform medication calculations.

2. List those factors influencing the action of drugs, such as: age of the patient, condition of the patient, dosage, absorption rate, distribution and elimination.

3. Safely administer parenteral medications.

4. Identify the trade name, class, actions, indications, contraindications, precautions, side effects, and dosage for the medications in the MICT formulary.

5. List five routes by which drugs are absorbed, and rank absorption rates from fastest to slowest.

C. Medical records

1. List the items that must be included in each part of a SOAP narrative.

2. After watching a videotaped scenario, complete a medical record that conforms to SOAP format.

3. Given a copy of a medical record, identify errors and omissions.

D. Patient assessment

1. Write the reasons for performing, and steps involved in initial, focused, detailed, and on-going assessments.

2. List the vital signs and their normal limits.

3. Demonstrate a detailed physical examination.

4. Effectively elicit a patient's medical history.

5. Given a chief complaint, perform a differential diagnosis.

IV. Cardiology and Airway Management

A. Cardiology

1. Identify and state the relevant parameters, clinical significance, treatment and etiology for the major cardiac dysrhythmias and infarct patterns.

2. State the topographic anatomical location of all of the electrode positions for a 12 lead ECG.

3. Demonstrate the procedures for electrical therapies.

4. Compare and contrast the signs/symptoms and field treatment for angina, unstable angina, acute myocardial infarction, and cardiogenic shock.

5. Identify all ACLS and BCLS algorithms and explain the rationale for treatments.

6. Given a description of a patient, write the appropriate treatment.

B. CHF and pulmonary edema

1. List the causes of signs/symptoms of compensatory mechanisms in and events that can lead to decompensation in heart failure.

2. Given a description of a patient in pulmonary edema, identify the patient is in pulmonary edema and initiate the appropriate treatment.

3. List five etiologies for non-cardiogenic pulmonary edema and differentiate between cardiogenic and non-cardiogenic pulmonary edema.

C. Techniques of airway management

1. Given specific patient situations and illnesses, select the best method of oxygen delivery.

2. Given a list of situations describing patients with airway maintenance problems, select those situations in which endotracheal intubation is indicated.

3. Given that a patient requires endotracheal intubation, list the correct procedure to be followed, including all steps in the proper sequence.

4. Given a patient with an airway management problem, correctly identify the most appropriate airway/ventilation interventions.

V. Psychomotor Skills

A. Patient assessment/communications

1. Write a patient report and deliver a biomedical communication from a videotaped or simulated emergency call.

2. Demonstrate initial assessment, focused assessment, detailed assessment, and on-going assessment.

B. Medication administration

1. Perform subcutaneous and intramuscular injections, intravenous cannulation and parenteral medication administration, and external jugular vein catheterization.

2. Demonstrate how to set up and administer an intravenous fluid infusion including timing an IV drip rate.

3. Calculate the dosage, prepare and administer IV piggyback medications, preloaded medications and medications drawn up from vials and ampules.

C. Electrical therapies

1. Demonstrate use of all controls on various portable heart monitor/defibrillators.

2. Choose appropriate energy setting, charge defibrillator and cardiovert using paddles, fast patch, and quick combo systems.

D. Airway management

1. Correctly perform the following skills according to task analysis: bag valve mask, metered dose inhaler, nonrebreather facemask, and endotracheal intubation.

E. Cardiac emergencies

1. According to ACLS algorithms, manage simulated cardiac emergencies including patient assessment, airway, electrical therapies, and medication administration.

Content Outline and Competencies:

