Appendix E

Appendix E - Document Samples

This section includes a format sample for the components referenced in the EMS Education Agenda for the Future document. The examples provided are samples for conceptual understanding only. The samples were created by the authors of the EMS Education Agenda for the Future using the 1990's revision of the respective EMS National Standard Curricula. They are designed to be illustrative, not restrictive. The authors for each of the actual component documents will alter the format as needs and methodology evolve.

To illustrate how one component of the EMS Education Agenda for the Future affects and relates to all the other components, the examples that are provided begin with the National EMS Core Content. The authors of the EMS Education Agenda for the Future have demonstrated a sample of what the adult pulmonary section of the National EMS Core Content document could look like. We have expanded the adult pulmonary section to include a level of detail that would be included throughout the document. Each section of the final document would follow the example of that model section. The adult pulmonary sections of the National EMS Scope of Practice Model and the National EMS Education Standards are also presented as samples to help illustrate what their formats and level of detail could look like.

Emergency Medical Services National EMS Core Content

Core Content Categories

PREPARATORY AND OPERATIONS
1 EMS Systems
2 The Roles and Responsibilities of the EMS Providers
3 The Well-Being of the EMS Provider
4 Illness and Injury Prevention
5 Medical / Legal Issues
6 Ethics
7 General Principles of Pathophysiology
8 Pharmacology
9 Venous Access and Medication Administration
10 Therapeutic Communications
11 Life Span Development
12 Ambulance Operations
13 Medical Incident Command
14 Rescue Awareness and Operations
15 Hazardous Materials Incidents
16 Crime Scene Awareness
17 Communications
18 Documentation
19 Airway Management and Ventilation
20 History Taking
21 Techniques of Physical Examination
22 Patient Assessment

TRAUMA
23 Trauma Systems
24 Mechanism of Injury
25 Hemorrhage and Shock
26 Soft Tissue Trauma
27 Burns
28 Head and Facial Trauma
29 Spinal Trauma
30 Thoracic Trauma
31 Abdominal Trauma
32 Musculoskeletal Trauma

MEDICAL
33 Pulmonary

33.1 Acute/ adult respiratory distress syndrome
33.2 Obstructive airway diseases
33.2.1 Asthma
33.2.2 Chronic bronchitis
33.2.3 Emphysema
33.3 Pneumonia
33.4 Pulmonary edema
33.5 Pulmonary thromboembolism
33.6 Neoplasms of the lung
33.7 Upper respiratory infection
33.8 Spontaneous pneumothorax
33.9 Hyperventilation syndrome

34 Cardiology
35 Neurology
36 Endocrinology
37 Allergies and Anaphylaxis
38 Gastroenterology
39 Renal/Urology
40 Toxicology
41 Hematology
42 Environmental Conditions
43 Infectious and Communicable Diseases
44 Behavioral and Psychiatric Disorders
45 Gynecology
46 Obstetrics
47 Neonatology
48 Pediatrics
49 Geriatrics
50 Abuse and Assault
51 Patients with Special Challenges
52 Acute Interventions for the Chronic Care Patient

National EMS Scope of Practice Model

Level A Respiratory arrest Respiratory distress	Mouth to mask ventilation
Level B Respiratory failure Exacerbated Chronic Obstructive Pulmonary Diseases Hyperventilation syndrome	Supplemental Oxygen Therapy Bag-Valve-Ventilation ATV Assisted Inhaled Beta Agonists
Level C Asthma Chronic bronchitis Emphysema	Administered Inhaled Beta Agonists Endotracheal intubation
Level D Acute/ adult respiratory distress syndrome Pneumonia Pulmonary edema Pulmonary thromboembolism Neoplasms of the lung Upper respiratory infection Spontaneous pneumothorax	Comprehensive emergency pharmacological management CPAP BiPAP

National EMS Education Standards

Level A

The entry level A provider must be able to recognize and provide immediate, life saving interventions for a patient with a respiratory emergency.

The entry level First Responder must be able to:
Identify and recognize and provide immediate, life saving interventions for the following respiratory emergencies:

a. Respiratory arrest
b. Respiratory distress

Recognize and value the assessment and treatment of patients with respiratory diseases.
Demonstrate safe, effective, and proper

a. Mouth to mask ventilation

Level B

The entry level B provider must be able to recognize and implement the treatment plan for the patient with a respiratory emergency.

The entry level B provider must be able to perform all the objectives of the A provider, plus:
Identify and describe the function of the structures located in the upper and lower airway.
Discuss the physiology of ventilation and respiration.
Discuss abnormal assessment findings associated with respiratory emergencies.
Review the use of equipment used during the physical examination of patients with respiratory emergencies.
Identify and implement a treatment plan for respiratory emergencies:

a. Respiratory failure
b. Exacerbated Chronic Obstructive Pulmonary Diseases
c. Hyperventilation syndrome

Recognize and value the assessment and treatment of patients with respiratory diseases.
Demonstrate safe, effective, and proper

a. Mouth to mask ventilation
b. Supplemental Oxygen Therapy
c. Bag-Valve-Ventilation
d. ATV
e. Assisted inhaled beta agonists

Safely assist patients in taking their own prescribed medication during a respiratory emergency.

Level C

The entry level C provider must be able to apply assessment findings and implement the treatment plan for the patient with respiratory emergencies.

The entry level C provider must be able to perform all of the objectives of a B provider, plus:
Identify and describe the function of the structures located in the upper and lower airway.
Discuss the physiology of ventilation and respiration.
Identify common pathological events that affect the pulmonary system.
Discuss abnormal assessment findings associated with respiratory emergencies.
Compare various airway and ventilation techniques used in the management of respiratory emergencies.
Review the use of equipment used during the physical examination of patients with complaints associated with respiratory diseases and conditions.
Identify the 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. 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 safe, effective, and proper

a. Mouth to mask ventilation
b. Supplemental Oxygen Therapy
c. Bag-Valve-Ventilation
d. ATV
e. Endotracheal intubation

Safely administer pharmacological agents used in the management of respiratory emergencies.

Level D

The entry level D provider must 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.

The entry level D provider must be able to perform all of the objectives of a level C provider, plus:
Identify and describe the function of the structures located in the upper and lower airway.
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 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

a. Mouth to mask ventilation
b. Supplemental Oxygen Therapy
c. Bag-Valve-Ventilation
d. ATV
e. Endotracheal intubation
f. CPAP
g. BiPAP

Safely administer pharmacological agents used in the management of respiratory patients.