COWLEY COLLEGE & Area Vocational Technical School

Transcription

1 COWLEY COLLEGE & Area Vocational Technical School COURSE PROCEDURE FOR Student Level: This course is open to students on the college level in either the freshman or sophomore year. Catalog Description: EMS5682 Paramedic 2 (12 hrs) This course provides students with an understanding of electrocardiography, cardiology, and resuscitation. Students also gain a functional knowledge of the principles, concepts, pathophysiology and treatment modalities for medical and trauma emergencies commonly encountered by the paramedic, as well as an understanding of EMS operations, MCIs, and other pertinent topics. The student will develop competencies in interpreting and treating ECG rhythms, localizing myocardial infarction sites, and advanced patient resuscitation. Students will gain the ability to assess and manage patients with medical and/or trauma emergencies, and will develop competencies in EMS operations. Prerequisites: EMS5681 Paramedic 1 Paramedic 2 EMS Credit Hours Controlling Purpose: This course provides students with an understanding of electrocardiography, cardiology, and resuscitation. Students also gain a functional knowledge of the principles, concepts, pathophysiology and treatment modalities for medical and trauma emergencies commonly encountered by the paramedic, as well as an understanding of EMS operations, MCIs, and other pertinent topics. Learner Outcomes: The student will develop competencies in interpreting and treating ECG rhythms, localizing myocardial infarction sites, and advanced patient resuscitation. Students will gain the ability to assess and manage patients with medical and/or trauma emergencies, and will develop competencies in EMS operations. Units Outcomes and Criterion Based Evaluation Key for Core Content: The following defines the minimum core content not including the final examination period. Instructors may add other content as time allows. Evaluation Key: A = All major and minor goals have been achieved and the achievement level is considerably above the minimum required for doing more advanced work in the same field. B = All major goals have been achieved, but the student has failed to achieve some of the 1

2 less important goals. However, the student has progressed to the point where the goals of work at the next level can be easily achieved. C = All major goals have been achieved, but many of the minor goals have not been achieved. In this grade range, the minimum level of proficiency represents a person who has achieved the major goals to the minimum amount of preparation necessary for taking more advanced work in the same field, but without any major handicap of inadequacy in his background. D = A few of the major goals have been achieved, but the student s achievement is so limited that he is not well prepared to work at a more advanced level in the same field. F = Failing, will be computed in GPA and hours attempted. N = No instruction or training in this area. Specific Competencies to be Developed Unit 1: Cardiac Anatomy and Physiology Unit Objective: At the completion of this unit, the paramedic student will understand the anatomy and physiology of the cardiovascular system and be able to perform a complete field assessment in order to identify pathophysiological occurrences. A B C D F N Describe the incidence, morbidity and mortality of cardiovascular disease. Discuss prevention strategies that may reduce the morbidity and mortality of cardiovascular disease. Identify the risk factors most predisposing to coronary artery disease. Describe the anatomy of the heart, including the position in the thoracic cavity, layers of the heart, chambers of the heart, and location and function of cardiac valves. Identify the major structures of the vascular system. Identify the factors affecting venous return. Identify and define the components of cardiac output. Identify phases of the cardiac cycle. Identify the arterial blood supply to any given area of the myocardium. Compare and contrast the coronary arterial distribution to the major portions of the cardiac conduction system. Identify the structure and course of all divisions and subdivisions of the cardiac conduction system. Identify and describe how the heart's pacemaking control, rate, and rhythm are determined. Explain the physiological basis of conduction delay in the AV node. Define the functional properties of cardiac muscle. 2

3 Define the events comprising electrical potential. List the most important ions involved in myocardial action potential and their primary function in this process. Describe the events involved in the steps from excitation to contraction of cardiac muscle fibers. Describe the clinical significance of Starling's law. Identify the structures of the autonomic nervous system (ANS). Identify the effect of the ANS on heart rate, rhythm and contractility. Define and give examples of positive and negative inotropism, chronotropism and dromotropism. Discuss the pathophysiology of cardiac disease and injury. Identify and describe the details of inspection, auscultation and palpation specific to the cardiovascular system. Define pulse deficit, pulsus paradoxus and pulsus alternans. Identify the normal characteristics of the point of maximal impulse (PMI). Identify and define the heart sounds. Relate heart sounds to hemodynamic events in the cardiac cycle. Describe the differences between normal and abnormal heart sounds. Identify and describe the components of the focused history as it relates to the patient with cardiovascular compromise. Unit 2: Introduction to the ECG Unit Objective: At the completion of this unit, the paramedic student will be able to explain the purpose of ECG monitoring while identifying wave forms and correlating the electrophysiological and hemodynamic events occurring throughout the cardiac cycle. A B C D F N Explain the purpose of ECG monitoring. Describe how ECG wave forms are produced. Use the ECG graph to identify and measure wave forms. Measure time and plot out wave forms and complexes. Correlate the electrophysiological and hemodynamic events occurring throughout the entire cardiac cycle with the various ECG wave forms, segments and intervals. Identify how heart rates, durations, and amplitudes may be determined from ECG recordings. Relate the cardiac surfaces or areas represented by the ECG leads. Determine heart rate and rhythm. Begin a systematic approach to ECG rhythm analysis 3