I. Medical Emergencies
   A. Alcoholism and alcohol
      1. From a list, select the signs and symptoms related to various
alcohol emergencies.
      2. List the physical characteristics of a patient suffering from
advanced alcoholism
   B. Acute abdomen and GU emergencies
      1. List the signs, symptoms, field treatment, and pathophysiology of
causes of acute abdomenal conditions. 
      2. List at least five questions that should be asked of any patient
with abdominal pain
      3. List the acute abdominal conditions most likely to cause shock
   C. Allergic reactions
      1. List the clinical presentation of anaphylaxis, from initial onset
to cause of death
      2. Given a description of a patient manifesting the signs and
symptoms of anaphylactic shock, specify the treatment.
   D. Asthma
      1. Identify the pathophysiology of asthma
      2. Given a dyspneic patient with a wheeze, identify at least four
other etiologies for the wheeze
      3. Given a patient in an acute asthma attack, identify the
mechanisms that contribute to or cause death
      4. Identify the significance pulse rate, retractions, diaphoresis,
accessory muscle use, skin color, LOC, ability to speak, respiratory rate,
and a paradoxical pulse have on assessing the severity of the asthma
attack
      5. State the questions that must be asked when eliciting an asthma
patient's history
   E. Barotrauma/hyperbaric oxygen therapy
      1. List the signs and symptoms and treatment of decompression
sickness
      2. State the physiology of nitrogen gas in the body
      3. State the mechanism by which hyperbaric oxygen therapy is
beneficial
   F. Behavioral emergencies
      1. List steps in assessment and techniques to manage behavioral
emergency patients
      2. List the factors that increase the risk of suicide
      3. Differentiate various etiologies of organic, inorganic, and
chemically induced behavioral emergencies
   G. Bites and stings
      1. Identify the pathophysiology, signs, symptoms, and treatment of a
pit viper bite
      2. From a picture or description, identify a black widow and brown
recluse spider, and list the signs, symptoms, and treatment of a bite
   H. Carbon monoxide and toxic gas poisoning
      1. Identify potential sources of toxic gasses, the signs and
symptoms of poisoning, and the treatment
   I. Chronic obstructive pulmonary disease
      1. Given a COPD patient in acute respiratory distress, list the
presenting signs and symptoms, and the treatment
      2. Given a patient with a history of COPD experiencing dyspnea, list
five factors that would allow the MICT to differentiate between COPD, CHF,
asthma, and pneumonia
      3. Define acute respiratory failure, and differentiate the various
presentations of ARF
   J. Cerebral vascular accident
      1. List the history, signs, and symptoms of CVA and TIA, and the
treatment and possible complications
      2. Given a patient with a possible non-traumatic neurological
problem, list at least five questions that should be asked during
assessment
      3. Given a hypertensive CVA patient, state why the BP should not be
aggressively lowered
   K. Diabetes
      1. List the signs, symptoms, precipitating factors, treatment, and
clinical significance of diabetic emergencies
      2. List the source and functions of insulin and glucagon in the
body
      3. Define the following terms: diabetes mellitus, diabetic
ketoacidosis, insulin shock, hypoglycemia, hyperglycemia, hyperglycemic
hyperosmolar coma, type I diabetes, type II diabetes, glycogenolysis,
gluconeogenesis
   L. Differential diagnosis of chest pain
      1. Identify the conditions capable of causing pain in the six
dermatome pain bands and differentiate their presentations from each
other
      2. List the appropriate treatment for a patient with chest pain of
probably non-cardiac etiology
   M. Endocrine emergencies
      1. List the pathophysiology, symptoms, and treatment of adrenal
crisis, thyroid storm, and myxedemic coma
   N. Environmental emergencies
      1. Identify the history, pathophysiology, clinical significance,
signs, symptoms, and treatment for heat cramps, heat exhaustion, heat
stroke, frostbite, and hypothermia
      2. Identify the normal body temperatures in degrees F and C, and the
regulatory mechanisms of temperature control
      3. Identify the hazards associated with treatment of heat stroke and
hypothermia
   O. Geriatric emergencies
      1. List the special problems to be considered when dealing with the
geriatric patient
      2. List principles of management that are unique to geriatric
patients 
   P. Hypertension
      1. Define (including numerical criteria) hypertension and
hypertensive crisis
      2. List the signs and symptoms of a hypertensive crisis and the
treatment, including specifics of blood pressure management
      3. List the common prescription medications taken for hypertension
   Q. Hyperventilation
      1. List the organic and inorganic causes of hyperventilation, the
proper field management, and complications that may result
      2. Identify the homeostatic mechanism for acid/base balance, and how
it is offset in the alkalotic state of hyperventilation
      3. Write blood gases for a patient who is in simple
hyperventilation
   R. Infectious disease
      1. Identify the pathophysiology, signs and symptoms, and management
of tuberculosis, hepatitis, meningitis, syphilis, gonorrhea, herpes
simplex type 2, AIDS, scabies, lice
      2. Identify the measures to be taken to ensure paramedic safety as
related to handling the patient with suspected infectious disease
      3. Write the major components of the immune system and describe the
function of each
   S. Near drowning
      1. List the pathophysiologies and potential causes of death in near
drowning, drowning, and secondary drowning
      2. Given a description of a patient who has been involved in a near
drowning, correctly provide the appropriate field treatment
      3. State the four factors affecting prognosis from near drowning
episodes
   T. Obstetrics and gynecology
      1. Identify the assessment procedures used when evaluating the
patient who is suspected of being pregnant, and the complications that
arise in the 1st, 2nd and 3rd trimester
      2. Identify the assessment procedures used when evaluating the
patient suspected of being in labor, and list four signs of imminent field
delivery
      3. Identify the steps necessary to assist with normal and abnormal
delivery
      4. Given a situation where the postpartum mother is bleeding,
identify if that bleeding is excessive, and the proper treatment
      5. Identify the complications of an assessment for the pregnant
patient who suffers trauma
      6. Identify the signs/symptoms of the distressed neonate and the
steps necessary for care of the newborn
      7. List the causes, signs and symptoms, histories, and treatment
priorities for five non-obstetrical causes of female abdominal pain
   U. Pediatric emergencies
      1. State age appropriate assessment techniques and vital signs for
pediatric patients
      2. Given a pediatric patient in respiratory distress, correctly
identify the etiology, signs, symptoms, classic age group, and treatment
      3. Identify the etiology, history, signs, and symptoms and treatment
of seizures, meningitis, poisoning, battered child, SIDS, dehydration,
sepsis, dysrhythmias, and congenital heart disease
      4. List the signs/symptoms and management of impending ventilatory
failure in the pediatric patient
      5. Given a child in bradycardia, tachycardia, or cardiac arrest,
identify proper treatment per ACLS/BCLS/PALS algorithms
   V. Pneumonia and atelectasis
      1. State three signs and two symptoms frequently found in patients
with pneumonia and describe appropriate treatment
   W. Pulmonary emboli -- spontaneous pneumothorax
      1. List the histories, signs, symptoms, and treatment for pulmonary
embolus
      2. List three potential etiologies for spontaneous pneumothorax and
signs, symptoms, and treatment
   X. Seizure disorders
      1. List four possible etiologies for grand mal seizures, and eight
questions that should be asked when ascertaining a history for the seizure
patient
      2. Given a description of a patient in an active grand mal seizure,
list the appropriate treatment, provide the rationale for that treatment,
and list four possible complications
      3. List the drugs that are commonly given in maintenance doses to an
epileptic to prevent seizure activity
   Y. The unconscious patient
      1. List the possible causes of unconsciousness using the AEIOU EMTPS
mnemonic
      2. List the chronological order of the steps in the assessment of an
unconscious patient, and five questions that should be asked about the
patient
      3. Define and briefly describe common causes of syncope
   Z. Toxicology
      1. List the signs, symptoms, mechanism of action that may lead to
death, street names, and field treatment for the following substances:
stimulants, hallucinogens, narcotics, sedative/hyponotics,
anti-cholinergics, psychotropics, caustics, petroleum products, alcohols,
hydrocarbons, aspirin, acetaminophen, and calcium channel blockers
      2. For tricyclic antidepressant overdose, list and how to manage
complications and why all patients should be evaluated at a hospital
regardless of initial presentation
      3. Given a description of a suspected OD/poisoning patient, identify
the suspected substance, key elements in differential diagnosis and
appropriate treatment
   AA. Vascular emergencies
      1. Identify the pathophysiology, signs and symptoms, and treatment
of aneurysms

