EMTP 1304 - Community Paramedicine

• Define community Paramedicine. 
• Describe the scope of practice for the community paramedic. 
• Discuss the history of community Paramedicine. 
• Describe the roles of the community paramedic, including bringing primary care to the home and acting as a navigator for the patient. 
• List the members of the health care team. 
• Describe the strategies used in building productive working relationships with the members of the health care team. 
• List the components that contribute to wellness and their importance in managing stress. 
• Identify the physiologic, physical, and psychological responses to stress. 
• Discuss reactions to expect from patients and how you can effectively work with patients exhibiting a range of behaviors. 
• Identify three stress management techniques.
• Identify the warning signs of burnout from stress. 
• Describe posttraumatic stress disorder (PTSD) and steps that can be taken to provide support for people at risk for PTSD.
• List various routes of disease transmission. 
• Describe the standard precautions that are used to prevent infection when treating patients. 
• Identify the steps to take for personal protection from airborne and blood borne pathogens. 
• Explain post-exposure management when exposed to patient blood or body fluids.
• Recognize the possibility of hostile situations due to behavioral emergencies and the steps to take to deal with them. 
• Describe how to safely lift and move a patient in the home environment. 
• Define professional boundaries and limits. 
• Describe why professional boundaries are vital to maintain in the patient-provider relationship. 
• Identify how professional boundaries protect both the patient and the community paramedic. 
• Summarize the challenges that may interfere with creating and maintaining professional boundaries. 
• Describe the warning signs that a professional boundary has been breached. 
• Identify the stages of a home visit. 
• Discuss the strategies used to ensure personal safety during each step of the home visit. 
• Identify the components of a personal safety plan. 
• Describe how to develop a personal safety plan. 
• Describe the enrollment visit, intake visit, follow-up home visit, and end-of-care visit, including the tasks performed by the community paramedic. 
• Describe the qualifications for a disenrollment visit. 
• Explain the factors that influence education of patients, including health literacy concerns. 
• Describe the various approaches to educating patients with chronic conditions. 
• Describe the role of payers in reimbursement for services. 
• Describe how to effectively communicate with payers, including their documentation requirements.
• Define ethics, and describe why the study of ethics is vital to community paramedics. 
• Describe the importance of understanding different worldviews, including naturalism, ethical theism, and postmodernism. 
• Explain traditional ethics theories: utilitarianism, consequentialism, deontology, relativism, and ethical reasoning. 
• Describe how ethical theories can be applied by community paramedics.
• Identify the steps for evaluating an ethical dilemma. 
• Explain the differences between public health, community health, and population health. 
• Describe the factors that affect the health of a community
• Identify current public health promotion initiatives in the United States, including Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention and the National Prevention Strategy. 
• Describe the activities of public health agencies at the federal, state, and local levels. Describe the role of the community paramedic in supporting public health initiatives.
• Define social determinants. 
• Identify common social determinants; include their impact on the overall health of the community and on patients. 
• Describe how social ecology identifies the correlation between the social aspects of the patient’s environment and overall health status.
• Describe how to identify environmental determinants of health. 
• Describe the role of documentation in developing a plan of care, monitoring patient progress, and helping to secure funding for programs. 
• Explain why culture is a broadly understood experience. 
• Describe how cultural beliefs may impact a person’s health and how the person accesses health care. 
• Define cultural competence, include why it is a critical skill set for community paramedics. 
• Describe how a community paramedic can learn and practice cultural competence. 
• Identify the risks of stereotyping and over-attribution.
• List the four dimensions of culture, include a description of each. 
• Describe how health care can be delivered with an awareness of cultural impacts. 
• Discuss how the community paramedic can tailor a style of interaction according to the needs of the audience to ensure effective communication. 
• Describe the purpose of a community health needs assessment. 
• Describe the purpose of a community map. 
• Explain how the statistics that populate a community map are collected. 
• Identify the purpose of a health care delivery system gap analysis. 
• Describe the purpose of a community resource capacity assessment. 
• Describe the role of outreach services in patient care. 
• Explain how the community paramedic builds a web of resources. 
• Describe how the community paramedic uses the community health needs assessment, the health care delivery system gap analysis, and the community resource capacity assessment in providing patient care.
• Describe the purpose of the patient needs assessment. 
• Explain why patient input is important to include in a patient needs assessment. 
• Identify the special considerations that can affect the needs of the patient. 