4 Given an ECG, identify the arrhythmia. Identify the limitations to the ECG. Differentiate among the primary mechanisms responsible for producing cardiac arrhythmias. Describe a systematic approach to the analysis and interpretation of cardiac arrhythmias. Identify the major classifications of pediatric cardiac rhythms. Identify the ECG changes characteristically produced by electrolyte imbalances and specify the clinical implications. Identify patient situations where ECG rhythm analysis is indicated. Value and defend the urgency in rapid determination of and rapid intervention of patients in cardiac arrest. Value and defend the possibility of termination of resuscitative efforts in the out-ofhospital setting. Demonstrate how to set and adjust the ECG monitor settings to varying patient situations. Demonstrate a working knowledge of various ECG lead systems. Demonstrate how to record an ECG. Defend patient situations where ECG rhythm analysis is indicated. Unit 3: ECG Interpretation Unit Objective: At the completion of this unit, the paramedic student will be able to describe dysrhythmias and their origins while understanding the morbidity and mortality associated with myocardial conduction defects. A B C D F N Describe the arrhythmias originating in the sinus node, the AV junction, the atria, and the ventricles. Identify the ECG characteristics of the atrial mechanisms. Differentiate atrial from junctional ectopics. Recognize the change in direction of the P wave. Differentiate between sinus and junctional P waves Differentiate between ectopic and escape junctional mechanisms. Identify the causes for the junctional mechanisms. Describe the arrhythmias originating or sustained in the AV junction. Describe the abnormalities originating within the bundle branch system. Describe the process of differentiating wide QRS complex tachycardias. Recognize the pitfalls in the differentiation of wide QRS complex tachycardias. 4

5 Recognize AVNRT and AVRT. Recognize Wolff-Parkinson-White and Brugada syndromes. Describe the conditions of pulseless electrical activity. Describe the phenomena of reentry, aberration and accessory pathways. Describe the incidence, morbidity and mortality associated with myocardial conduction defects. Unit 4: Pacemakers Rhythms and External Pacing Unit Objective: At the completion of this unit, the paramedic student will understand artificial pacemakers being able to describe their risks, benefits and hazards. A B C D F N Identify the clinical indications for transcutaneous and permanent artificial cardiac pacing. Describe the components and the functions of a transcutaneous pacing system. Explain what each setting and indicator on a transcutaneous pacing system represents and how the settings may be adjusted. Describe the techniques of applying a transcutaneous pacing system. Describe the characteristics of an implanted pacemaking system. Describe artifacts that may cause confusion when evaluating the ECG of a patient with a pacemaker. Identify the chambers of the heart that are being paced. List the possible complications of pacing. List the causes and implications of pacemaker failure. Identify additional hazards that interfere with artificial pacemaker function. Recognize the complications of artificial pacemakers as evidenced on ECG. Value and defend the application of transcutaneous pacing system. Value and defend the urgency in identifying pacemaker malfunction. Set up and apply a transcutaneous pacing system. Unit 5: Lead Electrocardiogram Unit Objective: At the completion of this unit, the paramedic student will be able to recognize ECG findings that may evidence myocardial ischemia and correlate these findings to a reach a clinical interpretation. A B C D F N Identify the surfaces of the heart visualized by the 12, 15 and 18 leads. Identify the surfaces of the heart visualized by the right precordial leads. Describe methods to calculate the electrical axis. Recognize a significant abnormal axis deviation. Recognize the changes on the ECG that may reflect evidence of myocardial ischemia 5

6 and injury. Recognize the limitations of the ECG in reflecting evidence of myocardial ischemia and injury. Correlate abnormal ECG findings with clinical interpretation. Demonstrate the ability to correctly run a lead ECG. Defend the rationale for performing a lead ECG in the pre-hospital setting. Unit 6: Emergency Cardiac Care Unit Objective: At the completion of this unit, the paramedic student will identify cardiac dysrhythmias and demonstrate appropriate interventions for these dysrhythmias. A B C D F N Identify the major therapeutic objectives in the treatment of the patient with any arrhythmia. Identify the major mechanical, pharmacological and electrical therapeutic interventions. Describe the major mechanical, pharmacological and electrical therapeutic interventions. Based on field impressions, identify the need for rapid intervention for the patient in cardiovascular compromise. Define the terms defibrillation and synchronized cardioversion. Demonstrate satisfactory performance of psychomotor skills of basic and advanced life support techniques according to the current American Heart Association Standards and Guidelines, including: a. Cardiopulmonary resuscitation in out-of-hospital setting b. Defibrillation c. Synchronized cardioversion d. Transcutaneous pacing e. Valsalva maneuver f. Carotid sinus massage g. Precordial thump Demonstrate proper techniques for performing infant and child defibrillation and synchronized cardioversion. Unit 7: Pulmonary Unit Objective: At the completion of this unit, the paramedic student will be able to integrate pathophysiological principles and assessment findings to formulate a field impression and implement the treatment plan for the patient with respiratory problems. A B C D F N Discuss the epidemiology of pulmonary diseases and conditions. Identify and describe the function of the structures located in the upper and lower airway. 6

