I



Detailed Lesson Plan

Chapter 1

Emergency Medical Care Systems, Research,

and Public Health

100–120 minutes

|Chapter 1 objectives can be found in an accompanying folder. |

|These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines. |

|Minutes |Content Outline |Master Teaching Notes |

| |Introduction |Case Study Discussion |

|5 |During this lesson, students will learn about the roles and responsibilities of an EMT. |Why is it important for partners to work together as a team? |

| |Case Study |What factors might affect your response to the scene? |

| |Present The Dispatch, En Route, and Upon Arrival information from the chapter. |Why is personal safety so important? |

| |Discuss with students how they would proceed. | |

| |The Emergency Medical Services System—A Brief History |Critical Thinking Discussion |

|10 |In days when the local funeral home was the ambulance provider, patient care did not begin until arrival at the |What would happen without regulation and policy as part of an |

| |hospital. |EMS system? |

| |Wars have helped to show the importance of emergency care before and during transport. | |

| |The EMS system permits patient care from the time of injury or illness until rehabilitation or discharge. | |

| |Many significant developments have affected emergency medical services. | |

| |The Highway Safety Act of 1966 helped emergency medical technician programs evolve. | |

| |The Emergency Medical Services System Act of 1973 provided funding to EMS systems. | |

| |The American Heart Association began to teach CPR and basic life support to the public. | |

| |The National Registry of EMTs released the National Emergency Medical Services Education and Practice Blueprint in | |

| |1993. | |

| |The National Highway Traffic Safety Administration in 1996 published the EMS Agenda for the Future. This was | |

| |followed by The EMS Education Agenda for the Future: A Systems Approach. | |

| |The National Highway Traffic Safety Administration and Health Resources and Services Administration published the |Weblinks |

| |National EMS Core Content in 2005. |Go to |

| |The National Highway Traffic Safety Administration published The National EMS Scope of Practice Model in 2006. |and click on the mykit link for Prehospital Emergency Care, |

| |The Institute of Medicine published The Future of EMS Care: EMS at the Crossroads in 2006. |9th edition to access web resources on the National Registry |

| |The National Highway Traffic Safety Administration’s National EMS Education Standards outlined objectives for |of EMTs, National EMS Scope of Practice Model, the CDC Weekly |

| |entry-level EMS personnel. |Morbidity and Mortality Report, and the EMS Agenda for the |

| | |Future. |

| |The Emergency Medical Services System—Technical Assistance Program Assessment Standards (NHTSA) |Discussion Question |

|20 |Standards |How do people in your community access EMS? |

| |Regulation and Policy | |

| |Resource Management | |

| |Human Resources and Training | |

| |Transportation | |

| |Facilities | |

| |Communications | |

| |Public Information and Education | |

| |Medical Direction |Teaching Tip |

| |Trauma Systems |Play 911 recordings from your local agency and discuss them |

| |Evaluation |with students. Be careful that the recordings contain no |

| |Access to the EMS System—Using 911 |confidential information. |

| |911 is the universal phone number used to access emergency services such as police, fire, and EMS. | |

| |Enhanced 911 (E911) system provides automatic number identification (ANI) and automatic location identification |Class Activity |

| |(ALI). |Arrange a tour of a PSAP to see how calls are received and |

| |Benefits |dispatched. |

| |A public service answering point (PSAP) receives calls. A PSAP is generally staffed by trained communications | |

| |personnel and likely Emergency Medical Dispatchers (EMDs). |Knowledge Application |

| |Using 911 reduces the time it takes the caller to access the emergency services system. |Describe a vehicle collision scenario. Ask students how they |

| |Calling 911 on a cell phone may cause problems with caller location and possibly delay response. Some EMS systems |would access EMS and describe the location and situation. |

| |are now using global-positioning-satellite (GPS) technology. | |

| |Levels of Training—National Scope of Practice Model | |

| |Emergency Medical Responder (EMR) |Discussion Question |

| |Emergency Medical Technician (EMT) |What are the differences in the scopes of practice of EMRs, |

| |Advanced Emergency Medical Technician (AEMT) |EMTs, AEMTs, and paramedics? |

| |Paramedic | |

| |The Health Care System |Knowledge Application |

| |EMTs provide prehospital care—emergency medical treatment given to patients before they are transported to a |Describe a scenario where EMRs are on the scene first. Ask |

| |hospital or other facility. |students to describe: 1) what care they should expect the EMRs|

| |An EMT may be required to decide on the facility to which the patient must be transported. |to provide; 2) how they will interact with EMRs on the scene. |

| |Hospital emergency department | |

| |Trauma center |Discussion Question |

| |Burn center |What are the specialty medical care facilities in your area? |

| |Obstetrical center | |

| |Pediatric center |Class Activity |

| |Poison center |Tour an emergency department to familiarize students with the |

| |Stroke center |facility. |

| |Cardiac center | |

| |Hyperbaric center | |

| |Spine injury center | |

| |Psychiatric center | |

| |The EMT—Roles and Responsibilities | |

|8 |Personal Safety and the Safety of Others |Video Clip |

| |Ensure scene safety (downed power lines, chemical spills, and so on). |Go to |

