Description:

MICT I is the first of four courses in advanced out-of-hospital emergency medical care leading to the opportunity to sit for the National Registry Examination for Paramedics. In this narrowly focused but intense foundational course, the paramedic student will gain a significant knowledge of patient assessment, pharmacology and medication administration techniques, electrocardiography, advanced airway management, and paramedic scope of practice. Much material will be covered rapidly, and emphasis is on organization, internalization and synthesis of the basic knowledge of the discipline in this 9-week course. Additionally, during the initial psychomotor teaching labs, students will gain the ability to assess patients, administer medications, treat dysrhythmias and manage the airway through manikin practice. Enrollment in certain courses may require a professional liability fee of $16.00. Students will be notified via their JCCC student e-mail account if the fee is due and instructions on how to pay the fee.24 hrs. lecture/wk.

Associated Costs: These are additional (out-of-pocket) expense considerations that students should expect in addition to the course tuition, fees, and textbooks. $700 to $1,000.

Supplies: Refer to the instructor's course syllabus for details about any supplies that may be required.

Textbook(s): For information see - http://bookstore.jccc.net

Course Fees: NONE

Course Objectives:

Upon successful completion of this course the student should be able to:

1. (1) Understand the roles and responsibilities of a Paramedic within an EMS system, apply the basic concepts of development, pathophysiology and pharmacology to assessment and management of emergency patients, be able to properly administer medications, and communicate effectively with patients.
2. (1-1) Understand his or her roles and responsibilities within an EMS system, and how these roles and responsibilities differ from other levels of providers.
3. (1-2) Understand and value the importance of personal wellness in EMS and serve as a healthy role model for peers.
4. (1-3) Integrate the implementation of primary injury prevention activities as an effective way to reduce death, disabilities and health care costs.
5. (1-6) Apply the general concepts of pathophysiology for the assessment and management of emergency patients.
6. (1-7) Integrate pathophysiological principles of pharmacology and the assessment findings to formulate a field impression and implement a pharmacologic management plan.
7. (1-8) Safely and precisely access the venous circulation and administer medications.
8. (1-9) Integrate the principles of therapeutic communication to effectively communicate with any patient while providing care.
9. (1-10) Integrate the physiological, psychological, and sociological changes throughout human development with assessment and communication strategies for patients of all ages.
10. (2) Establish and/or maintain a patent airway, oxygenate, and ventilate a patient.
11. (3) Take a proper history and perform a comprehensive physical exam on any patient, and communicate the findings to others.
12. (3-1) Use the appropriate techniques to obtain a medical history from a patient.
13. (3-2) Explain the pathophysiological significance of physical exam findings.
14. (3-3) Integrate the principles of history taking and techniques of physical exam to perform a patient assessment.
15. (3-4) Apply a process of clinical decision making to use the assessment findings to help form a field impression.
16. (3-5) Follow an accepted format for dissemination of patient information in verbal form, either in person or over the radio.
17. (3-6) Effectively document the essential elements of patient assessment, care and transport.
18. (5-2) Integrate pathophysiological principles and assessment findings to formulate a field impression and implement the treatment plan for the patient with cardiovascular disease.

*( ) Indicates module-lesson in national standard curriculum

Content Outline & Competencies:

I. Preparatory
   A. Stress and the MICT
      1. List the physiological and psychological manifestations of
stress.
      2. List the common causes of job stress for the MICT, and activities
that could be utilized to reduce stress.
   B. EMS systems
      1. List the components of an EMS system, and outline various system
designs and funding methods.
      2. Define medical control, and differentiate between on-line and
off-line medical control.
      3. List the components of a quality improvement system.
   C. Role of the MICT
      1. When given a list of activities performed by all levels of
pre-hospital personnel, the student should be able to correctly identify
the activities performed exclusively by the MICT.
      2. Utilizing the concepts of restorative vs. supportive care, the
MICT should be able to contrast the roles of the MICT in each situation.