7 Discuss the physiology of ventilation and respiration. Identify common pathological events that affect the pulmonary system. Discuss abnormal assessment findings associated with pulmonary diseases and conditions. Compare various airway and ventilation techniques used in the management of pulmonary diseases. Review the pharmacological preparations that paramedics use for management of respiratory diseases and conditions. Review the pharmacological preparations used in managing patients with respiratory diseases that may be prescribed by physicians. Review the use of equipment used during the physical examination of patients with complaints associated with respiratory diseases and conditions. Identify the epidemiology, anatomy, physiology, pathophysiology, assessment findings, and management for the following respiratory diseases and conditions: a. Adult respiratory distress syndrome b. Bronchial asthma c. Chronic bronchitis d. Emphysema e. Pneumonia f. Pulmonary edema g. Pulmonary thromboembolism h. Neoplasms of the lung i. Upper respiratory infections j. Spontaneous pneumothorax k. Hyperventilation syndrome Recognize and value the assessment and treatment of patients with respiratory diseases. Indicate appreciation for the critical nature of accurate field impressions of patients with respiratory diseases and conditions. Demonstrate proper use of airway and ventilation devices. Conduct a history and patient assessment for patients with pulmonary diseases and conditions. Demonstrate the application of CPAP/BiPAP unit. Unit 8: Cardiology Unit Objective: At the completion of this unit, the paramedic student will be able to integrate pathophysiological principles and assessment findings to formulate a field impression and implement the treatment plan for the patient with cardiovascular disease. A B C D F N Describe the epidemiology, morbidity and mortality, and pathophysiology of angina pectoris. 7

8 List and describe the assessment parameters to be evaluated in a patient with angina pectoris. Identify what is meant by the OPQRST of chest pain assessment. List other clinical conditions that may mimic signs and symptoms of coronary artery disease and angina pectoris. Identify the ECG findings in patients with angina pectoris. Identify the paramedic responsibilities associated with management of the patient with angina pectoris. Based on the pathophysiology and clinical evaluation of the patient with chest pain, list the anticipated clinical problems according to their life-threatening potential. Describe the epidemiology, morbidity and mortality of myocardial infarction. List the mechanisms by which an MI may be produced by traumatic and nontraumatic events. Identify the primary hemodynamic changes produced in myocardial infarction. List and describe the assessment parameters to be evaluated in a patient with a suspected myocardial infarction. Identify the anticipated clinical presentation of a patient with a suspected acute myocardial infarction. Differentiate the characteristics of the pain/ discomfort occurring in angina pectoris and acute myocardial infarction. Identify the ECG changes characteristically seen during evolution of an acute myocardial infarction. Identify the most common complications of an acute myocardial infarction. List the characteristics of a patient eligible for thrombolytic therapy. Describe the "window of opportunity" as it pertains to reperfusion of a myocardial injury or infarction. Based on the pathophysiology and clinical evaluation of the patient with a suspected acute myocardial infarction, list the anticipated clinical problems according to their life-threatening potential. Specify the measures that may be taken to prevent or minimize complications in the patient suspected of myocardial infarction. Describe the most commonly used cardiac drugs in terms of therapeutic effect and dosages, routes of administration, side effects and toxic effects. Describe the epidemiology, morbidity and mortality of heart failure. Define the principle causes and terminology associated with heart failure. Identify the factors that may precipitate or aggravate heart failure. Describe the physiological effects of heart failure. 8

9 Define the term "acute pulmonary edema" and describe its relationship to left ventricular failure. Define preload, afterload and left ventricular end-diastolic pressure and relate each to the pathophysiology of heart failure. Differentiate between early and late signs and symptoms of left ventricular failure and those of right ventricular failure. Explain the clinical significance of paroxysmal nocturnal dyspnea. Explain the clinical significance of edema of the extremities and sacrum. List the interventions prescribed for the patient in acute congestive heart failure. Describe the most commonly used pharmacological agents in the management of congestive heart failure in terms of therapeutic effect, dosages, routes of administration, side effects and toxic effects. Define the term "cardiac tamponade". List the mechanisms by which cardiac tamponade may be produced by traumatic and non-traumatic events. Identify the limiting factor of pericardial anatomy that determines intrapericardiac pressure. Identify the clinical criteria specific to cardiac tamponade. Describe how to determine if pulsus paradoxus, pulsus alternans or electrical alternans is present. Identify the paramedic responsibilities associated with management of a patient with cardiac tamponade. Describe the incidence, morbidity and mortality of hypertensive emergencies. Define the term "hypertensive emergency". Identify the characteristics of the patient population at risk for developing a hypertensive emergency. Explain the essential pathophysiological defect of hypertension in terms of Starling's law of the heart. Identify the progressive vascular changes associate with sustained hypertension. Describe the clinical features of the patient in a hypertensive emergency. Rank the clinical problems of patients in hypertensive emergencies according to their sense of urgency. From the priority of clinical problems identified, state the management responsibilities for the patient with a hypertensive emergency. Identify the drugs of choice for hypertensive emergencies, rationale for use, clinical precautions and disadvantages of selected antihypertensive agents. Correlate abnormal findings with clinical interpretation of the patient with a hypertensive emergency. 9

