Paramedic Program Minimum Terminal Competencies

 

In order to be recommended for certification, a graduate of the CCC Paramedic program must meet the following Paramedic Terminal Competencies (Professional Requirements):

 

The Paramedic provides prehospital emergency care under medical control authority to acutely ill and/or injured patients and/or transports patients by ambulance or other appropriate emergency vehicle.  The Paramedic shall demonstrate at 100% competency: 

 

  • An awareness of abilities and limitations;
  • The ability to relate to people; and
  • The capacity to make rational patient-care decisions under stress.

 

To fulfill the role of the Paramedic, as an individual must be demonstrate full competence to:

 

1.         Recognize a medical emergency; assess the situation; manage emergency care and, if needed, extricate; coordinate efforts with those of other agencies that may be involved in the care and transportation of the patient; and establish rapport with the patient and significant others to decrease their state of anxiety;

 

2.         Assign priorities to emergency treatment data for the designated medical control authority, or assign priorities of emergency treatment;

 

3.         Record and communicate pertinent data to the designated medical control authority;

 

4.         Initiate and continue emergency medical care under medical control, including  recognition of presenting conditions and initiation of appropriate treatments, including traumatic and medical emergencies, airway/ventilation problems, cardiac dysrhythmias, cardiac standstill,  psychological crises, and assess the response of the patient to the treatment, modifying medical therapy as directed;

 

5.         Exercise personal judgment and provide such emergency care as has been specifically authorized in advance, in cases where medical direction is interrupted by communication failure or in cases of immediate life threatening condition;

 

6.         Direct and coordinate the transport of the patient by selecting the best available method(s) in conjunction with medical control authority;

 

7.         Record, in writing, the details related to the patient's emergency care and the incident; and

 

8.         Direct the maintenance and preparation of emergency care equipment and supplies.

            - "Description of the Profession” from the Committee on Accreditation of Educational Programs for EMS Professions

 

Specific Paramedic Performance Objectives per NSC-99 (Terminal Competencies)

 

In order to receive an endorsement/recommendation to certify at the conclusion of the didactic, clinical and field internship portions of the paramedic program, a student will by the end of their Paramedic training be expected to demonstrate at 90% competency (without assistance) the ability to:

 

1.        Perform basic life support according to the standards established by the American Heart Association maneuvers as necessitated by the situation;

 

2.         Administer basic emergency skills including, but not limited to: splinting, bandaging, hemorrhage control, and cold application;

 

 3.        Establish a therapeutic patient relationship;

 

4.        Communicate verbally and in writing, using fundamental medical terminology;

 

5.        Obtain a history from a communicative patient including chief complaint, pertinent history of the present illness, past medical history, and mechanism of injury;

 

6.        Conduct a comprehensive physical assessment (initial and detailed) on a minimum of:

           

                        - 30 pediatric patients (newborn, infants, toddlers, school age, etc.)

                        - 50 adult patients

                        - 30 geriatric patients

           

                    AND include the following pathologies and complaints:

           

                        - 10 obstetric patients

                        - 40 trauma patients

                        - 20 psychiatric patients

                        - 30 chest pain patients

                        - 20 adult respiratory distress patients

                        -   8 pediatric patients in respiratory distress

                        - 10 patients with syncope

                        - 20 patients with abdominal complaints

                        - 20 patients with altered mental status

 

 7.        Properly record and report findings, including pertinent negatives;

 

 8.        Competently initiate IV infusion on minimum of 25 patients, various age groups

 

                      (At least15 IV infusions should be obtained during Hospital/Fixed Site clinical rotations and 10 during Pre-hospital clinical rotations.)

 

 9.        Calculate/regulate flow rate for IV infusion given volume, drop factor, time frame;

 

10.       Re-establish an IV infusion that becomes compromised;

 

11.       Remove air from IV tubing;

 

12.       Discontinue an IV infusion;

 

13.       Following Medical Control consultation, apply/inflate MAST while evaluating the patient's response to the procedure;

 

14.       Calculate the volume of medication to be administered given an ordered dosage;

 

15.       Read drug container labels, and identify components (i.e. name, concentration, expiration date, etc.);

 

16.       Withdraw solutions from ampoules and vials with an appropriate size syringe;

 

17.       Assemble a preloaded syringe (e.g., Bristoject, Abbojet, preload cartridges, etc.);

                                               

18.       Correctly administer an IV push medication to a minimum of 15 patients in various age groups

(At least10 of these should be obtained during Hospital/Fixed Site clinical rotations and 5 during Pre-hospital clinical rotations.)

