Syllabus for EMT BasicDuration: 280 hours
PART 1.Introduction to Pre-Hospital Emergency Medical Care:1.
The History of Pre-Hospital Emergency Medical Care.2. Components of
an Emergency Medical Services System.3. The Role and
Responsibilities of the Emergency Medical Technician.4. Levels of
Emergency Medical Technician Training.5. Professional Limitations,
Legal Aspects, and Medical Ethics.6. The P.S.E.M.T.7. The E.M.T.
Code of Conduct.8. Health Hygiene and Fitness.9. Health and Safety
at Work.PART 2.Operational Control and Ambulance Response
Procedures:1. Receiving the call for help.2. The role of the
Emergency Medical Dispatcher.3. Control Procedures.4. Operating the
Ambulance.5. Positioning the Ambulance at the scene of the
emergency.6. Routine, Urgent and Emergency Calls.7. Long Distance
Transfers.PART 3.Introduction to the Ambulance Vehicle and
Equipment:1. The Ambulance Vehicle.2. Equipment and Supplies.3.
General Care Of Ambulance Vehicle and Equipment.4. Daily checks Of
Ambulance Vehicle and Equipment.5. The Vital Role of
Cleanliness.PART 4.Infection Control and the Emergency Medical
Technician:1. The importance of Infection Control.2. Modes of
Infection3. Prevention of Infection.4. Barrier Devices.PART 5.
Anatomy and Physiology of the body Systems:1. Basic Cell Structure,
Tissues, Glands and Organs.2. Topographic Anatomy.3. The
Musculoskeletal System.4. Body Regions and Cavities.5. The
Respiratory System.6. The Lymphatic System.7. The Cardiovascular
System.8. The Nervous System.9. The Digestive System.10. The
Genitourinary System.11. The Endocrine System.12. The Reproductive
System.13. The Special Senses.14. Medical Terminology.PART
6.Patient Examination and Assessment:1. The Overall Approach.2.
Field Assessment / Taking a History.3. The Sequence of Patient
Assessment.4. The Primary Survey.5. The Secondary Survey.6.
Mechanism of Injury.7. Triage8. Reporting Methods.PART 7.Basic Life
Support:1. Clinical and Biological Death.2. The A, B, Cs of Basic
Life Support.3. Pulmonary Resuscitation.4. Cardiopulmonary
Resuscitation.5. Partial and Complete Airway Obstruction.6.
Management of Airway Obstruction.7. Basic Airway Management.8. CPR
in a Moving Ambulance.9. Introduction to Manual and Mechanical
Resuscitators / Ventilators.PART 8.The Automated External
Defibrillator ( AED ):1. Principles of Defibrillation.2. Using a
Defibrillator Safely.3. The Importance of Early Defibrillation.4.
The Electrocardiogram.5. Life Threatening Arrhythmia's.6. Automatic
and Semi - automatic Defibrillators.PART 9.Breathing Aids and
Oxygen Therapy:1. Hypoxia2. Artificial Ventilation Adjuncts
(Barrier Devices).3. Airway Adjuncts.4. The Importance of
Supplemental Oxygen.5. Oxygen Therapy Equipment.6. Oxygen Therapy
Procedures.7. The Hazards of Oxygen Therapy.8. Suction Equipment.9.
Suction Techniques.10. Mechanical Resuscitators / Ventilators.PART
10.Heamorrhage and Shock:1. Types of Haemorrhage - Internal /
External.2. Haemorrhage from Arteries / Veins / Capillaries.3. The
Effects of Haemorrhage.4. The Control of Haemorrhage.5. Shock.6.
Classifications of Shock.7. Basic Shock Management.8. Use of the
M.A.S.T. Suit - Indications / Contraindications.9. Introduction to
Advanced Shock Management.PART 11.Management of Trauma:1. Initial
Management.2. Secondary Management.3. Head Injuries.4.
Maxillo-Facial Injuries.5. Spinal Injuries: Cervical. Thoracic.
Lumbar. Sacro-Coccygeal.6. Chest Injuries.7. Abdominal Injuries.8.
Pelvic Injuries9. Back Injuries (Musculoskeletal).10. Genitalia
Trauma.11. Extremity Trauma.12. Traumatic Amputations.13. Trauma to
Pregnant Patients.PART 12.Burns and their Management:1.
Classification of Burns.2. Types of Burns.3. The Rule of Nines.4.
Management of Burns.5. Complications of Burns.6. Inhalation
Injuries.7. Transportation of Burns cases.PART 13.Environmental
Emergencies - Heat / Cold / Water and Ice:1. Heat Exhaustion and
Heat Stroke.2. Hypothermia.3. Frostbite.4. Drowning and
Near-Drowning.5. Decompression Sickness and Barotrauma.6. Bites and
Stings.7. Man made Hazards.PART 14.Medical Emergencies -
Cardiovascular:1. The Nature of Cardiovascular Disorders.2. Angina
Pectoris.3. Myocardial Infarction.4. Congestive Heart Failure.5.
Pacemaker Failure.6. Stokes Adams Attacks.7. Pericarditis.8.
Hypertension.9. Cardiac Tamponade.10. Aortic Aneurysms.11.
Management of Cardiovascular Medical Emergencies.PART 15.Medical
Emergencies Respiratory:1. The Nature of Respiratory Disorders.2.
Asthma.3. Chronic Obstructive Pulmonary Disease.4. Pulmonary
Edema.5. Pulmonary Embolism.6. Pneumonia.7. Pleurisy.8. Management
of Respiratory Medical Emergencies.PART 16.Medical Emergencies
Neurological Disorders:1. The Nature of Neurological Disorders.2.
Transient Ischaemic Attacks.3. Cerebro-Vascular Accidents
(CVA's).4. Epilepsy.5. Seizures.PART 17.Medical Emergencies
Misc.,1. Diabetic Emergencies.2. The Acute Abdomen.3.
Gastrointestinal Bleeding.4. Ulcerations.5. Eosophagitis.6.
Cholecystitis.7. Poisoning - Accidental / Non Accidental.8.
Allergic Reactions.9. Sepsis.10. Dehydration.11. Urinary Colic.PART
18.Emergency Childbirth, Obstetric and Gynecological Emergencies:1.
Emergency Childbirth2. Complications of Pregnancy.3. Complications
of Delivery.4. Evaluation of the Mother.5. Evaluation of the
Newborn Baby - The Apgar Scale.6. Pre-Delivery Emergencies.7. Post
Delivery Emergencies.8. Resuscitation of the Newborn Baby.9.
Premature Babies and Incubators.10. Stillborn Infants.11. Babies
and Oxygen.PART 19.Pediatric Emergencies:1. Parental Response2.
Child's Response.3. The ill or Injured Child - Special
Considerations.4. Assessment of the Pediatric Patient.5. Physical
Assessment Techniques.6. Assessing Pain in Children.7. Neurological
Assessment in Children.8. Common Emergencies in Children:
Obstructed Airway. Acute Asthmatic Attack. Status Asthmaticus.
Bronchiolitis. Epiglotitis. Croup. Infantile Convulsions.9. Common
Childhood Diseases: Measles. Rubella. Chickenpox. Mumps.
Tonsillis10. Assessment and Management of Pediatric Trauma.11.
Sudden Infant Death Syndrome.12. Child Abuse and Neglect.13.
Solvent Abuse.PART 20.Infectious Diseases:1. Infectious Diseases -
General.2. Infectious Diseases - Categories 1 & 11.3.
Infectious Diseases - Category 111.4. The Aids and Hepatitis B
Virus.5. Management of the Infectious PatientPART 21.Behavioral
Emergencies and Special Conditions:1. Psychological Emergencies -
General Principles.2. Emotional Response to Illness or Injury.3.
Communication with the Emotionally Disturbed Patient.4. Anxiety and
Phobias.5. The Depressive Patient.6. The Suicidal Patient.7.
Paranoid Patients.8. Schizoid Patients.9. Rage, Hostility and
Violent Behavior.10. Restraining the Physically Aggressive
Patient.11. Physical Disorders that resemble Psychological
Disturbances.12. The Blind Patient.13. The Deaf Patient.14. The
Geriatric Patient.15. The Renal Patient.16. Amputees and Artificial
Limbs.17. Alcohol abuse and the Alcoholic Patient.PART 22.Pain
Relief:1. Introduction to Analgesia.2. Pre-Hospital Analgesia.3.