10 Define the term "cardiogenic shock". Describe the major systemic effects of reduced tissue perfusion caused by cardiogenic shock. Explain the primary mechanisms by which the heart may compensate for a diminished cardiac output and describe their efficiency in cardiogenic shock. Differentiate progressive stages of cardiogenic shock. Identify the clinical criteria for cardiogenic shock. Describe the characteristics of patients most likely to develop cardiogenic shock. Describe the most commonly used pharmacological agents in the management of cardiogenic shock in terms of therapeutic effects, dosages, routes of administration, side effects and toxic effects. Correlate abnormal findings with clinical assessment of the patient in cardiogenic shock. Identify the paramedic responsibilities associated with management of a patient in cardiogenic shock. Describe the incidence, morbidity and mortality of vascular disorders. Describe the pathophysiology of vascular disorders. List the traumatic and non-traumatic causes of vascular disorders. Define the terms "aneurysm", "claudication" and "phlebitis". Identify the peripheral arteries most commonly affected by occlusive disease. Identify the major factors involved in the pathophysiology of aortic aneurysm. Recognize the usual order of signs and symptoms that develop following peripheral artery occlusion. Identify the clinical significance of claudication and presence of arterial bruits in a patient with peripheral vascular disorders. Describe the clinical significance of unequal arterial blood pressure readings in the arms. Recognize and describe the signs and symptoms of dissecting thoracic or abdominal aneurysm. Describe the significant elements of the patient history in a patient with vascular disease. Identify the hemodynamic effects of vascular disorders. Identify the complications of vascular disorders. Identify the paramedic's responsibilities associated with management of patients with vascular disorders. Develop, execute and evaluate a treatment plan based on the field impression for the patient with vascular disorders. 10

11 Differentiate between signs and symptoms of cardiac tamponade, hypertensive emergencies, cardiogenic shock, and cardiac arrest. Based on the pathophysiology and clinical evaluation of the patient with chest pain, characterize the clinical problems according to their life-threatening potential. Apply knowledge of the epidemiology of cardiovascular disease to develop prevention strategies. Integrate pathophysiological principles into the assessment of a patient with cardiovascular disease. Apply knowledge of the epidemiology of cardiovascular disease to develop prevention strategies. Integrate pathophysiological principles into the assessment of a patient with cardiovascular disease. Synthesize patient history, assessment findings and ECG analysis to form a field impression for the patient with cardiovascular disease. Integrate pathophysiological principles to the assessment of a patient in need of a pacemaker. Synthesize patient history, assessment findings and ECG analysis to form a field impression for the patient in need of a pacemaker. Develop, execute, and evaluate a treatment plan based on field impression for the patient in need of a pacemaker. Based on the pathophysiology and clinical evaluation of the patient with chest pain, characterize the clinical problems according to their life-threatening potential. Integrate pathophysiological principles to the assessment of a patient with chest pain. Synthesize patient history, assessment findings and ECG analysis to form a field impression for the patient with angina pectoris. Develop, execute and evaluate a treatment plan based on the field impression for the patient with chest pain. Integrate pathophysiological principles to the assessment of a patient with a suspected myocardial infarction. Synthesize patient history, assessment findings and ECG analysis to form a field impression for the patient with a suspected myocardial infarction. Develop, execute and evaluate a treatment plan based on the field impression for the suspected myocardial infarction patient. Integrate pathophysiological principles to the assessment of the patient with heart failure. Synthesize assessment findings and patient history information to form a field impression of the patient with heart failure. Develop, execute, and evaluate a treatment plan based on the field impression for 11

