Sub-Section 3-490-48 - Paramedic Academy Clinical Requirements

CMH EMS Education Manual


Definitions

Clinical experience is defined as a planned and scheduled educational student experience with live patient contact activities in settings, such as hospitals, clinics, free-standing emergency centers, and may include field experience.

Field experience is defined as planned and scheduled educational student time spent on an EMS unit, which may include observation and skill development, but which does not include team leading and does not contribute to the CoAEMSP definition of field internship.

Field internship is defined as planned and scheduled educational student time on an ALS EMS unit responsible for responding to critical and emergent patients who access the emergency medical system to develop and evaluate team leading skills. The primary purpose of field internship is a capstone experience managing the Paramedic-level decision-making associated with prehospital patients.

Eligibility

To be eligible to attend clinical rotations, the student must maintain passing status (min 70% overall grade) in the Paramedic Academy. Urine drug screen may be required prior to starting clinicals. CMH Lab will be used for these drug screens. Administrative contact for CMH Lab is Paulette Ivey.

Staff Substitutions

At no time may a paramedic student be substituted for EMT or paramedic staff. If the paramedic student is also an employee of the clinical site:

When functioning as a paramedic student: When functioning as staff:
  • Must wear student uniform.
  • Must NOT perform normal work duties that are outside the scope of the clinical objectives.
  • Must NOT wear student uniform.
  • Must NOT perform clinical student activities outside the scope of employed job description.

General Requirements

Students are required to participate and be eligible to participate at all clinical sites without exception. Students must also comply with the facilities’ policies and procedures. CMH is not obligated to locate an additional clinical site to accommodate a student for any reason.

Courses with a clinical component require mastery of the clinical objectives in order to successfully complete the course. The clinical component of any course is an integral portion of that course. Clinical experiences are graded on a pass/fail basis. If a student fails in clinical, he or she will fail the course. Students will be sent home from the clinical setting for unsafe or unprofessional behavior and may be grounds from dismissal from the course.

Inability to Encounter Live Patients

If the minimum number of patient contacts and skills listed for each clinical requirement is not completed by the end of the minimum hours required, additional hours must be scheduled to meet the contact requirements.

In the event a student is unable to obtain the minimum number of live patient encounters or skill competence, he or she should request in writing for an evaluation and alternative action plan. The deficiency will be evaluated on a case-by-case basis to develop an action plan that may include (but not limited to):

Scope

If, at any time during a clinical rotation, a student is asked to perform outside his/her scope of training, that student shall immediately tell the requestor that they are not trained for that procedure and are not allowed to do it.

Identification

All students will be required to wear a CMH-issued ID badge during all classroom, skills, and clinical rotations. The name badge shall be returned upon course completion (or having dropped the course). Students will assume replacement cost if their name badge is lost, mutilated, or destroyed. Replacement cost will be $10 each.

Documentation

Platinum Planner will be used to document and track skills, labs, scenarios, simulations, and clinical contacts. Documentation is the responsibility of the student. The patient medical record number must be documented with the skills performed. If the medical record number is not included, the patient encounter and skills associated will be returned to the student and will not count until the medical record number is attached. If, during spot checks and subsequent investigation, a falsification is found, disciplinary action will be taken and may include termination from the program.

When documenting live patient contacts and skills in Platinum Planner, the first line in the narrative must contain a medical record number trackable to the patient. This could be a hospital number off a face sheet or an EMS run number. Spot checks will be done to ensure accurate documentation.

Clinical Double-Dipping Policy

When documenting skills, you may document as many skills on the same patient as you actually perform (i.e. medication administration), however, patient assessments may only be documented once per patient per patient visit. If you assess the same patient on different shifts, both assessments may be counted. If the patient leaves and returns for a second visit (or calls 911 a second time while riding the ambulance), both assessments and both team leads (if applicable) may be documented.