The Advantages of effective pain relief during transport.4. Entonox
/ Nitronox Therapy.PART 23.Multiple Casualty Incidents and Disaster
Management:1. What is a Major Incident.2. Pre-Planning and
Preparedness.3. Establishing a Plan.4. Scene Assessment and
Management.5. Rescue and Extrication.6. Setting up Triage.7. Triage
Techniques.8. The Importance of Effective Communications.9. Staging
and Transportation.10. Special Considerations.11. Emotional Factors
of Major Incident Involvement.PART 24.Hazardous Substances and
Hazmed Procedures:1. Chemical, Radioactive and Biological
Substances.2. Legal Requirements for the Manufacture, Storage and
Transportation of Hazardous Substances.3. Regulations, Warning
Signs and Sources of Information.4. Hazmed Procedures for dealing
with the Incidents Involving Hazardous Substances.5. Explosives.6.
The Contaminated Patient.7. Decontamination Procedures and
Transport of Patients.PART 25.Civil Disturbances:1. Types of
Incidents.2. The Role of the Ambulance Service during Civil
Disturbance.3. Neutrality and Discipline.4. Protective Clothing.5.
General Guidelines for Operation.PART 26.Suspected Death and
Management of Human Remains:1. Legal Requirements for the
Certification of Death.2. Handling the Dead Body.3. Handling
Distressed Relatives.4. Co-operation with other Services and
Officials.5. Mortuary Procedures.PART 27.Lifting and Moving
Patients:1. The Kinetics of Lifting.2. Emergency Moves: Log Roles.
Clothes Drag. Blanket Drag. Fireman's Drag. Fireman's Carry. Human
Crutch Method.3. Non-Emergency Moves: Seat Carry. Extremity Lift.
Chair Lifts. Stretcher Lifts.4. Using Ambulance Lifting Equipment:
Ambulance Trolley Cot. Orthopaedic Stretcher. Carrying Chair.
Carrying Sheets. Poles / Canvas / Spreaders. Basket Stretchers.
Spinal Vacuum Mattress. Rescue Stretchers.5. Use of the Blanket.6.
House Removals.7. Patient Handling Techniques.8. Patient
Positioning.9. Ambulance Loading and Off-Loading.PART 28.Patient
Stabilization and Extrication:1. Road Traffic Accidents.2. Survey
of the Scene.3. Safety of the Scene.4. Gaining Access to the
Incident.5. Light Rescue Techniques.6. Triage.7. Preparing the
Patient for Extrication:8. Extrication Devices. Vacuum Mattress9.
Extrication Techniques. Vehicle Airbags.PART 29.Special
Transfers:1. High Dependency Patients.2. Patients with Spinal
Injuries.3. Transferring the Violent Patient.4. Patients with
Infectious Diseases.PART 30.Introduction to Helicopter Emergency
Medical Services (HEMS):1. Working with Helicopters.2. Organization
and Operation of the H.E.M.S. Unit.3. Air Rescue.4. Interhospital
Transfers.5. Personnel and Equipment.6. Clinical Considerations.7.
Use of the Helicopter in Disaster Situations.PART 31.Communications
and reports:1. Personal Communication / Communication with
Patients.2. Radio Communications.3. Patient Report Forms.4. Other
EMS Reports.5. Liaison and Communications with Hospitals.
PART 32.Introduction to Defibrillation:1. Anatomy of the
Heart.2. The Conductive Pathways of the Heart.3. Ventricular
Fibrillation.4. Ventricular Tachycardia.5. Electrical
Defibrillation of the Heart.
MINUMUM REQUIREMENTS:
Twelve Months appropriate experience.Evidence of a minimum of
sixty hours Continuous Medical Education.Minimum of six hundred and
forty hours active Emergency Medical Services Duty, with full
exposure to emergency cases.Submission of a log of experience
gained.
EVALUATION:
Examination - One Hour Multiple-Choice Paper. Examination - One
Hour Short Answer Paper. Examination - One Hour Essay Paper.
Examination - Written and Practical Test in Basic Life Support
(BLS). Examination - Eight Station Practical Test on General E.M.T.
Skills.
Syllabus EMT Defibrillator trainedDuration: 60 hours
PART 1.Role of the EMT(D):1. Role of the Emergency Medical
Technician, Defibrillation Trained as a part of the Cardiac Care
System.2. Laws governing Electrical Defibrillation of the heart,
death and dying.3. Medical Ethics concerning Defibrillation.PART
2.Review of Basic Life Support:1. Special considerations in Basic
Life Support.2. Re-certification in Basic Life Support.PART 3.
Review of Anatomy and Physiology of the Cardiovascular System:1.
Structure and Function of the Cardiovascular System.2. Focus on the
Pathophysiology of the Heart.3. Conduction pathways of the heart.4.
The Autonomic Nervous System and the Heart.PART 4.Assessment of the
Cardiac Patient:1. The importance of the History in the Cardiac
Patient.2. The Physical Examination of the Cardiac Patient.3. The
Electrocardiograph:4. Application of Monitoring Electrodes.5. The
12 Lead ECG.6. Interpretation of Basic Rhythms: Normal Sinus
Rhythm. Sinus Arrhythmia. Sinus Arrest. Sinus Bradycardia. Sinus
Tachycardia. Wandering Atrial Pacemaker. Premature Atrial
Contractions. Paroxysmal Supraventricular Tachycardia. Atrial
Flutter. Atrial Fibrillation. Premature Junctional Contractions.
First Degree AV Block. Second Degree AV Block (Type 1 & 2).
Third Degree (Complete) AV Block. Bundle Branch Blocks. Premature
Ventricular Contractions. Ventricular Tachycardia. Ventricular
Fibrillation. Asystole. Pacemaker Rhythms. ECG Artifacts.PART
5.Introduction to Advanced Cardiac Life Support and
Defibrillation:1. Philippine Heart Association Protocols.2. The
importance of early Defibrillation.3. Cardiac arrest and
Defibrillation.4. How Defibrillation works.5. Shockable Rhythms.6.
Non-Shockable Rhythms.7. The Importance of Expediency.PART
6.Defibrillation Equipment:1. The Automated External Defibrillator:
Generic Protocols. Algorithms.2. Introduction to the Semi Automated
External Defibrillator: Generic Protocols. Algorithms.3.
Introduction to the Manually Operated Defibrillator. Generic
Protocols. Algorithms.PART 7.Attaching the Defibrillator to the
patient:1. Anatomy of the chest.2. Correct Location of
Pads/Paddles.3. Safety Measures concerning Defibrillation.4. The
Importance of Equipment Checks.PART 8.Post Resuscitative Care and
Transportation:1. The Transport Decision.2. Patient Handling.3.
Ongoing Observations During Transportation Phase.PART 9.Medical
Culpability for Defibrillation:1. Medical Control.2. Quality
Assurance and Improvement.3. Reports and Documentation.
MINIMUM REQUIREMENTS:
Four hundred and eighty hours active Emergency Medical Services
Duty post "Basic Emergency Medical Technician Qualification EMT(B)"
with full exposure to emergency cases. Evidence of forty hours
clinical exposure in ICU, CCU, or Emergency Room. Successful
completion of selection interview / examinations.
EVALUATION:
Examination Thirty Minute Multiple Choice Paper. Examination One
Hour Short Answer Paper. Examination One Hour Practical Test In
Basic Life Support and Defibrillation Techniques.Syllabus EMT
AdvancedDuration: 360 hours
MODULE 1 : PREPARATION \ SELECTION:PART 1. Role of the Advanced
EMT:1. Overall Role of the Advanced Emergency Medical Technician.2.
Laws Governing Advanced Life Support Skills.3. Issues Concerning
the Health Professional : Medical Ethics. Death and Dying.PART 2.
Human Systems - The Respiratory System:1. Anatomy.2. External and
Internal Respiration.3. Factors Influencing Carbon Dioxide in the
Blood.4. Factors Influencing Oxygen in the Blood.5. Regulation of
Ventilation.6. Modified Forms of Respiration.PART 3. Human Systems
- The Cardiovascular System:1. Anatomy.2. Cardiac Output.3. Nervous
and Chemical Control of the Heart.4. The Electrical Conduction
System of the Heart.5. Basic Components of the E.C.G. Trace.6. The
Blood - Vascular System.7. The Lymphatic SystemPART 4. Human
Systems - The Nervous System:1. Anatomy.2. The Brain.3. The Spinal
Cord.4. The Autonomic Nervous System.5. The Peripheral Nervous
System.PART 5. Human Systems - Review of Other Body Systems:1. The
Musculoskeletal System.2. The Digestive System.3. The Urinary
System.4. The Reproductive System.5. The Endocrine System.PART 6.
Patient Assessment - A Review.1. The Overall Approach.2. Taking the
History.3. The Physical Examination: The Primary Survey. General
Appearance. Vital Signs. Examination of the Skin. Examination of
the Head and Neck. Respiratory Assessment. Cardiovascular
Assessment. Abdominal Assessment. Assessment of the Extremities and
Spine Putting it all Together.4. Presenting Medical
Information.PART 7. Advanced Airway Management:1. Hypoxia.2. Oxygen
Administration.3. Adjunctive Equipment: Airways. Ventilation
Devices for Patients Requiring Artificial Ventilation.4.