 

 

19.       Administer IM and/or SQ injections in various age groups

            - 5  patients (minimum) in various age groups

 

20.       Calculate, mix, administer  IV medication infusion using microdrip tubing;          

 

21.       Maintain the patient's airway and/or provide ventilations using the:

 

a.         Oropharyngeal airway               d.         Positive pressure ventilator

b.         Nasopharyngeal airway e.         Endotracheal tube

c.         Pocket mask                            f.          Bag-valve-mask

           

            The Student must demonstrate the ability to effectively ventilate unintubated patients of all age groups.   The student should effectively, and while performing all steps of each procedure, ventilate at least 20 live patients of various age groups.

           

    (At least15 different patients requiring artificial ventilations should be obtained during Hospital/Fixed Site clinical rotations and 5 during Pre-hospital clinical rotations.)

 

22.       The student must demonstrate the ability to safely perform endotracheal intubation.  The student should safely, and while performing all steps of each procedure, successfully intubate at least 5 live patients.

 

                        (At least 4 live intubations should be obtained during Hospital/Fixed Site clinical rotations and 1 during Pre-hospital clinical rotations.)

 

23.       In step by step fashion, describe the generic procedure of rapid sequence intubation

 

24.       Perform the suctioning technique in the following situations:

            a.         Oropharyngeal 

            b.         Nasopharyngea

            c.         Endotracheall   

 

25.       Obtain an EKG:

            a.         Equipment set-up

            b.         EKG electrode application site

                        (1)        Standard limb leads                  (2)        Standard 12 lead placement

            c.         “Quick-look”

 

26.       State the area of myocardial infarct or ischemia based on a 12 lead EKG tracing           

 

27.       Select and administer the appropriate drug for an identified dysrhythmia according to local and national protocol and evaluate the patient's response to the therapy;

 

28.       Recognize and provide proper treatment for the following dysrhythmias:

            a.         Normal Sinus Rhythm               k.         First degree block

b.         2nd degree, Type 1 (Wenckebach)

            c.         Second-degree, Type 2            l.          Third-degree block

            d.         Sinus bradycardia

            e.         Sinus tachycardia                      m.        Ventricular tachycardia and TDP

            f.          Ventricular fibrillation                n.         Asystole

            g.         PAC's                                      o.         Pulseless electrical activity (PEA)

            h.         PJC's                                       p.         Pacemaker rhythm

            I.          PVC's                                                 

            j.          SVT/PSVT                                         

                                   

29.       Instruct the patient to accomplish the Valsalva maneuver;

 

30.       Safely establish transcutaneous pacing, defibrillate or synchronized cardiovert as indicated;

 

31.       Accomplish venipuncture using vacuum collection tubes;

 

32.       Determine a blood sugar using a Dextrostix or equivalent chemical testing device;

 

33.       Employ safety precautions while controlling and restraining a violent patient;

 

34.       Intervene in a situation using fundamental crisis intervention techniques;

 

35.       Objectively observe and report nonverbal behaviors;

 

36.       Assign a neurological score utilizing the Glasgow coma scale;

 

37.       Estimate percentage of burns using the Rule of Nines;

 

38.       Monitor of the patient in labor and decide when birth is imminent;

 

39.       Attend an uncomplicated delivery, including resuscitation of the neonate;

 

40.       Assess and assign an APGAR score for the neonate;

 

41.       Apply primary injury prevention techniques at opportune moments;

 

42.       Recognize basic terms utilized in EMS research

 

43.       State techniques that will preserve a crime scene

 

44.       State the basic functions of incident command

 

45.       State the considerations and PPE needed for both HAZMAT and terrorism events

 

46.       Upon speaking to the lay public, be able to communicate basic concepts of wellness to include, nutrition, stress, alcohol, smoking and illegal drugs

 

47.       Demonstrate the ability to team lead in a variety of prehospital situations on a minimum of 50 patients in various emergency responses                       

 

48.       Possess the ability to perform patient transfer techniques commonly practiced pre and intra hospital; and

 

49.       Maintain the ability to perform all skills of the EMT-Basic.