HomeMy WebLinkAboutPAR-2041
2/6/2015
Bergen Community College
Division of Health Professions
Paramedic Science
PAR 204 Paramedic Clinical Concepts II
Date of most recent syllabus revision: New Course
Course typically offered: Spring Semester
Syllabus last reviewed by: BCC General Education Committee _____ Date: _________
Ad Hoc Committee on Learning Assessment
Curriculum Committee ______ Date: _________
Basic Information About Course and Instructor
Semester and Year Spring 2015
Course and Section Number PAR 2XX-001
Meeting Times and Locations: Wednesday 8:30 – 4:30 Meadowlands Campus and at off-site
clinical affiliates
Instructor: TBD
Office Location: TBD
Phone: TBD
Department Secretary: TBD
Office Hours: TBD
Email Address: TBD
Course Description
0 Lecture 0 lab 3 Clinical Total 3 credits
This course continues to introduce students to actual patient experiences in the hospital
clinical environment. Students will demonstrate the concepts and understanding of
paramedic clinical skills. Students will be introduced to higher acuity areas such as the
Intensive Care Units, Emergency Departments and specialty care areas like Obstetrics,
Neonatal and Pediatrics. Students are assigned to a preceptor who is responsible to
observe and assess performance. Travel to off-site clinical affiliates is required.
Clinical [284.00].
Prerequisite[s]: PAR-102, PAR-102, PAR-103, PAR-104, PAR-200. Corequisite[s]: PAR-201,
PAR-202, PAR-203.
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Paramedic Program Core Competencies:
A. Ethics and EMS Structure
A1. Exhibit a professional code of conduct with personal and professional integrity.
A1. Provide compassionate care to all populations while respecting cultural differences.
A3. Comply with all state and federal regulation/laws for an entry-level paramedic.
B. Patient Assessment and Skills
B1. Utilize a systematic assessment to determine appropriate modalities for medical
and trauma patients of all ages while prioritizing interventions needed to improve
patient outcomes.
B2. Demonstrate skill proficiency in all entry-level psychomotor skills, utilizing them
when clinically appropriate and at the correct time to improve patient outcomes.
B3. Function as a member of the paramedic team by using effective communication and
proper behavior that promotes customer service and efficient care.
C. Safety and Personal Wellness
C1. Correctly identifies potential hazards to promote a safe environment for self, co-
workers, patients and bystanders.
C2. Uses critical thinking skills to properly manage and diffuse stressful environments.
C3. Identifies personal stress and utilizes stress management techniques to ensure
physical and emotional health.
Student Learning Objectives:
As a result of meeting the requirements in this course, students will be able to:
Documentation and Charting
Integrate comprehensive knowledge of EMS systems, safety/well being of the paramedic,
and medical/legal and ethical issues, which are intended to improve the health of EMS
personnel, patients, and the community.
Burn Unit (12 Hours)
Act as part of the burn team participating in care for patients who require burn wound
management.
Psychiatric Unit (8 Hours)
Act as part of the crisis team participating in care for patients who require assistance for
behavioral emergencies and/or screenings.
In-Hospital Critical Care (48 Hours)
Act as part of the Intensive Care team participating in care for patients who require in-
hospital patient management.
Labor & Delivery (24 Hours)
Act as part of the labor and delivery team participating in care for patients who are
experiencing imminent birth.
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Pediatrics (48 Hours)
Act as part of the pediatric team participating in care for patients who require pediatric
patient management.
Emergency Room (144 Hours)
Act as part of the Emergency Department team participating in care for patients who
require emergent patient management.
Instructional Resources
Available in the library and computer labs
Annals of Emergency Medicine
Journal of Emergency Medical Services (JEMS)
Journal of Accident and Emergency Medicine
New England Journal of Medicine
Pre-Hospital Emergency Care Journal
Means of Assessment
In accordance with accreditation standards, students will be provided ample feedback to
allow them the ability to improve performance in cognitive, psychomotor and affective
domains of learning. Assessment for this course will include feedback in the following
areas written, psychomotor and behavior.