Suctioning: Tracheal Suctioning in the Non- Intubated Patient.
Tracheal Suctioning in the Intubated Patient.5. Management of
Airway Obstruction.6. Direct Laryngoscopy.7. Endotracheal
Intubation.8. Chest Decompression Techniques.9. The use of Positive
End-Expiratory Pressure (Peep).10. Cricothyrotomy.11. Transtracheal
Jet Insufflation.PART 8. Fluids and Shock:1. Water and
Electrolytes.2. Osmosis.3. Diffusion of Solutes.4. The Electrolytes
: The Principal Cations. The Principal Anions.5. Acid - Base
Balance : Respiratory Acidosis. Respiratory Alkalosis. Metabolic
Acidosis. Metabolic Alkalosis.6. Blood and its Components : General
Composition of Blood. Formed Elements. Plasma. Blood Typing. Rh
Factor.7. Blood Preparations, Derivatives and Substitutes : Whole
Blood. Packed Red Blood Cells. Plasma. Plasma " Substitutes ".
Crystalloids. Complications of Blood Transfusion.8. Abnormal States
of Fluid and Electrolyte Balance : Dehydration. Overhydration.
Shock and Shock Types.9. Peripheral Intravenous Infusion.10.
Complications of Intravenous Therapy.11. Medical Anti-Shock
Trousers : Application of the MAST. Indications and
Contraindications of MAST. Deflation of the MAST.12. Central Venous
Lines : External Jugular Vein Cannulation. Internal Jugular Vein
Cannulation. Subclavian Vein Cannulation. Hazards and Complications
of Jugular and Subclavian Cannulation.PART 9. Introduction to
Advanced Cardiac Life Support:1. Patient Assessment: The History in
the Cardiac Patient. Physical Examination of the Cardiac Patient.2.
Pathopysiology and the Management of Cardiovascular Disorders:
Coronary Artery Disease and Angina. Acute Myocardial Infarction.
Congestive Heart Failure. Cardiogenic Shock. Syncope. Myocardial
Trauma. Hypertensive Emergencies.3. Cardiac Arrhythmia's.4. Reading
an E.C.G.5. Application of Monitoring Electrodes.6. Specific
Cardiac Arrhythmia's.7. Life Threatening Cardiac Arrhythmia's.8.
Management of Cardiac Arrest. Pre-Hospital Approach. In-Hospital
Team Approach.9. Review of Basic Life Support (BLS).10.
Post-resuscitative Care.11. Defibrillation.12. Cardioversion.13.
Pharmacology.PART 10.Introduction to Advanced Trauma Management:1.
Initial Assessment and Management.2. Management of the Upper
Airway.3. Thoracic Trauma.4. Management of Hypovolemic Shock.5.
Head Injuries.6. Major Maxillofacial Injuries.7. Trauma of the
Spine and Spinal Cord.8. Abdominal Trauma.9. Trauma of the Urinary
Tract.10. Management of Limb Injuries.11. Trauma in Pregnancy.12.
Pediatric Trauma.13. Management of Burns.14. Blast and Gunshot
Injuries.15. Transport of the Injured Patient.16. Major Accidents
and Multiple Victim Incidents.17. Incidents Involving Hazardous
Substances.18. Handling Distressed Relatives and Breaking Bad
News.19. Scoring Systems for Trauma.
MODULE 2 - CARDIOVASCULAR EMERGENCIES & ADVANCED
PRE-HOSPITAL CARDIAC LIFE SUPPORT.PART 1. Review of Basic Life
Support:1. Adult CPR and Management of Airway Obstruction.2.
Pediatric CPR and Management of Airway Obstruction.3. Infant CPR
and Management of Airway Obstruction.4. Cough CPR and The
Pre-cordial Thump.PART 2. Review of the Anatomy of Circulatory
System:1. The Heart. Gross Anatomy. Structure of the Heart Wall.
Blood Supply to the Heart. Cardiac Output - Starlings Law. Blood
Flow Through the Heart. Extrinsic Control of the Heart.2. The Major
Arteries and Veins: The Structure of the Blood Vessels. The Blood
Pressure and it's Regulation.3. The Blood: Functions and
Components. Blood Groups - ABO and Rhesus Systems. The Lymphatic
System.4. Primary Nerves and Chemical Mediators.5. Effects of
Stimulation.PART 3. Common Cardiac Conditions and their
Management:1. Angina Pectoris.2. Acute Myocardial Infarction.3.
Left Sided Heart Failure.4. Right Sided Heart Failure.5.
Cardiogenic Shock.6. Aortic Aneurysm.7. Hypertensive CrisisPART 4.
Electrocardiogram Recognition:1. Electrophysiology.2. Review of the
Electrical Conduction System of the Heart. The Isoelectric Line.
The P Wave. The P-R Interval. The QRS Complex. The S-T Segment. The
T Wave. The R-R Interval. Relationships of the P wave, QRS complex
and the T wave.3. E.C.G. Electrode placement.4. Sources of
Artifact.5. Life threatening Ventricular Arrhythmia's.PART 5.
Arrhythmia Interpretation:1. Normal Sinus Rhythm.2. Sinus
Arrhythmia.3. Sinus Arrest.4. Sinus Bradycardia.5. Sinus
Tachycardia.6. Wandering Pacemaker.7. Premature Atrial
Contractions.8. Premature Junctional Contractions.9. Paroxysmal
Supraventricular Tachycardia.10. Atrial Flutter.11. Atrial
Fibrillation.12. Junctional Rhythm.13. First, Second and Third
Degree Atrioventricular Blocks.14. Bundle branch blocks.15.
Premature Ventricular Contractions.16. Ventricular Tachycardia.17.
Ventricular Fibrillation.18. Asystole.19. Artificial Pacemaker
Rhythms.20. Artifacts.PART 6. Conversion Techniques.1. Electrical
Conversion: Ventricular Fibrillation. Synchronized Cardioversion.
Unsynchronized Cardioversion.2. External Pacing.3. Implanted
Pacemakers and Defibrillators.4. Manual Defibrillators.5.
Semi-Automatic Defibrillators.6. Automated External
Defibrillators.7. Transcutaneous Cardiac Pacing.PART 7. Additional
Techniques:1. Carotid Sinus Massage.2. Intracardiac Injections.3.
Urinary Bladder Cathetherization.4. Naso Gastric Tube Placement.
Devices Used in Resuscitation:1. Mechanical CPR Devices. AMBU
Cardiopump. Cardiac Presses. Gas Powered
Resuscitators/Ventilators.PART 8. Pharmacology:1. Appropriate
agents for use in treating Cardiac Arrest, Life
ThreateningArrhythmia's and the relief of pain and anxiety. The
Characteristics anduses of each medication: Oxygen. Nitrous Oxide.
Adenosine. Atropine Sulphate. Bretylium Tosylate. Dopamine.
Epinepherine. Furosemide. Labetolol Lidocaine Hydrochloride.
Nifedipine. Nitro Glycerine. Norepinephrine. Propranolol.
Streptokinase. Tissue Plasminogen Activator. Verapamil.2. The
affects of Adrenergic and Dopaminergic receptors of the Autonomic
NervousSystem.3. Intropic Vasoactive Agents.4. Vasodilators and
Antihypertensives.5. Beta-Blockers.6. Diuretics7. Alpha and
Beta-Receptors.8. Dopaminergic receptors.9. Divisions of the
Autonomic Nervous System - Sympathetic / Parasympathetic.10. The
timeliness of appropriate pharmacological treatment.11.
Indications, mechanisms of action, dosages and precautions for each
medication.PART 7. Advanced Cardiac Life Support Algorithms
(Philippine Heart Association):1. Universal Emergency Cardiac
Care.2. Ventricular Fibrillation and Pulseless Ventricular
Tachycardia.3. Pulseless Electrical Activity.4. Aystole.5.
Bradycardia.6. Tachycardia.7. Cardioversion.8. Acute Pulmonary
Edema.9. Acute Myocardial Infarction.IN - HOSPITAL
A.C.L.S.Individuals involved with In-Hospital resuscitation during
advanced cardiac life support will be able to demonstrate their
knowledge and skills of:
Adapting to Team Resuscitation. The role of the Team Leader.
Organizing and directing the team. Problem Solving Skills. The
appropriate algorithm in accordance with Philippine Heart
AssociationGuidelines.
MODULE 4 - ADVANCED PRE_HOSPITAL TRAUMA MANAGEMENT.DURATION - 80
HOURS.