• Describe the discovery learning method. 
• Define pathophysiology and homeostasis, and describe how alterations in homeostasis can lead to disease. 
• Explain the structure of a cell and the general functions performed by different types of cells.
• Describe the implications of disruptions to fluid balance, water movement, and electrolyte balance. 
• Explain how the body’s buffering systems work to maintain acid−base balance and the consequences of acid−base imbalances. 
• Describe the processes of cell signaling and feedback, and explain how alterations in these processes cause disease. 
• List the types of tissues found in the body, and explain how they react to cell injury.
• Describe the components of the immune system. 
• List the types of inflammatory responses. 
• Describe the immune response. 
• Identify the subjective and objective components of a patient assessment in community paramedicine. 
• Identify the elements of a patient assessment in community paramedicine. 
• Describe the best practices of an effective patient interview. 
• Identify the elements of a thorough patient history in community paramedicine. 
• Describe the best practices of a comprehensive physical examination in community paramedicine. 
• Describe the four techniques of a physical examination-inspection, palpation, percussion, and auscultation-and explain how and when each technique is performed. 
• Explain the process of performing a general assessment. 
• Identify the vital signs that are assessed during the physical examination in community paramedicine. 
• Describe the system review approach to the physical examination used in community paramedicine. 
• Describe the assessment of the patient’s skin. 
• Describe the assessment of the patient’s head, eyes, ears, nose, and throat. 
• Explain the purpose of a complete blood count, including hemoglobin and hematocrit. 
• Identify the components and purpose of a basic metabolic profile, including concentrations of glucose, blood urea nitrogen, and creatinine; the electrolytes sodium, potassium, and chloride; and bicarbonate ion and carbon dioxide levels. 
• Explain the purpose of evaluating a serum lactate level. 
• Explain the purpose of evaluating a troponin level. 
• Explain the purpose of evaluating international normalized ratio values.
• Describe normal and abnormal findings in urine analysis.
• Explain the purpose of a stool guaiac test. 
• Explain the purpose of evaluating the hemoglobin A1C in a patient with diabetes.
• Explain the purpose of serum lipid profiles. 
• Describe the components of liver function tests. 
• Describe the components and purpose of venous blood gas analysis. 
• Describe the role of the plan of care in ensuring integrated care. 
• Describe the role of the plan of care in ensuring integrated care. 
• Explain who crafts the plan of care. 
• Describe how the plan of care is modified
• Describe the three types of intervention strategies in patient care. Explain how the Omaha system is used to create a plan of care. 
• Explain how the plan of care may be implemented by the community paramedic. 
• Define chronic disease.
• Describe the role of the community paramedic in promoting self-management in the patient. 
• Describe the monitoring, management, and education roles of the community paramedic for coronary artery disease.
• Describe the monitoring, management, and education roles of the community paramedic for congestive heart failure. 
• Describe the monitoring, management, and education roles of the community paramedic for hypertension. 
• Describe the monitoring, management, and education roles of the community paramedic for asthma. 
• Describe the monitoring, management, and education roles of the community paramedic for chronic obstructive pulmonary disease. 
• Describe the monitoring, management, and education roles of the community paramedic for chronic constipation.
• Describe the monitoring, management, and education roles of the community paramedic for chronic diarrhea. 
• Describe the monitoring, management, and education roles of the community paramedic for dysuria. 
• Describe the monitoring, management, and education roles of the community paramedic for kidney disease.
• Describe the evolution of the understanding and treatment of psychiatric disorders. 
• Explain the difference between psychiatric emergencies and chronic psychiatric disorders. 
• Identify the risk factors for violence toward others.
• Explain the strategies to employ when assessing a patient at risk of suicide. 
• Describe the tools to employ when assessing a patient at risk of substance abuse. 
• Identify the signs and symptoms of schizophrenia. 
• Describe the principal therapeutic interventions for schizophrenia.
• Identify the signs and symptoms of bipolar disorder. 
• Describe the principal therapeutic interventions for bipolar disorder. 
• Identify the signs and symptoms of depressive disorder. 
• Describe the principal therapeutic interventions for depressive disorder.
• Identify the signs and symptoms of anxiety disorder. 
• Describe the principal therapeutic interventions for anxiety disorder. 
• Describe the principles of patient- and family-centered care in the community paramedicine setting.
• Name the four types of developmental delays in children. 
• Describe common communication disorders in children. 
• Identify common motor and movement disorders in children. 
• Describe the signs and characteristics of autism spectrum disorder. 
• Describe the signs and characteristics of Down syndrome. 
• Describe the general strategies for the community paramedic in communicating with children with special health care needs, including using people-first language. Identify specific strategies for communicating with children with communication disorders. 
