Paramedic Program - Professional Requirements

In order to be recommended for certification to the State of Utah Bureau of Emergency Medical Services or the National Registry of Emergency Medical Technicians, a graduate of the WSU program must meet these Emergency Medical Technician-Paramedic Professional Requirements (or "terminal objectives").

The EMT-P provides prehospital emergency care under medical command authority to acutely ill and/or injured patients and/or transports patients by ambulance or other appropriate emergency vehicle. The EMT-P shall demonstrate at 100 percent 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 EMT-P, you must be able to demonstrate full competency in your abilities 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 command
   authority, or assign priorities of emergency treatment.
   
3. Record and communicate pertinent data to the designated medical command
   authority.
   
4. Initiate and continue emergency medical care under medical control, including the recognition of presenting conditions and initiation of appropriate treatments, including traumatic and medical emergencies, airway and ventilation problems, cardiac dysrhythmias, cardiac standstill, and psychological crises, and assess the response of the patient to that 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 command authority.
   
7. Record, in writing or dictation, the details related to the patient's emergency care and the incident.
   
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 1989 Standards.
 

WSU Emergency Care & Rescue Department, Paramedic Program
Specific Paramedic Performance (Terminal) Objectives per NSC-99

In order to receive an endorsement/recommendation to certify at the conclusion of the didactic, clinical and field internship portions of the paramedic program, AT A MINIMUM a student will be expected to demonstrate at 90 percent 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. Maintain sterile techniques in situations which require such activity
   
9. Identify and select the correct intravenous solution from the drug box as ordered
   
10. Competently initiate an IV infusion on a minimum of:
      - 25 patients in various age groups
    
11. Calculate and regulate the flow rate for an IV infusion given the volume, drop factor, and time frame
    
12. Re-establish an IV infusion that becomes compromised
    
13. Remove air from IV tubing
    
14. Discontinue an IV infusion
    
15. Apply and inflate the MAST while evaluating the patient's response to the procedure
    
16. Calculate the volume of medication to be administered when given an ordered dosage
    
17. Read drug container labels, and identify components (i.e. name, concentration, expiration date, etc.)
    
18. Withdraw solutions from ampoules and vials with an appropriate size syringe
    
19. Assemble a preloaded syringe (e.g., Bristoject, Abbojet, preload cartridges, etc.)
    
20. Correctly administer an IV push medication to a minimum of 15 patients in various age groups
    
21. Administer IM injections: dorsogluteal, ventrogluteal, vastus lateralis, and deltoid sites to 5 patients (minimum) in various age groups
    
22. Administer subcutaneous injections to 5 patients (minimum) in various age groups
    
23. Calculate, mix, and administer an IV medication infusion using microdrip tubing
     
24. Maintain the patient's airway and/or provide ventilations using the:
    a. Oropharyngeal airway   
    b. Nasopharyngeal airway  
    c. Pocket mask 
    d. Bag-valve-mask
    e. Positive pressure ventilator
    f. Endotracheal tube
    g. Laryngeal mask assembly
    
    on a minimum number of patients to include:
     - 5 live patients for ET
     -20 patients for all other airway adjuncts
    
25. In step by step fashion, describe the generic procedure of rapid sequence intubation
    
26. Perform the suctioning technique in the following situations:
    a. Oropharyngeal  
    b. Endotracheal
    c. Nasopharyngeal
    d. Tracheostomy
    
27. Obtain an ECG:
     a. Equipment set-up
     b. ECG electrode application site
      (1) Standard limb leads
      (2) Modified chest leads
      (3) Standard 12 lead placement
     c. Quick-look or "combo pad"
    
28. State the area of myocardial infarct or ischemia based on a 12 lead EKG tracing 
    
29. Select and administer the appropriate drug for an identified dysrhythmia according to local protocol and evaluate the patient's response to the therapy
    
30. Recognize and provide proper treatment for the following dysrhythmias:
    a. Normal Sinus Rhythm  
    b. Sinus arrhythmia  
    c. Sinus arrest   
    d. Sinus bradycardia  
    e. Sinus tachycardia  
    f. Atrial tachycardia  
    g. PAC's    
    h. PJC's    
    i. PVC's     
    j. SVT/PSVT
    k. First degree block
    l. Second-degree, Type 1 (Wenckebach)
    m. Second-degree, Type 2
    n. Third-degree block
    o. Ventricular tachycardia and TDP
    p. Ventricular fibrillation
    q. Asystole
    r. AIVP
    s. Pulseless electrical activity (PEA)
    t. Pacemaker rhythm    
    
31. Instruct the patient to accomplish the Valsalva maneuver
    
32. Safely establish transcutaneous pacing, defibrillate or cardiovert as indicated
    
33. Accomplish venipuncture using vacuum collection tubes
    
34. Determine a blood sugar using a Dextrostix or equivalent chemical testing device
    
35. Employ safety precautions while controlling and restraining a violent patient
    
36. Intervene in a situation using fundamental crisis intervention techniques
    
37. Objectively observe and report nonverbal behaviors
    
38. Catheterize the urinary bladder of a male or female patient
    
39. Perform nasogastric intubation
    
40. Assign a neurological score utilizing the Glasgow coma scale
    
41. Estimate percentage of burns using the Rule of Nines
    
42. Monitor of the patient in labor and decide when birth is imminent
    
43. Manage an uncomplicated delivery, including the resuscitation of the neonate
    
44. Assess and assign an APGAR score for the neonate
    
45. Apply primary injury prevention techniques at opportune moments
    
46. Recognize basic terms utilized in EMS research
    
47. State techniques that will preserve a crime scene
    
48. Demonstrate the ability to triage in mass casualty events using both START and military triage 
    
49. State the basic functions of incident command to include C-FLOP
    
50. State the considerations and PPE needed for both HAZMAT and terrorism events
    
51. Upon speaking to the lay public, be able to communicate basic concepts of wellness to include, nutrition, stress, alcohol, smoking and illegal drugs
    
52. Demonstrate the ability to team lead in a variety of prehospital situations on a minimum of 50 patients in various emergency responses
      
53. Possess the ability to perform patient transfer techniques commonly practiced pre-and intra-hospital
    
54. Maintain the ability to perform all skills required of the EMT-Basic
    
55. Demonstrate affective domain standards that include but are not limited to:
    a. integrity
    b. empathy
    c. self-motivation
    d. appearance-personal hygiene
    e. communications
    f. time management (punctuality)
    g. teamwork and diplomacy
    h. respect
    i. patient advocacy
    j. careful delivery of care