PART 1. Mechanism of injury attributed to Road Traffic
Accidents.The Machine collision:1. Head-on impact.2. Lateral
impact.3. Rear shunt impact.4. Rollover following impact.The body
collision:1. Involving the steering wheel.2. Involving the
dashboard.3. Involving the windshield.4. Involving doors &
sideposts.The organ collision:1. Coup & Contra-coup brain
injuries.2. Direct impact soft tissue injuries.3. Hyperextension
and flexion of the cervical spine.4. Internal injuries due to
shear, blunt and penetrating trauma.Assessment through vehicle
damage:1. Exterior impact damage.2. Interior impact damage.3.
Restraint systems.Injury patterns:1. Rapid vertical deceleration
injuries.2. Blast Injuries, projectile penetration injuries and
wound ballistics.PART 2. Preliminary actions at the scene.Scene
Survey:1. Assessment of hazards.2. Single patient incidents.3.
Multiple patient incidents.4. Extrication.5. Essential equipment.
Patient assessment and management priorities:1. Total overview on
approach to the incident.2. Patient assessment using the priority
plan.3. Critical interventions and transport decision.4. Critical
care and ongoing reassessment.PART 3. Initial and ongoing Airway
Management Skills:1. Airway Equipment & Adjuncts.2.
Observation.3. Suctioning Equipment & Techniques.4.
Oxygenation.5. Ventilation & Ventilation Techniques.6. Basic
& Advanced Airway Management.PART 4. Shock Evaluation and
Management:1. Basic Pathophysiology.2. Shock Assessment.3. Shock
Syndromes: Mechanical or Obstructive Shock. Hypoxemic Shock.4.
Management of Post Traumatic Shock States.PART 5. Special Fluid
Resuscitation Skills:1. Cannulation of the External Jugular Vein.2.
Intraosseous Infusion.MODULE 1 : PREPARATION \ SELECTION:PART 1.
Role of the Advanced EMT:1. Overall Role of the Advanced Emergency
Medical Technician.2. Laws Governing Advanced Life Support
Skills.3. Issues Concerning the Health Professional : Medical
Ethics. Death and Dying.PART 2. Human Systems - The Respiratory
System:1. Anatomy.2. External and Internal Respiration.3. Factors
Influencing Carbon Dioxide in the Blood.4. Factors Influencing
Oxygen in the Blood.5. Regulation of Ventilation.6. Modified Forms
of Respiration.PART 3. Human Systems - The Cardiovascular System:1.
Anatomy.2. Cardiac Output.3. Nervous and Chemical Control of the
Heart.4. The Electrical Conduction System of the Heart.5. Basic
Components of the E.C.G. Trace.6. The Blood - Vascular System.7.
The Lymphatic SystemPART 4. Human Systems - The Nervous System:1.
Anatomy.2. The Brain.3. The Spinal Cord.4. The Autonomic Nervous
System.5. The Peripheral Nervous System.PART 5. Human Systems -
Review of Other Body Systems:1. The Musculoskeletal System.2. The
Digestive System.3. The Urinary System.4. The Reproductive
System.5. The Endocrine System.PART 6. Patient Assessment - A
Review.1. The Overall Approach.2. Taking the History.3. The
Physical Examination: The Primary Survey. General Appearance. Vital
Signs. Examination of the Skin. Examination of the Head and Neck.
Respiratory Assessment. Cardiovascular Assessment. Abdominal
Assessment. Assessment of the Extremities and Spine Putting it all
Together.4. Presenting Medical Information.PART 7. Advanced Airway
Management:1. Hypoxia.2. Oxygen Administration.3. Adjunctive
Equipment: Airways. Ventilation Devices for Patients Requiring
Artificial Ventilation.4. Suctioning: Tracheal Suctioning in the
Non- Intubated Patient. Tracheal Suctioning in the Intubated
Patient.5. Management of Airway Obstruction.6. Direct
Laryngoscopy.7. Endotracheal Intubation.8. Chest Decompression
Techniques.9. The use of Positive End-Expiratory Pressure
(Peep).10. Cricothyrotomy.11. Transtracheal Jet Insufflation.PART
8. Fluids and Shock:1. Water and Electrolytes.2. Osmosis.3.
Diffusion of Solutes.4. The Electrolytes : The Principal Cations.
The Principal Anions.5. Acid - Base Balance : Respiratory Acidosis.
Respiratory Alkalosis. Metabolic Acidosis. Metabolic Alkalosis.6.
Blood and its Components : General Composition of Blood. Formed
Elements. Plasma. Blood Typing. Rh Factor.7. Blood Preparations,
Derivatives and Substitutes : Whole Blood. Packed Red Blood Cells.
Plasma. Plasma " Substitutes ". Crystalloids. Complications of
Blood Transfusion.8. Abnormal States of Fluid and Electrolyte
Balance : Dehydration. Overhydration. Shock and Shock Types.9.
Peripheral Intravenous Infusion.10. Complications of Intravenous
Therapy.11. Medical Anti-Shock Trousers : Application of the MAST.
Indications and Contraindications of MAST. Deflation of the
MAST.12. Central Venous Lines : External Jugular Vein Cannulation.
Internal Jugular Vein Cannulation. Subclavian Vein Cannulation.
Hazards and Complications of Jugular and Subclavian
Cannulation.PART 9. Introduction to Advanced Cardiac Life
Support:1. Patient Assessment: The History in the Cardiac Patient.
Physical Examination of the Cardiac Patient.2. Pathopysiology and
the Management of Cardiovascular Disorders: Coronary Artery Disease
and Angina. Acute Myocardial Infarction. Congestive Heart Failure.
Cardiogenic Shock. Syncope. Myocardial Trauma. Hypertensive
Emergencies.3. Cardiac Arrhythmia's.4. Reading an E.C.G.5.
Application of Monitoring Electrodes.6. Specific Cardiac
Arrhythmia's.7. Life Threatening Cardiac Arrhythmia's.8. Management
of Cardiac Arrest. Pre-Hospital Approach. In-Hospital Team
Approach.9. Review of Basic Life Support (BLS).10.
Post-resuscitative Care.11. Defibrillation.12. Cardioversion.13.
Pharmacology.PART 10.Introduction to Advanced Trauma Management:1.
Initial Assessment and Management.2. Management of the Upper
Airway.3. Thoracic Trauma.4. Management of Hypovolemic Shock.5.
Head Injuries.6. Major Maxillofacial Injuries.7. Trauma of the
Spine and Spinal Cord.8. Abdominal Trauma.9. Trauma of the Urinary
Tract.10. Management of Limb Injuries.11. Trauma in Pregnancy.12.
Pediatric Trauma.13. Management of Burns.14. Blast and Gunshot
Injuries.15. Transport of the Injured Patient.16. Major Accidents
and Multiple Victim Incidents.17. Incidents Involving Hazardous
Substances.18. Handling Distressed Relatives and Breaking Bad
News.19. Scoring Systems for Trauma.
MODULE 2 - CARDIOVASCULAR EMERGENCIES & ADVANCED
PRE-HOSPITAL CARDIAC LIFE SUPPORT.PART 1. Review of Basic Life
Support:1. Adult CPR and Management of Airway Obstruction.2.
Pediatric CPR and Management of Airway Obstruction.3. Infant CPR
and Management of Airway Obstruction.4. Cough CPR and The
Pre-cordial Thump.PART 2. Review of the Anatomy of Circulatory
System:1. The Heart. Gross Anatomy. Structure of the Heart Wall.
Blood Supply to the Heart. Cardiac Output - Starlings Law. Blood
Flow Through the Heart. Extrinsic Control of the Heart.2. The Major
Arteries and Veins: The Structure of the Blood Vessels. The Blood
Pressure and it's Regulation.3. The Blood: Functions and
Components. Blood Groups - ABO and Rhesus Systems. The Lymphatic
System.4. Primary Nerves and Chemical Mediators.5. Effects of
Stimulation.PART 3. Common Cardiac Conditions and their
Management:1. Angina Pectoris.2. Acute Myocardial Infarction.3.
Left Sided Heart Failure.4. Right Sided Heart Failure.5.
Cardiogenic Shock.6. Aortic Aneurysm.7. Hypertensive CrisisPART 4.
Electrocardiogram Recognition:1. Electrophysiology.2. Review of the
Electrical Conduction System of the Heart. The Isoelectric Line.
The P Wave. The P-R Interval. The QRS Complex. The S-T Segment. The
T Wave. The R-R Interval. Relationships of the P wave, QRS complex
and the T wave.3. E.C.G. Electrode placement.4. Sources of
Artifact.5. Life threatening Ventricular Arrhythmia's.PART 5.