12 the heart failure patient. Integrate pathophysiological principles to the assessment of a patient with cardiac tamponade. Synthesize assessment findings and patient history information to form a field impression of the patient with cardiac tamponade. Develop, execute and evaluate a treatment plan based on the field impression for the patient with cardiac tamponade. Integrate pathophysiological principles to the assessment of the patient with a hypertensive emergency. Synthesize assessment findings and patient history information to form a field impression of the patient with a hypertensive emergency. Develop, execute and evaluate a treatment plan based on the field impression for the patient with a hypertensive emergency. Integrate pathophysiological principles to the assessment of the patient with cardiogenic shock. Synthesize assessment findings and patient history information to form a field impression of the patient with cardiogenic shock. Develop, execute, and evaluate a treatment plan based on the field impression for the patient with cardiogenic shock. Integrate pathophysiological principles to the assessment of a patient with vascular disorders. Synthesize assessment findings and patient history to form a field impression for the patient with vascular disorders. Integrate pathophysiological principles to the assessment and field management of a patient with chest pain. Value the sense of urgency for initial assessment and intervention in the patient with cardiac compromise. Value and defend the sense of urgency necessary to protect the window of opportunity for reperfusion in the patient with suspected myocardial infarction. Based on the pathophysiology and clinical evaluation of the patient with acute myocardial infarction, characterize the clinical problems according to their lifethreatening potential. Defend the measures that may be taken to prevent or minimize complications in the patient with a suspected myocardial infarction. Defend the urgency based on the severity of the patient s clinical problems in a hypertensive emergency. From the priority of clinical problems identified, state the management responsibilities for the patient with a hypertensive emergency. Based on the pathophysiology and clinical evaluation of the patient with vascular 12

13 disorders, characterize the clinical problems according to their life-threatening potential. Value and defend the sense of urgency in identifying peripheral vascular occlusion. Value and defend the sense of urgency in recognizing signs of aortic aneurysm. Perform, document and communicate a cardiovascular assessment. Given the model of a patient with signs and symptoms of heart failure, position the patient to afford comfort and relief. Demonstrate how to determine if pulsus paradoxus, pulsus alternans or electrical alternans is present. Complete a communication patch with medical direction and law enforcement used for termination of resuscitation efforts. Demonstrate how to evaluate major peripheral arterial pulses. Unit 9: Neurology Unit Objective: At the completion of this unit, the paramedic student will be able to integrate pathophysiological principles and assessment findings to formulate a field impression and implement the treatment plan for the patient with a neurological problem. A B C D F N Describe the incidence, morbidity and mortality of neurological emergencies. Identify the risk factors most predisposing to the nervous system. Discuss the anatomy and physiology of the organs and structures related to nervous system. Discuss the pathophysiology of non-traumatic neurologic emergencies. Discuss the assessment findings associated with non-traumatic neurologic emergencies. Identify the need for rapid intervention and the transport of the patient with nontraumatic emergencies. Discuss the management of non-traumatic neurological emergencies. Discuss the pathophysiology of coma and altered mental status. Discuss the assessment findings associated with coma and altered mental status. Discuss the management/ treatment plan of coma and altered mental status. Describe the epidemiology, including the morbidity/ mortality and prevention strategies, for seizures. Discuss the pathophysiology of seizures. Discuss the assessment findings associated with seizures. Define seizure. Describe and differentiate the major types of seizures. List the most common causes of seizures. 13

14 Describe the phases of a generalized seizure. Discuss the pathophysiology of syncope. Discuss the assessment findings associated with syncope. Discuss the management/ treatment plan of syncope. Discuss the pathophysiology of headache. Discuss the assessment findings associated with headache. Discuss the management/ treatment plan of headache. Describe the epidemiology, including the morbidity/ mortality and prevention strategies, for neoplasms. Discuss the pathophysiology of neoplasms. Describe the types of neoplasms. Discuss the assessment findings associated with neoplasms. Discuss the management/ treatment plan of neoplasms. Define neoplasms. Recognize the signs and symptoms related to neoplasms. Correlate abnormal assessment findings with clinical significance in the patient with neoplasms. Differentiate among the various treatment and pharmacological interventions used in the management of neoplasms. Integrate the pathophysiological principles and the assessment findings to formulate a field impression and implement a treatment plan for the patient with neoplasms. Describe the epidemiology, including the morbidity/ mortality and prevention strategies, for abscess. Discuss the pathophysiology of abscess. Discuss the assessment findings associated with abscess. Discuss the management/ treatment plan of abscess. Define abscess. Recognize the signs and symptoms related to abscess. Correlate abnormal assessment findings with clinical significance in the patient with abscess. Differentiate among the various treatment and pharmacological interventions used in the management of abscess. Integrate the pathophysiological principles and the assessment findings to formulate a field impression and implement a treatment plan for the patient with abscess. Describe the epidemiology, including the morbidity/ mortality and prevention 14