Quiz (2) 10%
Affective Behavior Assessment 1/assigned shift 20%
Clinical Evaluation Form 1/assigned shift 20%
Patient Cases/Medication Cards 20%
Final Written Exam 20%
Participation 10%
From the BCC Distance Learning Education Website:
Partially online course: A partially online (hybrid) course (indicated by a suffix of HY --
eg., WRT-101-005HY) is a class that meets part of the time in a traditional classroom
setting and the rest of the class work is done online via the Internet. Typically, a partially
online (hybrid) course replaces at least one meeting time per week with online course
activities through Moodle. The online work is completed within the week before the next
in-class meeting, but normally does not require a student to be at their computer at a
specific time of the day.
It is the responsibility of the student to login to their online or hybrid course to continue
weekly discussions and submit assignments at the best time of day or night for the student,
giving these types of courses flexibility not available to a regular classroom course. You
must be willing to come to campus (usually once a week) because face-to-face class time is
required and an attendance policy will be enforced.
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Moodle Structure:
The delivery platform for this course is a hybrid format utilizing a Moodle program.
Students must fully participate in both online and on campus components of the course to
successfully complete the course.
The Moodle structure will provide opportunities for discussion boards, email
communication, class announcements, online patient cases, and completion of tests and
quizzes.
Course Menu in Moodle:
Online Syllabus
Course Announcements
Forums
Assignments
Email
My grades
Recommended Practice
To effectively manage this course for successful completion, you should do the following:
Read and follow the course syllabus by adhering to the assigned dates of completion
Read the messages under “Course Announcements”
Follow the course calendar in Moodle
Timely complete and submit all assignments – late assignments will not be
accepted!
Use the email communication platform to communicate with other students and the
instructor.
Actively participate in class and in online discussions
Course Content
This course will offer students the ability to gain cognitive knowledge related to patient
care principles. The majority of the class will require students to work individually.
Occasional group assignments may be utilized. Students will obtain clinical skill knowledge
and competency prior to entering a clinical rotation.
Special Features of the Course
Pass Rate:
The Paramedic Department pass rate is an 80%. Students are required to obtain a final
average of an 80% in each core curriculum course. At the end of the semester, any student
not achieving an 80% will be unable to continue in the program.
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Course Texts
Aelert, Barbara. ECGs Made Easy, 4th Edition. 2009, Mosby JEMS (ISBN 978-0323069243)
American Heart Association. Advanced Cardiovascular Life Support, April 2011, American
Heart Association Incorporated (ISBN – 978-1-6166-9010-6)
American Heart Association. Advanced Cardiovascular Life Support Handbook, April
2011, American Heart Association Incorporated (ISBN – 978-1-6166-9000-7)
American College of Surgeons. Advanced Trauma Life Support, 9th Edition, October 2012.
Caroline, Nancy. Emergency Care in the Streets, 6th Edition, 2008, Jones and Bartlett
Publishing, Sudbury, Mass (ISBN – 978-0-7637-6469-2)
Walls, Ron. Manual of Emergency Airway Management, 4th Edition, 2012, Lippincott,
Williams and Wilkins. (ISBN 9781451144918)
Research, Writing and Examination Requirements
Students will be required to develop patient case studies that effectively depict a common
medical emergency. Requirements will include appropriate description of signs,
symptoms, patient presentation, pertinent medical history, medications and/or recent
surgeries. Student will present their case to group.
In addition to the program pass rate, students are required to obtain a minimum grade of
77% on all final exams. Any student not obtaining a 77% on the final exam will be unable
to continue in the program.
Grading Scale
A 93-100
B+ 89-92
B 85-88
C+ 82-84
C 80-81
F Below 80
N Incomplete (course requirements not fulfilled)
Academic Conduct
The paramedic program faculty adheres to the policy statement governing academic
conduct as outlined in the Bergen Community College catalog.
Faculty may not post exam grades publicly due to privacy laws.