II. Anatomy and Physiology
   A. Acid/Base balance; fluids and electrolytes
      1. Identify normal pH and outline the function of the three
physiologic systems which maintain pH.
      2. Write a chemical equation that expresses the physiology of
acid/base balance.
      3. Given a set of blood gases identify what abnormality is
represented and list a common cause.
      4. Given a list of anions and cations, state which are chiefly
extracellular and which are intracellular.
      5. Explain the kidney's role in blood pressure maintenance, urine
formation, and acid/base regulation.
   B. Cardiovascular system
      1. Label anatomic features of the human heart and circulatory
system.
      2. Identify the normal physiological limits, components of, and
factors influencing: cardiac output, myocardial oxygen demand, stroke
volume, afterload, preload, blood pressure.
      3. Define Starling's law and state its implications for cardiac
output.
      4. Identify and define the phases of the cardiac cycle and the
function and position of the heart valves during each phase.
      5. Label the parts of the heart's conduction system and state the
intrinsic firing rate of each part.
      6. List the functions of blood, and define: hematocrit, hemoglobin,
universal donor, and universal recipient.
   C. Cellular physiology
      1. Identify the role of oxygen in cellular respiration and specify
the differences in resultant energy production when oxygen is absent.
      2. Identify the processes involved in the sodium pump and specify
any changes in cellular metabolism when the pump is inactive.
   D. Central and autonomic nervous systems
      1. Identify the autonomic neurotransmitters and their effects on the
body systems.
      2. List the processes of nerve impulse transmission.
      3. Label the anatomic parts and identify the function of the central
and peripheral nervous system.
      4. Identify the blood supply to the various regions of the brain,
and factors influencing cerebral blood flow.
   E. Musculoskeletal system
      1. Identify the sequence of events necessary for muscle
contraction.
      2. Describe the location of the major muscles.
      3. Describe the electrical phenomena, which result in neuromuscular
excitation.
   F. Respiratory system
      1. Given a diagram identify structures of the upper and lower
respiratory system.
      2. Write the primary stimulus for breathing and list five causes of
a change in respiratory rate.
      3. Identify the normal PaCO2 and PaO2, and given an increase or
decrease, name this condition and describe its effect on respiratory
activity and on blood pH.
      4. Given a PaO2, state the percent O2 saturation, and given a
percent O2 saturation, state the PaO2 using the oxygen hemoglobin
dissociation curve.
   G. Topographical anatomy
      1. Identify major topographic landmarks.
      2. Match definitions with terms denoting movement.
      3. Define anatomic terms that denote location with respect to a
reference point.

III. General Pharmacology, Patient Assessment and Communications
   A. EMS radio communications
      1. List and describe seven communication phases that occur in an EMS
event.
      2. List and describe EMS communications hardware.
      3. Describe the inherent differences in EMS communication radio
frequencies.
      4. Given a scenario, select the correct biocom format and content.
   B. General pharmacology
      1. Perform medication calculations.
      2. List those factors influencing the action of drugs, such as: age
of the patient, condition of the patient, dosage, absorption rate,
distribution, and elimination.
      3. Safely administer parenteral medications.
      4. Identify the trade name, class, actions, indications,
contraindications, precautions, side effects, and dosage for the
medications in the MICT formulary.
      5. List five routes by which drugs are absorbed, and rank absorption
rates from fastest to slowest.
   C. Medical records
      1. List the items that must be included in each part of a SOAP
narrative.
      2. After watching a videotaped scenario, complete a medical record
that conforms to SOAP format.
      3. Given a copy of a medical record, identify errors and omissions.
   D. Patient assessment
      1. Write the reasons for performing, and steps involved in initial,
focused, detailed, and on-going assessments.
      2. List the vital signs and their normal limits.
      3. Demonstrate a detailed physical examination.
      4. Effectively elicit a patient's medical history.
      5. Given a chief complaint, perform a differential diagnosis.

IV. Cardiology and Airway Management
   A. Cardiology
      1. Identify, state the relevant parameters, clinical significance,
treatment, and etiology for the major cardiac dysrhythmias and infarct
patterns.
      2. State the topographic anatomical location of all of the electrode
positions for a 12 lead ECG.
      3. Demonstrate the procedures for electrical therapies.
      4. Compare and contrast the signs/symptoms and field treatment for
angina, unstable angina, acute myocardial infarction, and cardiogenic
shock.
      5. Identify all ACLS and BCLS algorithms and explain the rationale
for treatments.
      6. Given a description of a patient, write the appropriate
treatment.
   B. CHF and pulmonary edema
      1. List the causes of signs/symptoms of compensatory mechanisms in
and events that can lead to decompensation in heart failure.
      2. Given a description of a patient in pulmonary edema, identify the
patient is in pulmonary edema, and initiate the appropriate treatment.
      3. List five etiologies for non-cardiogenic pulmonary edema and
differentiate between cardiogenic and non-cardiogenic pulmonary edema. 
   C. Techniques of airway management
      1. Given specific patient situations and illnesses, select the best
method of oxygen delivery.
      2. Given a list of situations describing patients with airway
maintenance problems, select those situations in which endotracheal
intubation is indicated.
      3. Given that a patient requires endotracheal intubation, list the
correct procedure to be followed, including all steps in the proper
sequence.
      4. Given a patient with an airway management problem, correctly
identify the most appropriate airway/ventilation interventions.