15 strategies, for stroke and intracranial hemorrhage. Discuss the pathophysiology of stroke and intracranial hemorrhage. Describe the types of stroke and intracranial hemorrhage. Discuss the assessment findings associated with stroke and intracranial hemorrhage. Discuss the management/ treatment plan of stroke and intracranial hemorrhage. Define stroke and intracranial hemorrhage. Recognize the signs and symptoms related to stroke and intracranial hemorrhage. Correlate abnormal assessment findings with clinical significance in the patient with stroke and intracranial hemorrhage. Differentiate among the various treatment and pharmacological interventions used in the management of stroke and intracranial hemorrhage. Integrate the pathophysiological principles and the assessment findings to formulate a field impression and implement a treatment plan for the patient with stroke and intracranial hemorrhage. Describe the epidemiology, including the morbidity/ mortality and prevention strategies, for transient ischemic attack. Discuss the pathophysiology of transient ischemic attack. Discuss the assessment findings associated with transient ischemic attack. Discuss the management/ treatment plan of transient ischemic attack. Define transient ischemic attack. Recognize the signs and symptoms related to transient ischemic attack. Correlate abnormal assessment findings with clinical significance in the patient with transient ischemic attack. Differentiate among the various treatment and pharmacological interventions used in the management of transient ischemic attack. Integrate the pathophysiological principles and the assessment findings to formulate a field impression and implement a treatment plan for the patient with transient ischemic attack. Describe the epidemiology, including the morbidity/ mortality and prevention strategies, for degenerative neurological diseases. Discuss the pathophysiology of degenerative neurological diseases. Discuss the assessment findings associated with degenerative neurological diseases. Discuss the management/ treatment plan of degenerative neurological diseases. Define the following: a. Muscular dystrophy 15

16 b. Multiple sclerosis c. Dystonia d. Parkinson s disease e. Trigeminal neuralgia f. Bell s palsy g. Amyotrophic lateral sclerosis h. Peripheral neuropathy i. Myoclonus j. Spina bifida k. Poliomyelitis Recognize the signs and symptoms related to degenerative neurological diseases. Correlate abnormal assessment findings with clinical significance in the patient with degenerative neurological diseases. Differentiate among the various treatment and pharmacological interventions used in the management of degenerative neurological diseases. Integrate the pathophysiological principles and the assessment findings to formulate a field impression and implement a treatment plan for the patient with degenerative neurological diseases. Integrate the pathophysiological principles of the patient with a neurological emergency. Differentiate between neurological emergencies based on assessment findings. Correlate abnormal assessment findings with the clinical significance in the patient with neurological complaints. Develop a patient management plan based on field impression in the patient with neurological emergencies. Characterize the feelings of a patient who regains consciousness among strangers. Formulate means of conveying empathy to patients whose ability to communicate is limited by their condition. Perform an appropriate assessment of a patient with coma or altered mental status. Perform a complete neurological examination as part of the comprehensive physical examination of a patient with coma or altered mental status. Appropriately manage a patient with coma or altered mental status, including the administration of oxygen, oral glucose, 50% dextrose and narcotic reversal agents. Perform an appropriate assessment of a patient with syncope. Appropriately manage a patient with syncope. Perform an appropriate assessment of a patient with seizures. Appropriately manage a patient with seizures, including the administration of diazepam or lorazepam. 16

17 Perform an appropriate assessment of a patient with stroke and intracranial hemorrhage or TIA. Appropriately manage a patient with stroke and intracranial hemorrhage or TIA. Demonstrate an appropriate assessment of a patient with a chief complaint of weakness. Unit 10: Endocrinology Unit Objective: At the completion of this unit, the paramedic student will be able to integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with an endocrine problem. A B C D F N Describe the incidence, morbidity and mortality of endocrinologic emergencies. Identify the risk factors most predisposing to endocrinologic disease. Discuss the anatomy and physiology of organs and structures related to endocrinologic diseases. Review the pathophysiology of endocrinologic emergencies. Discuss the general assessment findings associated with endocrinologic emergencies. Identify the need for rapid intervention of the patient with endocrinologic emergencies. Discuss the management of endocrinologic emergencies. Describe osmotic diuresis and its relationship to diabetes. Describe the pathophysiology of adult onset diabetes mellitus. Describe the pathophysiology of juvenile onset diabetes mellitus. Describe the effects of decreased levels of insulin on the body. Correlate abnormal findings in assessment with clinical significance in the patient with a diabetic emergency. Discuss the management of diabetic emergencies. Integrate the pathophysiological principles and the assessment findings to formulate a field impression and implement a treatment plan for the patient with a diabetic emergency. Differentiate between the pathophysiology of normal glucose metabolism and diabetic glucose metabolism. Describe the mechanism of ketone body formation and its relationship to ketoacidosis. Discuss the physiology of the excretion of potassium and ketone bodies by the kidneys. Describe the relationship of insulin to serum glucose levels. 17