Arrhythmia Interpretation:1. Normal Sinus Rhythm.2. Sinus
Arrhythmia.3. Sinus Arrest.4. Sinus Bradycardia.5. Sinus
Tachycardia.6. Wandering Pacemaker.7. Premature Atrial
Contractions.8. Premature Junctional Contractions.
COPYRIGHT: LSTI9. Paroxysmal Supraventricular Tachycardia.10.
Atrial Flutter.11. Atrial Fibrillation.12. Junctional Rhythm.13.
First, Second and Third Degree Atrioventricular Blocks.14. Bundle
branch blocks.15. Premature Ventricular Contractions.16.
Ventricular Tachycardia.17. Ventricular Fibrillation.18.
Asystole.19. Artificial Pacemaker Rhythms.20. Artifacts.PART 6.
Conversion Techniques.1. Electrical Conversion: Ventricular
Fibrillation. Synchronized Cardioversion. Unsynchronized
Cardioversion.2. External Pacing.3. Implanted Pacemakers and
Defibrillators.4. Manual Defibrillators.5. Semi-Automatic
Defibrillators.6. Automated External Defibrillators.7.
Transcutaneous Cardiac Pacing.PART 7. Additional Techniques:1.
Carotid Sinus Massage.2. Intracardiac Injections.3. Urinary Bladder
Cathetherization.4. Naso Gastric Tube Placement. Devices Used in
Resuscitation:1. Mechanical CPR Devices. AMBU Cardiopump. Cardiac
Presses. Gas Powered Resuscitators/Ventilators.PART 8.
Pharmacology:1. Appropriate agents for use in treating Cardiac
Arrest, Life ThreateningArrhythmia's and the relief of pain and
anxiety. The Characteristics anduses of each medication: Oxygen.
Nitrous Oxide. Adenosine. Atropine Sulphate. Bretylium Tosylate.
Dopamine. Epinepherine. Furosemide. Labetolol Lidocaine
Hydrochloride. Nifedipine. Nitro Glycerine. Norepinephrine.
Propranolol. Streptokinase. Tissue Plasminogen Activator.
Verapamil.2. The affects of Adrenergic and Dopaminergic receptors
of the Autonomic NervousSystem.3. Intropic Vasoactive Agents.4.
Vasodilators and Antihypertensives.5. Beta-Blockers.6. Diuretics7.
Alpha and Beta-Receptors.8. Dopaminergic receptors.9. Divisions of
the Autonomic Nervous System - Sympathetic / Parasympathetic.10.
The timeliness of appropriate pharmacological treatment.11.
Indications, mechanisms of action, dosages and precautions for each
medication.PART 7. Advanced Cardiac Life Support Algorithms
(Philippine Heart Association):1. Universal Emergency Cardiac
Care.2. Ventricular Fibrillation and Pulseless Ventricular
Tachycardia.3. Pulseless Electrical Activity.4. Aystole.5.
Bradycardia.6. Tachycardia.7. Cardioversion.8. Acute Pulmonary
Edema.9. Acute Myocardial Infarction.IN - HOSPITAL
A.C.L.S.Individuals involved with In-Hospital resuscitation during
advanced cardiac life support will be able to demonstrate their
knowledge and skills of:
Adapting to Team Resuscitation. The role of the Team Leader.
Organizing and directing the team. Problem Solving Skills. The
appropriate algorithm in accordance with Philippine Heart
AssociationGuidelines.MODULE 4 - ADVANCED PRE_HOSPITAL TRAUMA
MANAGEMENT.DURATION - 80 HOURS.PART 1. Mechanism of injury
attributed to Road Traffic Accidents.The Machine collision:1.
Head-on impact.2. Lateral impact.3. Rear shunt impact.4. Rollover
following impact.The body collision:1. Involving the steering
wheel.2. Involving the dashboard.3. Involving the windshield.4.
Involving doors & sideposts.The organ collision:1. Coup &
Contra-coup brain injuries.2. Direct impact soft tissue injuries.3.
Hyperextension and flexion of the cervical spine.4. Internal
injuries due to shear, blunt and penetrating trauma.Assessment
through vehicle damage:1. Exterior impact damage.2. Interior impact
damage.3. Restraint systems.Injury patterns:1. Rapid vertical
deceleration injuries.2. Blast Injuries, projectile penetration
injuries and wound ballistics.PART 2. Preliminary actions at the
scene.Scene Survey:1. Assessment of hazards.2. Single patient
incidents.3. Multiple patient incidents.4. Extrication.5. Essential
equipment. Patient assessment and management priorities:1. Total
overview on approach to the incident.2. Patient assessment using
the priority plan.3. Critical interventions and transport
decision.4. Critical care and ongoing reassessment.PART 3. Initial
and ongoing Airway Management Skills:1. Airway Equipment &
Adjuncts.2. Observation.3. Suctioning Equipment & Techniques.4.
Oxygenation.5. Ventilation & Ventilation Techniques.6. Basic
& Advanced Airway Management.PART 4. Shock Evaluation and
Management:1. Basic Pathophysiology.2. Shock Assessment.3. Shock
Syndromes: Mechanical or Obstructive Shock. Hypoxemic Shock.4.
Management of Post Traumatic Shock States.PART 5. Special Fluid
Resuscitation Skills:1. Cannulation of the External Jugular Vein.2.
Intraosseous Infusion.PART 6, Spinal Trauma:1. Review - The Normal
Spinal Column and Cord.2. Kinematics of Blunt Spinal Injury.3.
Spinal Cord Injury.4. Mechanisms of Spinal Injury.5. Assessment of
Spinal Injuries.6. Management of Spinal Injuries: Immobilization
& Extrication. Special Situations.7. Airway Intervention.PART
7. Head Injuries:1. Review - Anatomy.2. Pathophysiology of Head
Trauma. Intracranial Pressure. Herniation Syndrome. Anoxic Brain
Injury.3. Wounds to the Scalp.4. Skull Injuries.5. Brain
Injuries.6. Initial and Ongoing Assessment of Head Trauma
Patients.7. Management of the Head Trauma Patient.8. Potential
Problems.
PART 8. Thoracic Trauma:1. Review - Anatomy.2. Pathophysiology
of Thoracic Trauma.3. Assessment and Management of Thoracic Trauma.
Open Pneumothorax. Tension Pneumothorax. Massive Heamothorax. Flail
Chest. Cardiac Tamponade. Tracheal or Bronchial Tree Injuries.
Myocardial Contusion. Diaphragmatic Tears. Oesophageal Injury.
Pulmonary Contusion. Other chest Injuries.4. Chest
Decompression.PART 9. Abdominal and Pelvic Trauma:1. Review -
Anatomy.2. Specific Injuries: Penetrating Trauma to the Abdomen.
Blunt Trauma to the Abdomen. Genitourinary Injuries. Pelvic
Fractures.3. Examination and Evaluation.4. Stabilization and
Management.
PART 10. Trauma to the Extremities:1. Review - Anatomy.2.
Mechanisms of Musculoskeletal Injuries to the Extremities.3. Types
of Musculoskeletal Injury to the Extremities: Fractures
Dislocations. Sprains & Strains. Traumatic Amputations.4.
Assessment and Management Of Injuries to the Extremities.PART 11.
Burn Injuries:1. Review - Anatomy & Pathology of the Skin.2.
Hazards - Dealing with the Cause.3. Assessment.4. Characteristics
of Various Depths of Burns.5. Initial Field care.6. Special
Problems Associated with Burn Management: Thermal burns. Electrical
Burns. Chemical Burns. Burns due to Radiation.7. Primary and
Secondary Transportation.PART 12. Trauma in Children:1. Review -
Anatomical Considerations.2. Communications with Child and
Family.3. Equipment specifically designed for Pediatric use.
Pediatric Femoral Traction Splints. Pediatric Cervical Collars.
Pediatric Bag Valve Mask Resuscitators. Pediatric B/P Cuffs.
Pediatric Cannulae - Over the Needle & Butterfly. Pediatric
Drug Regimes. Pediatric Ventilation Regimes. Brownlow Tape.4.
Assessment of Pediatric Patients: Scene Survey. Assessment and
Management of Respiration. Assessment and Management of
Circulation. The Critical Trauma Decision. Head Injuries - Level of
Consciousness. Spinal Injuries. Chest Injuries. Abdominal and
Pelvic Injuries. Specific Injuries to the Extremities.5. Airway
& C. Spine Stabilization.6. Common Mechanisms of Injury in
Children.7. Child Restraint Seats.PART 13. Trauma in the Elderly:1.
Pathophysiology of Aging.2. Assessment of the Elderly Patient:
Scene Survey. Evaluating Airway, Breathing and Circulation Head
Injuries. Spinal Injuries. Chest Injuries. Abdominal and Pelvic
Injuries. Specific Injuries to the Extremities.3. Critical
Transport Decisions.