Scholastic dishonesty including but not limited to plagiarism, cheating, and collusion
will not be tolerated. Any student who has demonstrated any of these behaviors
will be disciplined according to the Policy and Procedure Manual of the program.
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Attendance Policy
Bergen Community College’s attendance policy states: “All students are expected to attend
punctually every scheduled meeting of each course in which they are registered.
Attendance and lateness policies and sanctions are to be determined by the instructor of
each course. These will be established in writing on the individual course outline.”
The Commission on Accreditation of Allied Health Education Programs (CAAHEP) requires
that students meet a minimum number of didactic/lab, clinical and field internship hours.
Therefore students are expected to attend all class sessions.
No make-up quizzes, tests or exams will be given. Any student who is absent for a quiz,
test, or exam will receive a grade of “0”.
Students will be allowed one excused absence per semester. An absence is considered
excused when a student notifies the professor prior to the start of class that they will be
absent. Any additional absences will negatively affect the student’s grade. For each
unexcused absence the final grade will reduce by 1 point. For each excused absence the
final grade will reduce by 0.5 point.
Tardiness will not be tolerated. In accordance with New Jersey state regulation, an
attendance sheet will be available at the beginning of the class. If a student is tardy 3 times
it will be calculated as an unexcused absence.
Other College, School and/or Departmental Policy Statements
The Paramedic Program is accredited by two agencies, The Commission on Accreditation of
Allied Health Education Programs (CAAHEP) and the New Jersey Department of Health and
Human Service – Office of Emergency Medical Services.
The Paramedic Department Policy and Procedure Manual will be reviewed at orientation
and revisited at the start of any core courses. The manual will address specific policies
required by either the state or national accrediting bodies. The purpose of the manual is to
clearly outline the role and responsibility of each stakeholder in the education process; the
student, the patient, the faculty, the clinical affiliate and the college. Students and faculty
are expected to adhere to the policies of the program.
Student and Faculty Services
Students will be encouraged to utilize the support services offered by BCC. During the
School of Health Profession orientation, these services will be highlighted. The faculty of
the Paramedic Program will encourage students to access these services.
In addition, the Paramedic Program is structured to ensure the needs of the paramedic
student will be met. Each squad will be assigned an adjunct faculty mentor to help facilitate
their interaction positively within the program. There will be open skill labs and
simulation sessions available to allow students to access adjunct faculty for support with
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any learning difficulties. Peer tutors will be utilized to facilitate further success in the
program.
Americans with Disabilities Act
Students who require accommodations in accordance with Americans with Disabilities Act
(ADA) can request these services form the Office of Specialized Services. To learn more
about the services offered at Bergen Community College, visit them at
www.bergen.edu/oss.
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Course Outline and Calendar
Week Topic Assignment
1 Clinical Orientation
Focused Charting and Documentation
Clinical Handbook
Emergency Care in the
Streets
Chapter 6
2 Burn Rotation 12 Hours
Clinical Handbook
3 Crisis Intervention 8 hours
Clinical Handbook
4 Critical Care 24 hours
Clinical Handbook
5 Critical Care 12 hours
Quiz #1
Clinical Handbook
6 Labor and Delivery 24 hours
Clinical Handbook
7 Critical Care 12 hours
Clinical Handbook
8 Pediatrics 24 hours
Clinical Handbook
9 Spring Break
10 Pediatrics 24 hours
Quiz #2
Clinical Handbook
11 Emergency Department 24 hours
Clinical Handbook
12 Emergency Department 24 hours
Clinical Handbook
13 Emergency Department 24 hours
Clinical Handbook
14 Emergency Department 24 hours
Clinical Handbook
15 Emergency Department 24 hours
Final Exam
Clinical Handbook
Syllabus Subject to Change
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Unit Objectives:
As a result of meeting the requirements in this course, students will be able to:
Documentation and Charting
1. Identify the general principles regarding the importance of EMS documentation and
ways in which documents are used.