II. Trauma Management
   A. Abdominal trauma
      1. List two categories of abdominal trauma, and the organs most
often injured in each
      2. List the steps involved in the evaluation of possible abdominal
trauma, the signs, and symptoms, and the treatment
   B. Burns
      1. List the signs and symptoms of 1st, 2nd, and 3rd degree burns
      2. List those factors that mandate admission to a burn unit
      3. Identify the history, signs/symptoms, significance, and field
treatment for pulmonary burns
      4. List the steps in assessing the burn patient and the appropriate
treatment
   C. Chest trauma
      1. Identify the pathophysiology, clinical significance, history,
signs and symptoms, and the treatment for tension pneumothorax, open
pneumothorax, flail chest, pericardial tamponade, traumatic asphyxia, and
ARDS
      2. Given a patient with a tension pneumothorax, list the procedure
for field decompression
   D. Ear, eye, and nose trauma
      1. List the steps for management of foreign bodies, and hemorrhage
from the ear and eye
      2. List two hazards associated with blunt trauma to the eye
      3. List four causes of epistaxis, and list the treatment
   E. Pneumatic anti-shock garment
      1. Identify the indications, contraindications, and complications
associated with PASG use
   F. Neck and facial trauma
      1. List problems with airway management, hemorrhage control, and
shock involved with treatment of facial and neck trauma
      2. List considerations in managing each of the following: orbital
blow-out fracture, impaled objects in the face or neck, trauma to the
mouth and jaw, trauma to the teeth,  temporomandibular joint dislocation,
blunt trauma to the neck with inadequate ventilation
   G. Neurological trauma
      1. Define various types of head trauma, associated complications,
and list the steps in treatment
      2. List the pathophysiology, clinical significance, signs, symptoms,
and treatment of neurogenic shock
   H. Orthopedic injuries
      1. List the signs, symptoms, clinical significance and treatment for
fractures and dislocations involving various bones of the body
      2. List four orthopediac emergencies
      3. Identify the objective for splinting and the procedure for
application of various types of splints
   I. Pediatric trauma
      1. Identify the most common causes of pediatric death from trauma 
      2. List at least two anatomical differences between the adult and
pediatric trauma patient that result in different patterns of injury
      3. Differentiate between the physiologic response to hypovolemic
shock in pediatric and adult patients
   J. Radiation emergencies
      1. Given a situation describing a radiation emergency, list
appropriate management including avoidance of self-contamination
   K. Shock
      1. Identify the pumping action of the heart, peripheral vascular
resistance, and blood volume as they pertain to the physiology of the
various types of shock
      2. State the changes in vital signs which usually occur in early
compensated shock and those occurring in later progressive shock
      3. List the body's physiologic reaction to shock
      4. List at least two ways in which the MICT can estimate if
sufficient fluid has been administered to the hypovolemic patient
   L. Spinal trauma
      1. Correctly list the incidents that mandate spinal immobilization
      2. List the signs and symptoms of spinal injury and the treatments
      3. Identify the procedure for applying the Kendrick Extrication
Device, and the long spine board
   M. Multiple systems trauma
      1. Given a description of a patient with multiple systems trauma,
list the appropriate treatment in an appropriate order of priorities
      2. Identify the ten steps in MCI scene command
   N. Wounds and bleeding
      1. List in order the proper techniques for stopping bleeding
      2. List the signs of arterial, venous, and capillary bleeding
      3. List the proper bandaging techniques