18 Describe the effects of decreased levels of insulin on the body. Describe the effects of increased serum glucose levels on the body. Discuss the pathophysiology of hypoglycemia. Discuss the utilization of glycogen by the human body as it relates to the pathophysiology of hypoglycemia. Describe the actions of epinephrine as it relates to the pathophysiology of hypoglycemia. Recognize the signs and symptoms of the patient with hypoglycemia. Describe the compensatory mechanisms utilized by the body to promote homeostasis relative to hypoglycemia. Describe the management of a responsive hypoglycemic patient. Correlate abnormal findings in assessment with clinical significance in the patient with hypoglycemia. Discuss the management of the hypoglycemic patient. Integrate the pathophysiological principles and the assessment findings to formulate a field impression and implement a treatment plan for the patient with hypoglycemia. Discuss the pathophysiology of hyperglycemia. Recognize the signs and symptoms of the patient with hyperglycemia. Describe the management of hyperglycemia. Correlate abnormal findings in assessment with clinical significance in the patient with hyperglycemia. Discuss the management of the patient with hyperglycemia. Integrate the pathophysiological principles and the assessment findings to formulate a field impression and implement a treatment plan for the patient with hyperglycemia. Discuss the pathophysiology of nonketotic hyperosmolar coma. Recognize the signs and symptoms of the patient with nonketotic hyperosmolar coma. Describe the management of nonketotic hyperosmolar coma. Correlate abnormal findings in assessment with clinical significance in the patient with nonketotic hyperosmolar coma. Integrate the pathophysiological principles and the assessment findings to formulate a field impression and implement a treatment plan for the patient with nonketotic hyperosmolar coma. Discuss the management of the patient with hyperglycemia. Integrate the pathophysiological principles and the assessment findings to 18

19 formulate a field impression and implement a treatment plan for the patient with hyperglycemia. Discuss the pathophysiology of diabetic ketoacidosis. Recognize the signs and symptoms of the patient with diabetic ketoacidosis. Describe the management of diabetic ketoacidosis. Correlate abnormal findings in assessment with clinical significance in the patient with diabetic ketoacidosis. Discuss the management of the patient with diabetic ketoacidosis. Integrate the pathophysiological principles and the assessment findings to formulate a field impression and implement a treatment plan for the patient with diabetic ketoacidosis. Discuss the pathophysiology of thyrotoxicosis. Recognize signs and symptoms of the patient with thyrotoxicosis. Describe the management of thyrotoxicosis. Correlate abnormal findings in assessment with clinical significance in the patient with thyrotoxicosis. Discuss the management of the patient with thyrotoxicosis. Integrate the pathophysiological principles and the assessment findings to formulate a field impression and implement a treatment plan for the patient with thyrotoxicosis. Discuss the pathophysiology of myxedema. Recognize signs and symptoms of the patient with myxedema. Describe the management of myxedema. Correlate abnormal findings in assessment with clinical significance in the patient with myxedema. Discuss the management of the patient with myxedema. Integrate the pathophysiological principles and the assessment findings to formulate a field impression and implement a treatment plan for the patient with myxedema. Discuss the pathophysiology of Cushing's syndrome. Recognize signs and symptoms of the patient with Cushing's syndrome. Describe the management of Cushing's syndrome. Correlate abnormal findings in assessment with clinical significance in the patient with Cushing's syndrome. Discuss the management of the patient with Cushing s syndrome. Integrate the pathophysiological principles and the assessment findings to formulate a field impression and implement a treatment plan for the patient with 19

20 Cushing's syndrome. Discuss the pathophysiology of adrenal Insufficiency. Recognize signs and symptoms of the patient with adrenal insufficiency. Describe the management of adrenal insufficiency. Correlate abnormal findings in assessment with clinical significance in the patient with adrenal insufficiency. Discuss the management of the patient with adrenal insufficiency. Integrate the pathophysiological principles and the assessment findings to formulate a field impression and implement a treatment plan for the patient with adrenal insufficiency. Integrate the pathophysiological principles to the assessment of a patient with a endocrinological emergency. Differentiate between endocrine emergencies based on assessment and history. Correlate abnormal findings in the assessment with clinical significance in the patient with endocrinologic emergencies. Develop a patient management plan based on field impression in the patient with an endocrinologic emergency. Unit 11: Allergies and Anaphylaxis Unit Objective: At the completion of this unit, the paramedic student will be able to integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with an allergic or anaphylactic reaction. A B C D F N Define allergic reaction. Define anaphylaxis. Describe the incidence, morbidity and mortality of anaphylaxis. Identify the risk factors most predisposing to anaphylaxis. Discuss the anatomy and physiology of the organs and structures related to anaphylaxis. Describe the prevention of anaphylaxis and appropriate patient education. Discuss the pathophysiology of allergy and anaphylaxis. Describe the common methods of entry of substances into the body. Define natural and acquired immunity. Define antigens and antibodies. List common antigens most frequently associated with anaphylaxis. Discuss the formation of antibodies in the body. Describe physical manifestations in anaphylaxis. 20