2. Identify and use medical terminology correctly.
3. Recite appropriate and accurate medical abbreviations and acronyms.
4. Record all pertinent administrative information.
5. Explain the role of documentation in agency reimbursement.
6. Analyze the documentation for accuracy and completeness, including spelling.
7. Identify and eliminate extraneous or nonprofessional information.
8. Describe the differences between subjective and objective elements of
documentation.
9. Evaluate a finished document for errors and omissions.
10. Evaluate a finished document for proper use and spelling of abbreviations and
acronyms.
11. Evaluate the confidential nature of an EMS report.
12. Describe the potential consequences of illegible, incomplete, or inaccurate
documentation.
13. Describe the special considerations concerning patient refusal of transport.
14. Record pertinent information using a consistent narrative format
15. Explain how to properly record direct patient or bystander comments.
16. Describe the special considerations concerning mass casualty incident
documentation
17. Apply the principles of documentation to computer charting, as access to this
technology becomes available.
18. Identify and record the pertinent, reportable clinical data of each patient interaction
19. Note and record “pertinent negative” and “pertinent positive” clinical findings.
20. Correct errors and omissions, using proper procedures as defined under local
protocol.
Burn Unit (12 Hours)
Objectives:
Demonstrate proper classification of burns, and correct calculation of the
percentage of BSA affected.
Identify current guidelines for the pre-hospital treatment for burns.
Define the Parkland Formula, and explain its application to the MICU setting.
Required Activities:
Submit a minimum of 1 patient case study.
Document a minimum of 2 patient assessments using the patient assessment form.
Prepare a minimum of 5 medication cards. The medications should be non-MICU
approved drugs encountered during the Burn ICU rotation; medication cards will
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include: generic and trade names, mechanism of action, indications,
contraindications, dosage range, route(s) of administration, desired effect, and
potential adverse reactions.
Skill Expectations:
Observe a minimum of 1 patient assessment for a new admission to the Burn ICU.
Perform a minimum of 2 patient histories and physical assessments.
Observe daily rounds in Burn ICU, if available.
Participate in burn care as directed by Preceptor.
Psychiatric Unit (8 Hours)
Objectives:
Identify common psychiatric emergencies, including typical signs & symptoms, and
current treatment modalities.
Demonstrate appropriate communication techniques for a patient experiencing a
psychiatric emergency.
Required Activities:
Submit a minimum of 1 patient case study.
Prepare a minimum of 10 medication cards. The medications should be psychiatric
medications encountered during the Psychiatric unit rotation; medication cards will
include: generic and trade names, mechanism of action, indications,
contraindications, dosage range, route(s) of administration, desired effect, and
potential adverse reactions.
Skill Expectations:
Observe a minimum of 5 crisis interviews and/or interventions.
Participate for a minimum of one-hour in-group milieu activities.
In-Hospital Critical Care (48 Hours)
Objectives:
Demonstrate a complete patient history and physical assessment.
Identify common dysrhythmias and their appropriate treatment modalities.
Demonstrate proper application and use of a transcutaneous pacemaker.
Demonstrate correct technique for defibrillation and synchronized cardioversion.
Demonstrate the appropriate cardiac arrest treatment modalities utilizing current
ACLS guidelines.
Demonstrate insertion of a nasogastric tube using proper technique, including
confirmation of correct placement.
Identify etiologies, clinical presentation and treatment modalities of the following:
angina pectoris, acute myocardial infarction, congestive heart failure, ventricular
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and aortic aneurysm, cardiogenic shock, myocardial trauma, acute hypertensive
crisis, diabetic emergencies, poisonings and overdoses, hypovolemic shock, acute
respiratory failure, chronic obstructive pulmonary diseases (COPD), asthma,
pneumonia, head injury and coma, cerebral vascular accident, seizures, burns,
infectious diseases, acute abdomen, renal failure, fractures, septic shock, neurogenic
shock, pulmonary edema, pulmonary embolism and anaphylaxis.