| |Drive safely and wear seatbelt unless helping patient. |and click on the mykit link for Prehospital Emergency Care, |

| |Follow direction from police, fire, utility, and other expert personnel. |9th edition to access a video on EMS, the community, and |

| |Wear reflective and protective gear when necessary. |children. |

| |Patient Assessment and Emergency Care | |

| |Perform primary assessment to identify life-threatening problems. | |

| |Complete secondary assessment to treat other conditions or injuries you discover. | |

| |Safe Lifting and Moving | |

| |Transport and Transfer of Care |Critical Thinking Discussion |

| |Determine which facility will be most appropriate. |What factors should you consider when deciding which hospital |

| |Use communication equipment to notify/update facility. |to transport a patient to? |

| |Drive safely, and use lights and sirens as appropriate. | |

| |Report verbally and in writing to facility about injuries, care given, and patient response. | |

| |Provide assistance as needed at facility. | |

| |Record Keeping and Data Collection—Fill out prehospital care report | |

| |Patient Advocacy |Discussion Question |

| |Collect and safeguard a patient’s valuables. |What are some examples of patient advocacy? |

| |Shield the patient from bystanders and curious onlookers. | |

| |Inform patient’s friends and loved ones at the scene about the facility to which the patient is being transferred. | |

| |Provide necessary information to facility personnel. | |

| |Adhere to confidentiality rules. | |

| |The EMT—Professional Attributes |Teaching Tips |

|7 |Appearance |Have students close their books and describe the traits and |

| |Neat, clean appearance |attributes they feel are important to being excellent EMTs. |

| |Complete uniform or other appropriate dress |Explain the importance of getting to know classmates. Learning|

| |Knowledge and Skills |in the course depends on teamwork, and teamwork is an |

| |Completion of basic training program for EMT |important EMS competency. |

| |Use and maintenance of common emergency equipment | |

| |Assistance with the administration of medications |Class Activity |

| |Cleaning, disinfection, and sterilization of nondisposable equipment |Have pairs of students interview each other for ten minutes, |

| |Safety and security measures |and then have them introduce each other to the class. |

| |Territory and terrain | |

| |State and local traffic laws and ordinances |Teaching Tips |

| |Physical Demands |Assign groups of students to each of the characteristics |

| |Lift and carry up to 125 pounds |listed under Personal Traits. Give each group ten minutes to |

| |Good eyesight and color vision |come up with examples of their characteristic and explain the |

| |Communicate effectively both orally and in writing |consequences of having EMS providers without these traits. |

| |Good hearing |Explain your state’s requirements for maintaining |

| |Personal Traits |certification and licensure. |

| |Calm and reassuring personality | |

| |Leadership ability |Critical Thinking Discussion |

| |Good judgment |What are some ways you can ensure that your knowledge and |

| |Good moral character |skills are up-to-date? |

| |Stability and adaptability | |

| |Ability to listen | |

| |Resourcefulness and ability to improvise | |

| |Cooperativeness | |

| |Maintenance of Certification and Licensure | |

| |Meet necessary continuing education requirements. | |

| |Verify skill competency. | |

| |Avoid criminal or unethical behavior. | |

| |Submit all fees to maintain current certification and licensure. | |

| |The EMT—Medical Direction and Oversight |Teaching Tip |

|5 |An EMT is a designated agent of the medical direction of the EMS system. |Have the course medical director speak about his roles and |

| |The medical director provides medical oversight. |responsibilities in the EMS system. |

| |Found in every emergency medical service | |

| |Legally responsible for the clinical and patient care aspects of the EMS system |Discussion Question |

| |Oversees and provides continuing education |What are the differences between on-line and off-line medical |

| |Facilitates the quality improvement system |direction? |

| |Provides medical direction by establishing guidelines, or protocols | |

| |Off-line medical direction |Critical Thinking Discussion |

| |On-line medical direction |Why is medical direction a critical component of EMS? |

| |Standing orders | |

| |The EMT—Quality Improvement (QI or CQI) |Teaching Tip |

|5 |System of internal and external reviews and audits of all aspects of an emergency medical system |Describe the quality improvement process in your EMS system. |

| |Identifies aspects of the system that can be improved and implements plans and programs to remedy shortcomings | |

| |Should be used as a tool to improve overall system improvement, not to penalize individuals |Discussion Question |

| |EMT role in QC |What are ways EMTs can participate in EMS quality improvement |

| |Document carefully. |programs? |

| |Perform reviews and audits. | |

| |Obtain feedback. |Class Activity |

| |Maintain equipment. |Have groups of students develop a list of five to ten |

| |Participate in continuing education. |benchmarks for EMS system quality improvement. Have students |

| |Maintain skills. |determine how the benchmarks could be measured and present |