21 Differentiate manifestations of an allergic reaction from anaphylaxis. Recognize the signs and symptoms related to anaphylaxis. Differentiate among the various treatment and pharmacological interventions used in the management of anaphylaxis. Integrate the pathophysiological principles of the patient with anaphylaxis. Correlate abnormal findings in assessment with the clinical significance in the patient with anaphylaxis. Develop a treatment plan based on field impression in the patient with allergic reaction and anaphylaxis. Unit 12: Gastroenterology Unit Objective: At the completion of this unit, the paramedic student will be able to integrate pathophysiological principles and assessment findings to formulate a field impression and implement the treatment plan for the patient with a gastroenterologic problem. A B C D F N Describe the incidence, morbidity and mortality of gastrointestinal emergencies. Identify the risk factors most predisposing to gastrointestinal emergencies. Discuss the anatomy and physiology of the organs and structures related to gastrointestinal diseases. Discuss the pathophysiology of inflammation and its relationship to acute abdominal pain. Define somatic pain as it relates to gastroenterology. Define visceral pain as it relates to gastroenterology. Define referred pain as it relates to gastroenterology. Differentiate between hemorrhagic and non-hemorrhagic abdominal pain. Discuss the signs and symptoms of local inflammation relative to acute abdominal pain. Discuss the signs and symptoms of peritoneal inflammation relative to acute abdominal pain. List the signs and symptoms of general inflammation relative to acute abdominal pain. Based on assessment findings, differentiate between local, peritoneal and general inflammation as they relate to acute abdominal pain. Describe the questioning technique and specific questions the paramedic should ask when gathering a focused history in a patient with abdominal pain. Describe the technique for performing a comprehensive physical examination on a patient complaining of abdominal pain. Define upper gastrointestinal bleeding. 21

22 Discuss the pathophysiology of upper gastrointestinal bleeding. Recognize the signs and symptoms related to upper gastrointestinal bleeding. Describe the management for upper gastrointestinal bleeding. Integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with upper GI bleeding. Define lower gastrointestinal bleeding. Discuss the pathophysiology of lower gastrointestinal bleeding. Recognize the signs and symptoms related to lower gastrointestinal bleeding. Describe the management for lower gastrointestinal bleeding. Integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with lower GI bleeding. Define acute gastroenteritis. Discuss the pathophysiology of acute gastroenteritis. Recognize the signs and symptoms related to acute gastroenteritis. Describe the management for acute gastroenteritis. Integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with acute gastroenteritis. Define colitis. Discuss the pathophysiology of colitis. Recognize the signs and symptoms related to colitis. Describe the management for colitis. Integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with colitis. Define gastroenteritis. Discuss the pathophysiology of gastroenteritis. Recognize the signs and symptoms related to gastroenteritis. Describe the management for gastroenteritis. Integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with gastroenteritis. Define diverticulitis. Discuss the pathophysiology of diverticulitis. Recognize the signs and symptoms related to diverticulitis. Describe the management for diverticulitis. Integrate pathophysiological principles and assessment findings to formulate a field 22

23 impression and implement a treatment plan for the patient with diverticulitis. Define appendicitis. Discuss the pathophysiology of appendicitis. Recognize the signs and symptoms related to appendicitis. Describe the management for appendicitis. Integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with appendicitis. Define peptic ulcer disease. Discuss the pathophysiology of peptic ulcer disease. Recognize the signs and symptoms related to peptic ulcer disease. Describe the management for peptic ulcer disease. Integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with peptic ulcer disease. Define bowel obstruction. Discuss the pathophysiology of bowel obstruction. Recognize the signs and symptoms related to bowel obstruction. Describe the management for bowel obstruction. Integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with bowel obstruction. Define Crohn s disease. Discuss the pathophysiology of Crohn s disease. Recognize the signs and symptoms related to Crohn s disease. Describe the management for Crohn s disease. Integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with Crohn s disease. Define pancreatitis. Discuss the pathophysiology of pancreatitis. Recognize the signs and symptoms related to pancreatitis. Describe the management for pancreatitis. Integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with pancreatitis. Define esophageal varices. Discuss the pathophysiology of esophageal varices. Recognize the signs and symptoms related to esophageal varices. Describe the management for esophageal varices. 23

24 Integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with esophageal varices. Define hemorrhoids. Discuss the pathophysiology of hemorrhoids. Recognize the signs and symptoms related to hemorrhoids. Describe the management for hemorrhoids. Integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with hemorrhoids. Define cholecystitis. Discuss the pathophysiology of cholecystitis. Recognize the signs and symptoms related to cholecystitis. Describe the management for cholecystitis. Integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with cholecystitis. Define acute hepatitis. Discuss the pathophysiology of acute hepatitis. Recognize the signs and symptoms related to acute hepatitis. Describe the management for acute hepatitis. Integrate pathophysiological principles and assessment findings to formulate a field impression and implement a treatment plan for the patient with acute hepatitis. Integrate pathophysiological principles of the patient with a gastrointestinal emergency. Differentiate between gastrointestinal emergencies based on assessment findings. Correlate abnormal findings in the assessment with the clinical significance in the patient with abdominal pain. Develop a patient management plan based on field impression in the patient with abdominal pain. Demonstrate insertion of a nasogastric tube. Demonstrate insertion of an orogastric tube. Unit 13: Renal/Urology Unit Objective: At the completion of this unit, the paramedic student will be able to integrate pathophysiological principles and the assessment findings to formulate a field impression and implement a treatment plan for the patient with a renal or urologic problem. A B C D F N Describe the incidence, morbidity, mortality, and risk factors predisposing to urological emergencies. Discuss the anatomy and physiology of the organs and structures related to 24