Required Activities:
Document all patient assessments completed on the patient assessment form.
Prepare a minimum of 10 medication cards. The medications should be non-MICU
approved drugs encountered during the critical care rotation; medication cards will
include: generic and trade names, mechanism of action, indications,
contraindications, dosage range, route(s) of administration, desired effect, and
potential adverse reactions.
Submit a minimum of 2 patient case studies. The case study must include: chief
complaint, history of present illness, past medical history, medication, allergies,
clinical presentation, treatment modalities, response to treatment, and patient
outcome.
Document all skills performed and medications administered on the patient record
in accordance with hospital policy.
Document all patient assessments completed, skills performed, and medications
administered on the clinical log sheet and/or FISDAP.
Collect an ECG rhythm strip for each patient within the treatment area with an
abnormal ECG or dysrhythmia; document rhythm interpretation and treatment
modality.
Skill Expectations:
Observe daily rounds in ICU, if available.
Perform a minimum 10 complete patient histories and physical assessments.
Perform a minimum of 5 neurological assessments.
Perform a minimum of 5 trauma assessments.
Observe a minimum of 1 pacemaker insertion or care for a minimum of 1 patient
with an external pacemaker.
Perform a minimum of 1 transcutaneous pacemaker application. (May be completed
in other clinical areas)
Participate in a minimum of 5 cardiopulmonary resuscitations. (May be completed
in other clinical areas)
Perform at least 5 defibrillations or synchronized cardioversions. (May be
completed in other clinical areas)
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Perform a minimum of 2 nasogastric tube insertions. (May be completed in other
clinical areas)
OPTIONAL: Review and demonstrate the utilization of a Doppler.
Labor & Delivery (24 Hours)
Objectives:
Identify the normal stages of labor.
Identify the etiologies, clinical presentations, and treatment modalities for common
complications / abnormal delivery presentations.
Demonstrate assessment of the newborn and post-partum mother.
Required Activities:
Submit a minimum of 2 patient case studies.
Prepare a minimum of 4 medication cards. The medications should be medications
encountered during the L & D rotation; medication cards will include: generic and
trade names, mechanism of action, indications, contraindications, dosage range,
route(s) of administration, desired effect, and potential adverse reactions.
Document patient assessments and skills performed on the patient record in
accordance with hospital policy, and on the clinical log sheet and/or FISDAP.
Skill Expectations:
Observe a minimum of 5 vaginal deliveries.
Assist in the care of the newborn and the postpartum mother for a minimum of 5
deliveries.
OPTIONAL: Observe a minimum of 2 C-Section deliveries.
Pediatrics (48 Hours)
Student must complete a minimum of one shift in two different levels of pediatric care. If
available, at least one shift should be completed in the Pediatric ICU and one shift
completed in the Neonatal ICU.
Objectives:
Identify normal vital signs for each developmental milestone of childhood.
Identify the correct administration and pediatric doses for all MICU approved
medications.
Demonstrate a pediatric patient assessment, using age-appropriate assessment
techniques.
Demonstrate the appropriate cardiac arrest and peri-arrest treatment modalities
utilizing current PALS guidelines.
Required Activities:
Submit a minimum of 3 pediatric case studies.
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Prepare a report on age-specific approaches to pediatric assessment and treatment.
Prepare a minimum of 10 medication cards. The medications should be non-MICU
approved medications encountered during the Pediatrics rotation; medication cards
will include: generic and trade names, mechanism of action, indications,
contraindications, dosage range, and route of administration, desired effect, and
potential adverse reactions.
Complete a patient assessment form for each pediatric assessment completed.
Document all skills performed on the patient record in accordance with hospital
policy.
Document all assessments, skills performed, and medications administered on the
clinical log sheet and/or FISDAP.
Skill Expectations:
Observe daily rounds in Pediatric and/or Neonatal ICU, if available.
Perform a minimum of 5 pediatric patient assessments; the patients selected should
represent a variety of age groups / stages of development.