PART 14. Trauma in Pregnancy:1. Physiological Changes During
Pregnancy.2. Response to Hypovolemia.3. Vehicular Collisions.4.
Blunt Trauma to the Abdomen.5. Penetrating Trauma to the Abdomen.6.
Falls.7. Evaluation.8. Management of the Pregnant Patient.9. Oxygen
Administration.10. Transportation.PART 15. Patients Under the
Influence of Drugs or Alcohol:1. Drug Abuse: Abuse. Physical
Dependence. Psychological Dependence. Tolerance. Drug Addiction.
Withdrawal Syndrome.2. Drug Categories: Narcotics. Central Nervous
System Depressants. Central Nervous System Stimulants.
Hallucinogens.3. Drug Overdose and Drug Toxicity.4. General
Principles of Assessment and Management.5. Profile of the
Alcoholic.6. Medical Consequences of Alcohol. Acute Alcoholic
Intoxication. Withdrawal Seizures. Delirium Tremens.7. Placement of
Naso-Gastric Tubes.8. Principles of Management of the Uncooperative
Patient.9. Principles of Long Term Management and the risk of
Relapse.PART 16. Drowning, Barotrauma and Decompression Sickness:1.
Pathophysiology of Drowning.2. Near Drowning and Secondary
Drowning.3. Acute Pulmonary Edema: Left Ventricular Failure. Acute
Mountain/Altitude Sickness and High Altitude Pulmonary Edema.4.
Assessment of Diving Incidents: Barotrauma of Descent and Ascent.5.
Decompression Sickness: Type 1. Illness. Type 2. Illness.6.
Management of Decompression Sickness.7. Shallow Water Blackout.PART
17. Critical Trauma Situations - The Load & Go Decision:1.
Critical interventions.2. The "Load and Go" Versus the "Stay and
Treat" the Decision Making Process.3. Stabilizing Measures.4.
Reassessment Surveys.PART 18. Cardiopulmonary Arrest due to
Trauma:1. The Pathophysiology of Cardiopulmonary Arrest due to
Trauma.2. Treatable Causes of Traumatic Cardiopulmonary Arrest:
Respiratory Causes. Circulatory Causes.3. Approach to Trauma
Victims in Cardiopulmonary Arrest.4. General Plan of Action.5.
Stabilizing Measures.6. Reassessment Surveys.PART 19. Infection
Control in the Pre-Hospital Setting:1. Transmission of Communicable
Diseases. Direct Contact. Contact with Contaminated Materials.
Droplet Infection. Human, Animal or Insect Bites. Puncture by
Contaminated Needle. Contact with Contaminated Body Fluids.2.
Standard Precautions Against Disease Transmission: Barrier
Precautions During Patient Exposures. Personal Precautions.
Ambulance Hygiene. Handling of Items Exposed to Blood or Body
Fluids.3. Procedure after Accidental Exposure to Blood or Body
Fluids.PART 20. Pre-Hospital Trauma Scoring:1. Functions of Trauma
Scoring.2. Revised Trauma Scoring System: Glasgow Coma Scale.
Respiratory Status. Systolic Blood Pressure. Pediatric Trauma
Scoring System.PART 21. Injury Prevention:1. The Injury Epidemic.2.
The Injury Process and Why Injuries Occur: Analyzing Injury Events.
Phases of Injury Event.3. General Principles for Safe
Extrication.4. Stages of Extrication: Safety Surveys of the Scene
and Stabilization. Gaining Access to the Patient. Providing
Emergency Care. Disentanglement. Packaging and Removal.5. Role of
the EMS Provider in Injury Prevention and Control.MINIMUM
REQUIREMENTS: Successful completion of selection interview /
examinations. Completion of nine hundred and sixty hours post "EMT
I & I" appropriate Emergency Medical Services experience to
include emergency response duties. Submission of log of experience
gained.EVALUATION: One Hour Multiple Choice Paper. One Hour Short
Answer Paper. One Hour Essay Paper. One Hour Practical Skills Test.
Minimum of Thirty Minute Oral Examination given by Duly Appointed
Panel.
1. Review - The Normal Spinal Column and Cord.2. Kinematics of
Blunt Spinal Injury.3. Spinal Cord Injury.4. Mechanisms of Spinal
Injury.5. Assessment of Spinal Injuries.6. Management of Spinal
Injuries: Immobilization & Extrication. Special Situations.7.
Airway Intervention.PART 7. Head Injuries:1. Review - Anatomy.2.
Pathophysiology of Head Trauma. Intracranial Pressure. Herniation
Syndrome. Anoxic Brain Injury.3. Wounds to the Scalp.4. Skull
Injuries.5. Brain Injuries.6. Initial and Ongoing Assessment of
Head Trauma Patients.7. Management of the Head Trauma Patient.8.
Potential Problems.PART 8. Thoracic Trauma:1. Review - Anatomy.2.
Pathophysiology of Thoracic Trauma.3. Assessment and Management of
Thoracic Trauma. Open Pneumothorax. Tension Pneumothorax. Massive
Heamothorax. Flail Chest. Cardiac Tamponade. Tracheal or Bronchial
Tree Injuries. Myocardial Contusion. Diaphragmatic Tears.
Oesophageal Injury. Pulmonary Contusion. Other chest Injuries.4.
Chest Decompression.PART 9. Abdominal and Pelvic Trauma:1. Review -
Anatomy.2. Specific Injuries: Penetrating Trauma to the Abdomen.
Blunt Trauma to the Abdomen. Genitourinary Injuries. Pelvic
Fractures.3. Examination and Evaluation.4. Stabilization and
Management.
PART 10. Trauma to the Extremities:1. Review - Anatomy.2.
Mechanisms of Musculoskeletal Injuries to the Extremities.3. Types
of Musculoskeletal Injury to the Extremities: Fractures
Dislocations. Sprains & Strains. Traumatic Amputations.4.
Assessment and Management Of Injuries to the Extremities.PART 11.
Burn Injuries:1. Review - Anatomy & Pathology of the Skin.2.
Hazards - Dealing with the Cause.3. Assessment.4. Characteristics
of Various Depths of Burns.5. Initial Field care.6. Special
Problems Associated with Burn Management: Thermal burns. Electrical
Burns. Chemical Burns. Burns due to Radiation.7. Primary and
Secondary Transportation.PART 12. Trauma in Children:1. Review -
Anatomical Considerations.2. Communications with Child and
Family.3. Equipment specifically designed for Pediatric use.
Pediatric Femoral Traction Splints. Pediatric Cervical Collars.
Pediatric Bag Valve Mask Resuscitators. Pediatric B/P Cuffs.
Pediatric Cannulae - Over the Needle & Butterfly. Pediatric
Drug Regimes. Pediatric Ventilation Regimes. Brownlow Tape.4.
Assessment of Pediatric Patients: Scene Survey. Assessment and
Management of Respiration. Assessment and Management of
Circulation. The Critical Trauma Decision. Head Injuries - Level of
Consciousness. Spinal Injuries. Chest Injuries. Abdominal and
Pelvic Injuries. Specific Injuries to the Extremities.5. Airway
& C. Spine Stabilization.6. Common Mechanisms of Injury in
Children.7. Child Restraint Seats.PART 13. Trauma in the Elderly:1.
Pathophysiology of Aging.2. Assessment of the Elderly Patient:
Scene Survey. Evaluating Airway, Breathing and Circulation Head
Injuries. Spinal Injuries. Chest Injuries. Abdominal and Pelvic
Injuries. Specific Injuries to the Extremities.3. Critical
Transport Decisions.
PART 14. Trauma in Pregnancy:1. Physiological Changes During
Pregnancy.2. Response to Hypovolemia.3. Vehicular Collisions.4.
Blunt Trauma to the Abdomen.5. Penetrating Trauma to the Abdomen.6.
Falls.7. Evaluation.8. Management of the Pregnant Patient.9. Oxygen
Administration.10. Transportation.PART 15. Patients Under the
Influence of Drugs or Alcohol:1. Drug Abuse: Abuse. Physical
Dependence. Psychological Dependence. Tolerance. Drug Addiction.
Withdrawal Syndrome.2. Drug Categories: Narcotics. Central Nervous
System Depressants. Central Nervous System Stimulants.
Hallucinogens.3. Drug Overdose and Drug Toxicity.4. General
Principles of Assessment and Management.5. Profile of the
Alcoholic.6. Medical Consequences of Alcohol. Acute Alcoholic
Intoxication. Withdrawal Seizures. Delirium Tremens.7. Placement of
Naso-Gastric Tubes.8. Principles of Management of the Uncooperative
Patient.9. Principles of Long Term Management and the risk of
Relapse.PART 16. Drowning, Barotrauma and Decompression Sickness:1.