| | |their ideas to the class. |

| | | |

| | |Knowledge Application |

| | |List several areas of focus from your local quality |

| | |improvement program. Ask students to discuss how improvements |

| | |could be made in each area. |

| |The EMT—Issues in Patient Safety | |

|5 |Safety of care is one of most important issues | |

| |High-risk activities |Discussion Question |

| |Transfer of care |How can EMTs reduce risk of patient injury during high-risk |

| |Poor communication |EMS activities? |

| |Carrying and moving patients in a risky manner | |

| |Involvement in an ambulance crash | |

| |Lack of spinal immobilization or improper spinal immobilization procedure | |

| |Steps to prevent errors during patient care | |

| |Develop clear protocols. | |

| |Light the scene effectively. | |

| |Minimize interruptions during assessment and emergency care. | |

| |Clearly mark all drugs and packages so each is distinct. | |

| |Reflect on all actions. | |

| |Question all assumptions. | |

| |Use decision aids if necessary. | |

| |Ask for assistance if needed. | |

| |IX. Research and EMS Care |Teaching Tip |

|20 |Medical practice has evolved to evidence-based medicine. |Provide examples of peer-reviewed research articles. Students |

| |Evidence-based medicine focuses on clear evidence that procedures, medications, and equipment improve patient’s |can look at them during class breaks. |

| |outcome. | |

| |Evidence-based decision making |Discussion Questions |

| |Formulate a question about emergency care. |Why is it not always possible to apply emergency medicine |

| |Search medical literature for data related to the question. |research to prehospital care? |

| |Appraise the evidence for validity and reliability. |What are reliability and validity in research? |

| |Change protocol if evidence supports a change in practice. | |

| |Initiatives are underway to increase the amount of research conducted to support or change delivery of prehospital |Class Activity |

| |emergency care. |Have students read a short research article. Discuss the |

| | |applicability and limitations of the article. |

| | | |

| | |Critical Thinking Discussion |

| | |What are some reasons that research in EMS may be difficult? |

| | |What is the benefit of a peer-review process for research |

| | |articles? |

| | Public Health |Video Clip |

|20 |Identifies problems that affect the health of a particular population |Go to |

| |Reduces the incidence of injury and illness through preventative strategies |and click on the mykit link for Prehospital Emergency Care, |

| |Enforces laws and regulations that protect the health and safety of the public |9th edition to access a video on Healthy People 2010. |

| |Vision: “Healthy people in healthy communities” | |

| |Mission: “Promote physical and mental health and prevent disease, injury, and disability” |Teaching Tips |

| |Greatest public health achievements in the 20th century |Invite a guest speaker from the health department. |

| |Vaccinations |Arrange for students to assist at a health fair sometime |

| |Motor-vehicle safety |during the course. |

| |Workplace safety | |

| |Control of infectious disease |Discussion Question |

| |Reduction in deaths from coronary heart disease and stroke |What are some examples of prevention programs? |

| |Safer and more healthful foods | |

| |Decline in maternal and infant mortality |Class Activity |

| |Use of barrier devices during sexual contacts |Give groups of students ten minutes to identify a public |

| |Flouridation in drinking water |health problem in their community and develop ideas for |

| |Reduction in the use of tobacco products |addressing the problem. Have each group share their ideas with|

| |Roles of EMS in public health |the rest of the class. |

| |Health prevention and promotion | |

| |Disease surveillance |Knowledge Application |

| |Injury prevention and surveillance |Present a public health concern from the community to the |

| | |class. Ask for ideas about ways in which EMS could be involved|

| | |in prevention and education. |

| | | |

| | |Critical Thinking Discussion |

| | |If you could expand the role of EMTs, what would you add that |

| | |would contribute to public health? |

| |XI. Follow-Up |Case Study Follow-Up Discussion |

|10 |Answer student questions. |What roles and responsibilities of the EMT were demonstrated |

| |Case Study Follow-Up |in the case study? |

| |Review the case study from the beginning of the chapter. |What are some ways Mr. Robinson’s injuries could have been |

| |Remind students of some of the answers that were given to the discussion questions. |prevented? |

| |Ask students if they would respond the same way after discussing the chapter material. Follow up with questions to | |

| |determine why students would or would not change their answers. |Class Activity |

| |Follow-Up Assignments |Alternatively, assign each question to a group of students and|

| |Review Chapter 1 Summary. |give them several minutes to generate answers to present to |

| |Complete Chapter 1 In Review questions. |the rest of the class for discussion. |

| |Complete Chapter 1 Critical Thinking. | |

| |Assessments |Teaching Tips |

| |Handouts |Answers to In Review and Critical Thinking questions are in |

| |Chapter 1 quiz |the appendix to the Instructor’s Wraparound Edition. Advise |

| | |students to review the questions again as they study the |

| | |chapter. |

| | |The Instructor’s Resource Package contains handouts that |

| | |assess student learning and reinforce important information in|

| | |each chapter. This can be found under mykit at |

| | |. |

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MASTER TEACHING NOTES

• Case Study Discussion

• Teaching Tips

• Discussion Questions

• Class Activities

• Media Links

• Knowledge Application

• Critical Thinking Discussion

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