Emergency Room (144 Hours)
Objectives:
Demonstrate a complete patient history and physical assessment.
Identify common dysrhythmias and their appropriate treatment modalities.
Demonstrate proper application and use of a transcutaneous pacemaker.
Demonstrate correct technique for defibrillation and synchronized cardioversion.
Demonstrate the appropriate cardiac arrest treatment modalities utilizing current
ACLS guidelines.
Demonstrate proper technique for the following skills: 12-lead ECG, venipuncture,
IV insertion, medication administration, advanced airway insertion, defibrillation,
synchronized cardioversion, and transcutaneous pacing.
Required Activities:
Document all patient assessments completed on the patient assessment form.
Prepare a minimum of 10 medication cards. The medications should be non-MICU
approved drugs encountered during the ER rotation; medication cards will include:
generic and trade names, mechanism of action, indications, contraindications,
dosage range, route(s) of administration, desired effect, and potential adverse
reactions.
Submit a minimum of 4 patient case studies. The case study must include: chief
complaint, history of present illness, past medical history, medication, allergies,
clinical presentation, treatment modalities, response to treatment, and patient
outcome.
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Document all skills performed and medications administered on the patient record
in accordance with hospital policy.
Document all patient assessments completed, skills performed, and medications
administered on the clinical log sheet and/or FISDAP.
Collect an ECG rhythm strip for each patient within the treatment area with an
abnormal ECG or dysrhythmia; document rhythm interpretation and treatment
modality.
Skill Expectations:
Perform a minimum 20 complete patient histories and physical assessments.
o Perform a minimum of 5 neurological assessments.
o Perform a minimum of 5 trauma assessments.
o Perform a minimum of 5 respiratory assessments.
o Perform a minimum of 5 cardiac assessments.
Perform a minimum of 30 intravenous infusions using proper aseptic technique.
Prepare and administer a minimum of 10 intravenous medications, using proper
equipment, dosing, and technique.
Prepare and administer a minimum of 5 subcutaneous and/or intramuscular
medications, using proper equipment, dosing, and technique.
Perform a minimum of 1 transcutaneous pacemaker application. (May be completed
in other clinical areas)
Participate in a minimum of 5 cardiopulmonary resuscitations. (May be completed
in other clinical areas)
Perform at least 5 defibrillations or synchronized cardioversions. (May be
completed in other clinical areas)
Perform a minimum of 2 nasogastric tube insertions. (May be completed in other
clinical areas)
The chart below is intended as a guide, and is not a substitute for review of the individual
area’s detailed learning objectives, required activities, and skill expectations. This chart
reflects the minimum skill totals that should be achieved by completion of the Clinical
Internship. Some skills may be completed in more than one clinical area.
The paramedic student is expected to achieve all Clinical Internship skill performance
minimums prior to beginning the Field Internship. In the event that a skill performance
minimum has not yet been achieved, the paramedic student may progress to the Field
Internship only at the discretion of the Program Clinical Coordinator, Program Director and
Program Medical Director. Skill minimums not achieved during the Clinical Internship must
be completed through skill performance during the Field Internship.
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Clinical Skill Minimum Successful
Ventilation of the Unintubated Patient 10
Endotracheal Intubation 5
Supraglottic Airway Insertion 2
Venipuncture 20
IV Insertion 50
12-Lead ECG 10
Auscultate Breath Sounds 20
Endotracheal Suctioning 5
Medication Administration – Nebulized 10
Medication Administration – Intravenous 10
Medication Administration – Subcutaneous or
Intramuscular
5
Patient History and Physical Assessment 30
Neurological Assessment 5
Trauma Assessment 5
Respiratory Assessment 5
Cardiac Assessment 5
Pediatric Assessment 5
Transcutaneous Pacemaker 1
Defibrillation / Synchronized Cardioversion 5
Cardiopulmonary Resuscitation 5
Nasogastric Tube Insertion 2
CPAP 5
Neonatal Assessment and Post-Partum Care 5
Observation of Vaginal Deliveries 5