Pathophysiology of Drowning.2. Near Drowning and Secondary
Drowning.3. Acute Pulmonary Edema: Left Ventricular Failure. Acute
Mountain/Altitude Sickness and High Altitude Pulmonary Edema.4.
Assessment of Diving Incidents: Barotrauma of Descent and Ascent.5.
Decompression Sickness: Type 1. Illness. Type 2. Illness.6.
Management of Decompression Sickness.7. Shallow Water Blackout.PART
17. Critical Trauma Situations - The Load & Go Decision:1.
Critical interventions.2. The "Load and Go" Versus the "Stay and
Treat" the Decision Making Process.3. Stabilizing Measures.4.
Reassessment Surveys.PART 18. Cardiopulmonary Arrest due to
Trauma:1. The Pathophysiology of Cardiopulmonary Arrest due to
Trauma.2. Treatable Causes of Traumatic Cardiopulmonary Arrest:
Respiratory Causes. Circulatory Causes.3. Approach to Trauma
Victims in Cardiopulmonary Arrest.4. General Plan of Action.5.
Stabilizing Measures.6. Reassessment Surveys.PART 19. Infection
Control in the Pre-Hospital Setting:1. Transmission of Communicable
Diseases. Direct Contact. Contact with Contaminated Materials.
Droplet Infection. Human, Animal or Insect Bites. Puncture by
Contaminated Needle. Contact with Contaminated Body Fluids.2.
Standard Precautions Against Disease Transmission: Barrier
Precautions During Patient Exposures. Personal Precautions.
Ambulance Hygiene. Handling of Items Exposed to Blood or Body
Fluids.3. Procedure after Accidental Exposure to Blood or Body
Fluids.PART 20. Pre-Hospital Trauma Scoring:1. Functions of Trauma
Scoring.2. Revised Trauma Scoring System: Glasgow Coma Scale.
Respiratory Status. Systolic Blood Pressure. Pediatric Trauma
Scoring System.PART 21. Injury Prevention:1. The Injury Epidemic.2.
The Injury Process and Why Injuries Occur: Analyzing Injury Events.
Phases of Injury Event.3. General Principles for Safe
Extrication.4. Stages of Extrication: Safety Surveys of the Scene
and Stabilization. Gaining Access to the Patient. Providing
Emergency Care. Disentanglement. Packaging and Removal.5. Role of
the EMS Provider in Injury Prevention and Control.MINIMUM
REQUIREMENTS: Successful completion of selection interview /
examinations. Completion of nine hundred and sixty hours post "EMT
I & I" appropriate Emergency Medical Services experience to
include emergency response duties. Submission of log of experience
gained.EVALUATION: One Hour Multiple Choice Paper. One Hour Short
Answer Paper. One Hour Essay Paper. One Hour Practical Skills
Test.Minimum of Thirty Minute Oral Examination given by Duly
Appointed Panel.
Syllabus Registered EMT (Paramedic)
PART 1. Introduction to Emergency Medicine:1. Scope and Practice
of Emergency Medicine: Pre-Hospital Care. Emergency Department
Approach. Surgical and Critical Care Decisions - The Golden Hour
Principle. Principles of Emergency Care.2. Initial Approach to the
Patient & Gathering Data: Primary Survey. Secondary Survey. The
History. The Diagnostic Process - Decision Priorities and
Preliminary Differential Diagnosis. Diagnostic Adjuncts\Aids.3.
Transports Considerations.4. Principles of Management.5. Special
Considerations.6. Clinical Pearls.7. Telemetry &
Communications.PART 2. Neurological Disorders and Emergencies:1.
Review of Anatomy and Physiology of the Nervous System.2. The
Neurological Examination & The Glasgow Coma Scale.3. Head and
Spinal Trauma.4. Altered Mental Status.5. Headache & Facial
Pain.6. Dizziness & Vertigo.7. Meningitis, Encephalitis and
Brain Abscess.8. Seizures & Status Epilepticus.9. Cerebral
Ischemia.10. Cerebro-Vascular Accident.11. Peripheral Neurological
Lesions Vs. Central Nervous System Lesions.12. Multiple
Sclerosis.PART 3.Cardiovascular Diseases and Emergencies:1. Review
of Anatomy and Physiology of the Circulatory System.2. Myocardial
Ischemia and Infarction.3. Pre-Hospital Thrombolytic Therapy.4.
Heart Failure & Pulmonary Edema.5. Palpatations.6. Diseases
Effecting the Valves.7. Endocarditis, Myocarditis and Pericardial
Disease.8. Pulmonary Embolism.9. Hypertensive Emergencies.10.
Aortic Aneurysms.11. Physiological Effects of Aging on the
Cardiovascular System.12. Cardiac Transplants.13. Preliminary
Diagnosis and Decision Priorities.14. Principles of Pre-Hospital
Management of Cardiovascular Diseases.15. Special Considerations:
Pediatric Patients. Geriatric Patients. Diabetic Patients.16.
Pharmacology.PART 4.Pulmonary Diseases and Emergencies:1. Review of
Anatomy and Physiology of the Respiratory System.2. Pneumonia's:
Bacterial, Viral & Mycoplasma. Aspiration Pneumonia, Empysema
and Lung Abscess.3. Tuberculosis.4. Chronic Obstructive Pulmonary
Disease.5. Acute Asthma.6. Malignant Diseases of the Lungs.7. Chest
Trauma: Pneumothorax. Tension Pneumothorax Subcutaneous Emphysema.
Heamothorax. Flail Chest Management of Pulmonary Diseases and
Emergencies. Relative Pharmacology.PART 5. The Digestive System,
Diseases and Emergencies:1. Review of the Anatomy and Physiology of
the Digestive System.2. Injuries to the Bucal Cavity.3. Esophageal
Emergencies.4. Peptic Ulcers.5. Perforated Viscus.6. Acute
Appendicitis.7. Peritonitis8. Haematemesis and Melena.9. Intestinal
Obstruction.10. Hernia.11. Ileitis and Colitis.12. Colonic
Diverticular Disease.13. Ano-rectal Conditions.14. Diarrhea and
Food Poisoning.15. Cholecystitis and Bilary Colic.16. Hepatitis and
Acute Jaundice.17. Pancreatitis.18. Liver Dysfunction and
Failure.19. Metabolic Complications of Diabetes Mellitus.20. Acute
Metabolic Acidosis and Alkalosis.21. Hyponatremia.22.
Hyperkalemia.23. Hypercalcemia.24. Management of Digestive System
Diseases and Emergencies.PART 6. Genito -Urinary System Diseases
and Emergencies:1. Review of the Anatomy and Physiology of the
Genito-Urinary System.2. Emergency Renal Problems: Acute Renal
Failure. Glomerulonephritis. Pyelonephritis Nephrotic Syndrome.
Cystitis & Renal Colic Dysuria. Urinary Tract Infections.
Rupture of the Urinary Bladder. Ruptured Urethra. Acute Retention
of Urine.3. Male Genital Problems: Scrotal Edema Direct Trauma to
the Scrotum, Penetrating and Non-Penetrating Balanoposthitis
Phimosis & Paraphimosis. Entrapment Injuries. Penile Fracture.
Priapism. Torsion of the Testes & Appendages. Epididymitis.
Testicular Malignancy.4. Female Genital Problems: Vulvovaginitis.
Genital Herpes. Vaginal Foreign Bodies. Rape Trauma Syndrome.PART
7. Muscoskeletal Injuries and Conditions:1. Emergencies Involving
the Eye: Trauma to the Eye. Injury to the Orbits. Eyelid Injuries.
Injuries to the Globe.2. Medical Emergencies Involving the Eye.
Central Retinal Artery Occlusion. Other Ocular Emergencies. General
Management of Injuries to the Eye.3. Injuries to the Face, Ears,
Nose and Throat: Facial Injuries. Ear Injuries. Trauma To the Nose
& Mouth. Injuries to the Jaw - Fractures & Dislocations.4.
Trauma to the Neck.5. Trauma to the Shoulder.6. Trauma to the Chest
& Back.7. Trauma to the Abdomen.8. Trauma to the Pelvis &
Lower Back.9. Trauma to the Lower Limbs.10. Trauma to the Upper
Limbs.11. Control of External Hemorrhage.12. Control of Internal
Hemorrhage.13. Compartment Syndromes.14. Muscle Ruptures.15.
Inflammatory Conditions.16. Rheumatic Disorders.PART 8. Obstetric
and Gynaecological Emergencies:1. Review of the Anatomy and
Physiology of the Female Reproductive System.2. Non -Pregnancy
Causes of Abdominal Pain: Ovarian Torsion. Mittelschmerz Pelvic
Inflammatory Disease. Endometriosis. Rupture of the Corpus
Luteum.3. Vaginal Bleeding: Traumatic. Non-Traumatic.4.