V. Psychomotor Skills
   A. Patient assessment/communications
      1. Write a patient report and deliver a biomedical communication
from a videotaped or simulated emergency call.
      2. Demonstrate initial assessment, focused assessment, detailed
assessment, and on-going assessment.
   B. Medication administration
      1. Perform subcutaneous and intramuscular injections, intravenous
cannulation and parenteral medication administration, and external jugular
vein catheterization.
      2. Demonstrate how to set up and administer an intravenous fluid
infusion including timing an IV drip rate.
      3. Calculate the dosage, prepare and administer IV piggyback
medications, preloaded medications, and medications drawn up from vials
and ampules.
   C. Electrical therapies
      1. Demonstrate use of all controls on various portable heart
monitor/defibrillators.
      2. Choose appropriate energy setting, charge defibrillator, and
cardiovert using paddles, fast patch, and quick combo systems.
   D. Airway management
      1. Correctly perform the following skills according to task
analysis: bag valve mask, metered dose inhaler, nonrebreather facemask,
and endotracheal intubation.
   E. Cardiac emergencies
      1. According to ACLS algorithms, manage simulated cardiac
emergencies including patient assessment, airway, electrical therapies,
and medication administration.

Methods of Evaluation of Competencies:

Evaluation of student mastery of course competencies will be accomplished using the following methods:

Cognitive - competency will be verified through 6 homework
assignments, 6 quizzes, and 3 module finals. Quizzes and module finals
will be blueprinted. Items will represent a variety of question types and
levels of taxonomy, each of which is tied to a course competency. The
module final exam must be passed before the student can proceed to the
next module

Grading Scale:
   Cognitive:
      94-100% = A
      86- 93% = B
      80- 85% = C - minimum passing score
      70- 80% = D
        < 70% = F

6 homework assignments  @ 80 points each
6 quizzes               @ 120 points each
3 module exams          @ 400 points each
Total didactic points =  2400

Caveats:

1. Students will have provided proof of health conducive to being in a health care environment. In addition, drug screening and other requirements may be imposed by clinical agencies. Students are responsible for any and all costs related to their health care or other imposed requirements. Students will also need to provide their own transportation to and from scheduled clinical activities. They will also need to be dressed and prepared appropriately as outlined in the MICT Student Manual dress policy.
2. Students entering the health programs should be aware that they will be in contact with other individuals having a variety of health problems in which etiology (cause) may or may not be known. This exposure places health program students in the "high risk" category for health problems. Programs have specific precautionary requirements based on the type of exposure and/or clinical agency policies. It is the responsibility of each student to follow the program guidelines for necessary precautions against contracting and transmitting disease. Students experiencing any injury or health risk (including blood borne or airborne exposure to disease) must report it immediately to the assigned instructor and seek necessary medical treatment.
3. Transportation to and from clinical/field agencies is the responsibility of the student; thus access to a dependable automobile is a necessity. Communication from and to program faculty and field/clinical preceptors in a timely manner is essential and therefore the student must maintain a working home telephone as well as carry a pager at all times, and maintain an email account which he/she checks regularly.
4. Students are expected to comply with the JCCC Student Code of Conduct as detailed in the JCCC College Catalog. Failure to comply may result in a faculty decision regarding program promotion and constitute a reason to fail the course.
5. Students are expected to comply with the attendance and other program policies described in the MICT Student Manual.
6. A grade of "C" or better is required for the course and promotion to MICT II.
7. "During the course of the paramedic program (MICT I, II, III, IV) there are various fees required from year to year in addition to tuition. The fees include items such as textbooks, uniforms, specialty classes, pagers, state and national exams, and other miscellaneous costs. These fees average about $1,500 for the entire program. As the actual amounts are subject to change they are listed in the Course Syllabus for each academic year."

Disabilities:

If you are a student with a disability, and if you will be requesting accommodations, it is your responsibility to contact Access Services. Access Services will recommend any appropriate accommodations to your professor and his/her director. The professor and director will identify for you which accommodations will be arranged.

JCCC provides a range of services to allow persons with disabilities to participate in educational programs and activities. If you desire support services, contact the office of Access Services for Students With Disabilities (913) 469-8500, ext. 3521 or TDD (913) 469-3885. The Access Services office is located in the Success Center on the second floor of the Student Center.