• Identify specific strategies for communicating with children with autism spectrum disorder. 
• Identify specific strategies for communicating with children with Down syndrome.
• Identify specific strategies for communicating with children with physical and physiologic barriers to communication
• Describe the types of technologies that may be used in providing in-home care for children with special health needs. 
• Describe the normal aging process.
• Identify the topics to cover when taking the history of a geriatric patient, including use and abuse of medications and other substances. 
• Explain how to conduct a physical examination of a geriatric patient. 
• Identify the “five I’s of geriatrics,” which contribute to abnormal findings in the assessment of older patients. 
• Describe mental health disorders, including delirium, dementia, and depression, in geriatric patients.
• Explain trauma-related findings in geriatric patients.
• Identify the potential signs of elder abuse. 
• Describe common complaints among older patients, including shortness of breath; abdominal pain; dizziness and vertigo; fever; generalized pain; and nausea, vomiting, and diarrhea. 
• Compare the differences and similarities between palliative care, curative care, and hospice care. 
• List the five stages of the grieving process as developed by Elisabeth Kübler-Ross.
• Describe the strategies the community paramedic may employ in assisting a patient with a terminal illness. 
• Describe the strategies the community paramedic may employ in assisting the family members of a patient with a terminal illness
• Explain how to interact across multiple cultural and religious customs while caring for a patient in hospice care. 
• Explain how the incident command structure can provide a familiar framework in organizing the potential resources that may be used in hospice care. 
• Describe how advance directives, do not resuscitate (DNR) orders, and physician orders for life-sustaining treatment (POLST) may be used to preserve patient autonomy. 
• Explain the importance in knowing and understanding the laws surrounding end-of-life issues in the state of practice. 
• Explain the need for nutrition in health.
• List the five food groups.
• Describe the nutritional components of food. 
• Describe the components of a well-balanced diet for a healthy adult.
• Describe how a nutritional assessment is performed. 
• Explain how a community paramedic can help the patient to implement a food plan written by a nutritionist. 
• Explain how to prepare and store food safely. 
• Describe the nutritional needs of older adults.
• Describe the nutritional requirements of patients with chronic diseases, such as diabetes, chronic obstructive pulmonary disease, heart failure, and mental illness. 
• Describe the components of a special diet. 
• List strategies to help a patient maintain a special diet. 
• Describe the community paramedic’s role in medication inventory and compliance.
• Identify the categories of medications used for managing diabetes. 
• Describe the potential side effects of the medications used for managing diabetes.
• Identify categories of medications used for managing inflammatory bowel disease. 
• Describe the potential side effects of the medications used for managing inflammatory bowel disease.
• Identify the categories of medications used for managing cardiovascular disorders, including hypertension, congestive heart failure, coagulation disorders, and elevated cholesterol. 
• Describe the basic function of the immune system. Identify the types of vaccines and how they provide immunity
• Explain how the community paramedic may assist in implanting an immunization schedule. 
• Identify contraindications and precautions to vaccinations
• Identify special populations and the considerations to apply during immunization. 
• Describe how to conduct an immunization assessment. 
• Describe how to communicate the benefits and risks of vaccination.
• Describe how to administer vaccinations via intradermal, subcutaneous, intramuscular, Z-track, and oral routes.
• Describe the potential types of reactions to vaccines and the actions the community paramedic should take.
• Explain the proper storage and handling techniques for vaccines.
• Discuss the role of the community paramedic when vaccinating in patient-focused and population-focused settings. 
• Describe the potential side effects of the medications used for managing cardiovascular disorders. 
• Identify the categories of medications used for managing respiratory disorders, including chronic obstructive pulmonary disease and asthma. 
• Describe the potential side effects of the medications used for managing respiratory disorders.
• dentify the categories of medications used for managing psychiatric disorders, including depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder and schizophrenia.

• Students develop higher order thinking skills.
• Students demonstrate information literacy.

• Introduction to Community Paramedicine
• Personal Safety and wellness
• Professional Boundaries
• Interactions
• Ethics
• The Role of the Community Paramedic in Public Health
• Social Determinants of Health
• Cultural Competence
• Community Needs Assessment
• Patient Needs Assessment
• Pathophysiology
• Patient Assessment
• Lab Values
• Plan of Care
• Chronic Disease Management
• Mental Health
• Communication Strategies for Children With Special Needs
• Geriatrics
• Hospice and Palliative Care
• Nutrition
• Pharmacology
• Immunizations

Learning activities

• N/A

Assessments

Written Exams 

Grading guidelines 

• Written quizzes and unit exams will make up the total points for grading.