III. Field Observation Lab
   A. Closely observe all aspects of EMS operations
   B. Write a patient report on each patient contact

IV. Advanced Cardiac Life Support
   A. Successfully complete an Advanced Cardiac Life Support course

V. Psychomotor Skills Labs
   A. Demonstrate competency in all component motor skills
   B. Run a cardiac emergency simulation according to skill criteria
   C. Given a simulated respiratory or cardiac emergency,  diagnose and
treat the patient according to established medical protocol

Cognitive - competency will be verified through 6 homework
assignments, 6 quizzes, and 3 module finals. Quizzes and module finals
will be blueprinted. Items will represent a variety of question types and
levels of taxonomy, each of which is tied to a course competency. The
module final exam must be passed before the student can proceed to the
next module.

Motor Skills - competency will be verified by faculty observation of motor
skills performance utilizing skills task analysis as the standard.

Affective - competency will be evaluated by field preceptors utilizing
field evaluation instruments, two program staff using lab evaluation
instruments.

Medical Director - synthesizing information about student's progress in
each of the three domains, the course medical director will make a final
decision about terminal competence, and thus course completion.

Grading Scale:
   Cognitive:
   94-100% = A
   86- 93% = B
   80- 85% = C - minimum passing score
   70- 80% = D
     < 70% = F

6 homework assignments @  80 points each
6 quizzes              @ 120 points each
3 module exams         @ 400 points each
Total didactic points = 2400

Motor skills: pass/fail
Affective evaluations: pass/fail

Note: Successful course completion requires passing grade in didactic work
AND successful demonstration of skills competency, AND acceptable
evaluation of ALL affective competencies.