Physiological Changes in Normal Pregnancy: Cardiovascular.
Pulmonary. Renal. Gastrointestinal. Coagulation. Hematological.
Metabolic. Uterine.5. Complications of Pregnancy: First Trimester
Bleeding. Ectopic Pregnancy. Spontaneous Abortion. Septic Abortion.
Placenta Abruption. Placenta Previa. Third Trimester Bleeding.
Pre-Term Labor. Pre-eclampsia Eclampsia (Toxicity in Pregnancy).
Rh-Immune Globulin (RHIG RhoGAM) Rupture of the Corpus Luteum.
Trauma During Pregnancy. Normal Labor and Delivery.6. Abnormal
Deliveries: Breech Presentation. Prolapsed Umbilical Cord. Limb
Presentation. Multiple Births. Premature Births.7. Complications of
Labor & Delivery. Antepartal Heamorrhage. Postpartum
Heamorrhage. Supine Hypotensive Syndrome. Uterine Inversion.
Pulmonary Embolism. Endometriosis. Mastitis.PART 9.Disorders
Presenting in Infancy and Childhood:1. The Normal Development of
the Infant and Child.2. Techniques for the Approach to and
Examination of Infants & Children.3. Common Neonatal Problems:
Crying, Irritability and Lethargy. Febrile Infants. Intestinal
Colic Regurgitation. Vomiting. Diarrhea. Dehydration. Abdominal
Distension. Constipation.4.. Cardio-Respiratory Disorders:
Pneumonia. Croup. Status Asthmaticus Bronchiolitis Epiglotitis
Cough & Nasal Congestion. Noisy Breathing & Stridor Apnea
Vs Periodic Breathing Syncope & Voluntary Breath Holding.
Cyanosis & Blue Spells.5. Sudden Infant Death Syndrome.6.
Seizures in the Pediatric Age Group.7. The Battered and / or
Sexually Abused Child.8. The Diabetic Child.9. Heart Disease.10.
Abdominal Emergencies in Children.11. Skin and Soft Tissue
Infections.12. Bacteremia and Sepsis.13. Meningitis in Children.14.
Pneumonia in Children.15. Gastroenteritis.16. Muscoskeletal
Disorders in Children.17.Trauma In Children - General
Considerations in the Injured Child: Hypovolemia and Shock. Fluid
& Electrolyte Therapy. Head Injuries. Chest Trauma. Blunt and
Penetrating Abdominal Trauma. Kidney Injuries. Pediatric Analgesia
& Sedation. Fractures of the Extremities.17. The Handicapped or
Disabled Child.PART 9. Infectious Diseases:1. Sexually Transmitted
Diseases: Syphilis. Gonorrhea. N.S.U. HIV Infection and AIDS.2.
Malaria.3. Tetanus.4. Rabies.5. Tuberculosis.6. Cholera.7. Typhoid
& Paratyphoid.8. Viral Hepatitis.9. Diphtheria.10.
Pertussis.11. Poliomyelitis.12. Dengue and Hemorrhagic Fever.13.
Common Parasitic Infections.14. Tick-Borne Diseases.15.
Immunizations for Emergency Care Personnel.16. Universal
Precautions & Routine Measures for Preventing Spread of
Disease.PART 10. Toxicology:1. General Management of the Poisoned
Patient: History. Physical Examination. Principles of Management.
Self Protection Factors.2. Ingested Poisons: Strong Acids. Strong
Alkalis & Caustic Substances. Petroleum Products. Alcohol's.
Cyanide. Organophosphates & Carbamates. Paraquat. Heavy Metals.
Poisonous Plants & Fungi. Marine Life.3. Common Pharmaceutical
Preparations: Aspirin & Other Salicylates. Paracetamol.
Non-Steriodal Anti-inflammatory Agents. Phenytoin. Amphetamines.
Antidepressants. Narcotics. Neuroleptics. Barbiturates.
Benzopdiazepines. Sedative-Hypnotics.4. Illegal Narcotics and Other
Substances: Opium. Heroine. Cocaine. Shabu. Ecstacy. Marijuana.5.
Inhaled Poisons:6. Carbon Monoxide.7. Freons.8. Solvent Abuse.9.
Smoke Inhalation.10. Absorbed Poisons: Organo Phosphates. Cyanide.
Lime. Phenol.11. Injected Poisons. Self Injected Toxins.
Snakebites. Arachnid Bites. Insect Bites. Mammalian Bites.PART 11.
Environmental Emergencies:1. The Physiology of Body Temperature
Regulation.2. Heat Exposure: Head Edema. Prickly Heat. Heat
Syncope. Heat Cramps. Heat Tetany. Heat Exhaustion. Heat Stroke.
General Management of Heat Exhaustion & Heat Stroke.3. Cold
Exposure: Pathophysiology & Clinical Features. Frostnip &
Frostbite. Hypothermia. General Management of Cold Related
Conditions.4. High Altitude Ailments.5. Hyperbaric Ailments:
Physical Principles. Gas Laws. Barotrauma, Descent & Ascent.
Air Embolism. Nitrogen Narcosis. Decompression Sickness. General
Management of Hyperbaric Conditions.6. Near Drowning: Fresh Water.
Salt Water. Secondary Drowning.7. Burns and their Management:
Thermal Burns. Chemical Burns. Electrical Burns. Radiation
Injuries.PART 12. Endocrine Related Emergencies:1. Hypoglycemia
& Hyperglycemia. Diabetic Ketoacidosis. Alcoholic Ketoacidosis.
Lactic Acidosis. Thyroid Storm. Hyperthyroidism and Coma. Adrenal
Conditions.PART 13. The Emotionally Disturbed Patient:1. Emotional
Aspects of Illness & Injury: Response of Patient. Response of
Relatives, Friends & Bystanders. Response of EMS Staff.
Response to Mass Casualty Situations.2. Behavioral Disorders:
Depression. Suicide. Suicide Threat or Attempt. Rage, Hostility
& Violent Behavior. Paranoia. Anxiety and Phobias.
Disorganization & Disorientation. Clinical Features. Interview
& Assessment. Stabilization. Common Psychotropic
Medications.PART 14. Review of General Pharmacology:1. Drugs Used
in the Field: Activated Charcoal. Aminophylline. Atropine Sulphate.
Bretylium Tosylate. Calcium Preparations. 50% Dextrose Solution.
Diazepam. Dopamine. Epinepherine. Furosemide Lidocaine. Mannitol.
Morphine Sulphate. Naloxone. Nitronox. Norephedrine. Oxygen. Sodium
Bicarbonate. Syrup of Ipecac. Verapmil.2. Drugs Commonly Found in
the Home: Cardiovascular Medications. Respiratory Medications.
Diabetic Medications. Anticonvulsant. Gastrointestinal Medications.
Psychotropic Medications.PART 15. Multiple Injuries, Multiple
Casualties and Triage:1. Assessment, Triage & Treatment of the
Multiply Injured Patient.2. Multiple Casualty Situations: Multiple
Victim Incident Planning & Scene Organization. Principles of
"Major" Incident Planning. Management Roles in "Major" Situations.
Receiving the call and Responding. Arrival at the Scene.
Establishing a Patient Collection Area. Establishing a Primary
Triage and Treatment Area. Casualty Sorting. Information Gathering
& Record Keeping. Priorities of Evacuation. General Guidelines
for Behavior in Mass Casualty Situations. The Recovery Phase. The
Importance of Post Incident Counseling.PART 16. Management of
EMS/Pre-Hospital Care Systems:1. Basic Considerations of
Management.2. Underlying Principles of Organization & the
Decision Process.3. Management by Objectives.4. The Philosophy of
Management.5. Rank Structure.6. Functions of Management & the
Management System.7. Organization of Physical Facilities, Vehicles
& Equipment.8. Communications.9. Reports & Statistics.10.
Policies & Procedures.11. Disciplinary & Grievance
Procedures.12. Financial Control & Budgeting.13. Overall
Administrative Control.MINIMUM REQUIREMENTS: Nine hundred and sixty
hours post "EMT (A)" appropriate Emergency Medical Services
experience to include emergency response duties. Submission of log
of experience gained. Successful completion of selection interview
/ examinations.
EVALUATION: One Hundred and Fifty Question Multiple Choice
Paper. One Hour Enumeration & Short Answer Paper - Fifty
Questions. Case Study Question Paper - Ten Cases. Two Hour Essay
Paper. One Hour Practical Skills Test. Forty Five Minute (minimum)
Oral Examination given by Duly Appointed Panel.The Star of Life -
the universal symbol for EMS or Emergency Medical Services.
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