Clinical Skill Requirements

The table below meets or exceeds CoAEMSP Appendix G requirements. Asterisks (*) with a red background in the table indicate a minimum success rate is also required. Only successful attempts are counted toward your minimum requirements, however, all attempts should be documented regardless if they are successful or not.

Double-asterisks (**) with a green background in the table indicate these requirements are typically extremely difficult to obtain on live humans. Special high-fidelity simulations will be scheduled during lab time to obtain these skills.

Minimum Number of Successful Attempts:

Skill Individual Live Skill
Preceptor Evaluator
Live Skill in Clinical or Field Experience
Preceptor Evaluator
Live Skill in Field Internship
Preceptor Evaluator
Abnormal Delivery with Newborn Care 4 **
Airway Management 25
ALS Team Leads 30 *
Assessment of Adolescents 2
Basic - 12-Lead ECG Placement 4
Basic - Inhaled Medication Administration 2
Comprehensive Normal Physical Assessment - Pediatric 2
CPAP and PEEP 2
Defibrillation 10 **
Direct Orotracheal Intubation - Adult 12 *
Direct Orotracheal Intubation - Pediatric 12 **
Intramuscular Medication Administration 3
Intravenous Therapy 20 * 30
Intraosseous Infusion 2 **
IV Medication Administration 2 30
Medical Including Cardiac Physical Assessment 40 10
Needle Cricothyrotomy 2 **
Neonatal Resuscitation Beyond Routine Newborn Care 4 **
Normal Delivery with Newborn Care 2
2 **
Obtain a Patient History from an Alert and Oriented Patient 8
Pathology - Any - Pediatric - Adolescent (12-18 yr) 2
Pathology - Any - Pediatric - Infant (1-12 mo) 2
Pathology - Any - Pediatric - Neonate (1-28 dy) 2
Pathology - Any - Pediatric - Newborn (1-24 hr) 2
Pathology - Any - Pediatric - Preschooler (3-6 yr) 2
Pathology - Any - Pediatric - School-Ager (6-12 yr) 2
Pathology - Any - Pediatric - Toddler (1-3 yr) 2
Pathology - Medical - Abdominal Pain 2
Pathology - Medical - Acute Coronary Syndrome 2
Pathology - Medical - Altered Mental Status 10
Pathology - Medical - Any - Adult (18-64 yr) 36
Pathology - Medical - Any - Geriatric (>63 yr) 12
Pathology - Medical - Any- Pediatric (<18 yr) 18
Pathology - Medical - Cardiac Dysrhythmia 5
Pathology - Medical - Chest Pain 15
Pathology - Medical - Hypoglycemia 2
Pathology - Medical - Psychiatric 6
Pathology - Medical - Respiratory Distress - Adult 10
Pathology - Medical - Respiratory Distress - Pediatric 5
Pathology - Medical - Sepsis 5
Pathology - Medical - Shock 2
Pathology - Medical - Stroke 2
Pathology - Medical - Toxicological Event 2
Pleural Decompression 2 **
Synchronized Cardioversion 10 **
Subcutaneous Medication Administration 1
Supraglottic Airway Device - Adult 12 **
Transcutaneous Pacing 10 **
Trauma Endotracheal Intubation - Adult 2 **
Trauma Physical Assessment - Geriatric 6
Trauma Physical Assessment - Adult 6 18
Trauma Physical Assessment - Pediatric 6
Ventilate via BVM 10

Change Log:

DateLink to
previous
version
Description of change
10/31/20Moved online.
01/04/21pdfMoved skills from lab to clinical and will schedule special high-fidelity simulations to meet these needs.

Return to Education Manual Table of Contents.

Search education manual:


CMH EMS Education Mission: "Provide state-of-the-art education to develop and support a team of exceptional emergency medical professionals."
Creative Commons License CMH EMS Education Manual by Theron Becker is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at http://ozarksems.com/edman-4-240.php.

OzarksEMS.com Main page.