Content Outline and Competencies:

I. Field Observation Lab
   A. Upon discretion of the preceptor, perform biomedical communication,
patient assessment, ECG monitoring, IV infusion, endotracheal intubation,
medication set-up
   B. Perform basic level EMT functions
   C. Write a patient report on each patient contact

II. Clinical Internship
   A. Emergency Department
      1. Perform patient assessment, including primary assessment,
history, vital signs, physical exam, and documentation
      2. Develop a clinical impression of the patient's diagnosis and
discuss this with the preceptor
      3. Initiate intravenous cannulation and administer parenteral
medications
      4. Perform airway management
      5. Correctly apply ECG leads
   B. Obstetrics
      1. Correctly identify the signs and symptoms of the different stages
of labor
      2. Closely observe and describe the normal delivery and management
of complications during labor, delivery, or postpartum care of mother and
baby
   C. Intensive Care Unit
      1. Perform patient assessment, including primary assessment,
history, vital signs, physical exam, and documentation
      2. Develop a clinical impression of the patient's diagnosis and
discuss this with the preceptor
      3. Initiate intravenous cannulation and administer parenteral
medications
      4. Perform airway management
      5. Correctly apply ECG leads
      6. Closely observe for and identify any complications in patient's
condition that are associated with pre-hospital care
   D. Anesthesiology
      1. Ventilate the patient with a bag mask assessing for adequate face
to mask seal and adequacy of chest rise
      2. Assess the degree of compliance and discuss the causes and
implications of increased or decreased compliance with preceptor
      3. Correctly intubate an unconscious patient with an endotracheal
tube and correctly tape the tube in place
   E. Burn Unit
      1. Observe and describe burn wound healing, debridement, surgical
procedures
      2. Observe and evaluate airway care including endotracheal
intubation, upper airway burns, oxygen saturation and blood gases, and
burns to the chest
   F. Pediatrics
      1. Correctly take and evaluate vital signs in the pediatric patient
      2. Observe and identify closely the treatment and symptomatology of:
asthma, croup, epiglottitis, pediatric trauma, dehydration, and seizures
      3. Assess pediatric patients
   G. Respiratory Therapy
      1. Evaluate patients in respiratory distress paying particular
attention to their lung sounds, respiratory mechanics, PEFR, blood gases,
oxygen saturation, and end tidal CO2
      2. Administer nebulized breathing treatments

III. Cognitive and Motor Skills
   A. Techniques of patient handling
      1. Demonstrate the body mechanics of proper lifting technique
      2. Demonstrate proper technique for side lifts, extremity lifts, and
sheet lift
      3. Demonstrate proper technique with the following adjunctive
equipment: cot, long spine board, portable stretchers, stair chair, scoop
stretcher
   B. Renal and dialysis emergencies
      1. List common emergencies associated with dialysis patients
      2. List the appropriate treatments
   C. The twelve lead ECG
      1. State the criteria for a presumptive diagnosis of AMI from the 12
lead ECG including acute Qwave and non-Qwave AMI, qualify and quantify
diagnostic changes, numbers of contiguous leads in which the change must
be observed, and reciprocal changes
      2. Given a 12 lead ECG, identify ECG changes present, localize the
infarct site, and arrive at a presumptive diagnosis ruling AMI out or in
   D. Clinical case study
      1. Select patient(s) cared for during clinicals and research
      2. Write and present in-depth case studies
   E. EMS call simulation
      1. Demonstrate a satisfactory performance on a randomly selected
simulated emergency call with three attempts

IV. Affective Domain

Attitudinal Competencies - from the MICT Student Manual

Successful completion of the JCCC MICT program shall include demonstration
of the following attitudes/behaviors.

1. INTEGRITY - The student is honest and trustworthy.
   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 - The student is respectful and compassionate.
   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 - The student demonstrates personal responsibility to
initiate, follow through and complete tasks and assignments without
supervision.
   The student receives and acts upon constructive feedback. 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 - The student exercises good personal
hygiene and professional appearance.
   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 - The student demonstrates composed competent
leadership.
   Examples of professional behavior include, but are not limited to,
demonstrating the ability to trust personal judgment, demonstrating an
awareness of strengths and limitations, exercising good personal
judgment.

6. COMMUNICATION - The student utilizes effective communication
strategies.
   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 - The student makes effective use of time, thus meeting
deadlines, and is punctual.
   Examples of professional behavior include, but are not limited to,
consistent punctuality, completing tasks and assignments on time.

8. TEAMWORK AND DIPLOMACY - The student values teamwork.
   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 - The student is respectful of others.
   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 - The student always keeps the patient number one.
   Examples of professional behavior include, but are not limited to, not
allowing personal bias 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 - The student is thorough and safe.
   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.

Taken together, these values constitute professional behavior.

The student's progression in these areas is evidenced by initially
expressing willingness to learn new attitudes and behaviors, which
progresses to active participation in discussing them. Next, the student
demonstrates acceptance and integration of these attitudes and behaviors
in interactions with others. Later, the student demonstrates preference
for these values and ultimately an internal commitment to them.

Content Outline and Competencies:

I. Field Internship

A. Perform patient assessment when given a real patient, according to skill criteria. Patient assessment should include history, physical examination, and vital signs.

B. Given a variety of patients manifesting different degrees of illness or injury, assign appropriate assessment, treatment and transportation priorities.

C. Given a situation where the student must perform Basic Cardiac Life Support on a patient, performance should be consistent with established standards.

D. Given a patient requiring the following techniques, they should be performed according to established skill criteria:

1. Intravenous cannulation and parenteral medication administration

2. Basic and advanced airway management

3. Acquiring the 12 lead ECG and electrical therapies

4. Mechanical CPR devices

5. Spinal and extremity immobilization

6. Hemorrhage control

7. Patient handling

E. Given a situation requiring biomedical communications, perform according to skill criteria, with regard to patient's acuity.

F. Identify specified ECG rhythms from written tracing or dynamic tracing with 90% accuracy.

G. State the dosages, indications, contraindications, side effects and precautions for any of the medications in the MICT Formulary.

H. Given any medical or traumatic emergency, initiate appropriate treatment, as per service protocols, in an assertive manner.

I. Demonstrate the ability to communicate in a calm, professional manner to the patient's family and/or bystanders, as determined by the JCCC faculty or preceptor.

J. Write patient reports in an acceptable fashion with regard to spelling, grammar, legibility and content.

K. Demonstrate the ability to constantly "put it all together," organize the call, assess the patient, assign priorities, treat appropriately and demonstrate suitable patient rapport.

II. Cognitive and Motor Skills

A. Demonstrate a satisfactory performance on a randomly selected simulated emergency call within three attempts.

B. Understand the legal issues that impact decisions made in the out-of-hospital environment.

C. Understand standards and guidelines that help ensure safe and effective ground and air medical transport.

D. Integrate the principles of general incident management and multiple casualty incident (MCI) management techniques in order to function effectively at major incidents.

E. Integrate the principles of rescue awareness and operations to safely rescue a patient from water, hazardous atmospheres, trenches, highways, and hazardous terrain.

F. Evaluate hazardous materials emergencies, call for appropriate resources, and work in the cold zone.

G. Demonstrate an awareness of the human hazard of crime and violence and the safe operation at crime scenes and other emergencies.

III. Affective Domain

Attitudinal Competencies - from the MICT Student Manual

Successful completion of the JCCC MICT program shall include demonstration of the following attitudes/behaviors:

1. Integrity: The student is honest and trustworthy.

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: The student is respectful and compassionate.

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: The student demonstrates personal responsibility to initiate, follow through and complete tasks and assignments without supervision.

The student receives and acts upon constructive feedback. 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: The student exercises good personal hygiene and professional appearance.

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: The student demonstrates composed competent leadership.

Examples of professional behavior include, but are not limited to, demonstrating the ability to trust personal judgment, demonstrating an awareness of strengths and limitations, exercising good personal judgment.

6. Communication: The student utilizes effective communication strategies.

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: The student makes effective use of time, thus meeting deadlines, and is punctual.

Examples of professional behavior include, but are not limited to, consistent punctuality, completing tasks and assignments on time.

8. Teamwork and diplomacy: The student values teamwork.

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: The student is respectful of others.

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: The student always keeps the patient number one.

Examples of professional behavior include, but are not limited to, not allowing personal bias 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: The student is thorough and safe.

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.

Taken together, these values constitute professional behavior.

The student's progression in these areas is evidenced by initially expressing willingness to learn new attitudes and behaviors, which progresses to active participation in discussing them. Next, the student demonstrates acceptance and integration of these attitudes and behaviors in interactions with others. Later, the student demonstrates preference for these values and ultimately an internal commitment to them.