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fractures and reduces selected dislocations. Delivers newborn. Provides pre-hospital emergency care of simple
and multiple system trauma such as controlling hemorrhage, bandaging wounds, manually stabilizing painful,
swollen joints and injured extremities, and immobilizing spine.
Uses basic and advanced life support equipment to open airway and upper airway adjuncts, removes foreign
bodies, uses upper airway suction devices, performs orotracheal intubation, nasotracheal intubation, oral
intubation with pharmacological assistance and surgery on airway. Uses dual or single lumen airway devices.
Provides mouth to mouth barrier device ventilation, oxygen administration, chest injury management, bag-valve
mask resuscitation. Uses powered ventilation devices, hand held aerosol nebulizer. Performs cardio-pulmonary
resuscitation, uses automatic defibrillator apparatus in application of electric shock to heart, manages
amputation, uses anti-shock garment, conducts peripheral venous access, intraosseous infusion, manual
defibrillation, interprets EKGs and uses external pacemaker.
Administers medication (narcotics), determines the patient’s most appropriate body route based on patient
diagnosis. Calculates amount of medication to be given in relation to patient’s weight, age and other factors that
warrant adjustment of volume. Uses oral, auto-injection, sublingual, inhalation, subcutaneous, intramuscular,
intraosseous, transcutaneous, rectal, endotracheal, and intravenous routes including central and peripheral lines
and venesection as well as infusion pumps to administer medications.
Assists other EMS providers in lifting patient onto stretcher, places patient in ambulance, secures stretcher.
Continues to monitor patient enroute to the hospital.
Checks, maintains vehicles, and provides mechanical report. Restocks and replaces used supplies, uses
appropriate disinfecting procedures to clean equipment, checks all equipment to insure adequate working
condition for next response. Takes inventory of and accounts for all medications (narcotics) given. Keeps log of
all transactions. Prepares accurate and legible medical reports. Provides medical reports to staff.
Transports non-emergency patients to regularly scheduled appointments, for example, transport geriatric
patients in nursing homes. Uses computer to enter data for EMS reports.
Supervises the activities and educational experiences of assigned observers and students. Complies with
regulations in handling the deceased.
Functions as the primary direct care provider of emergency health care services to sick and injured patients in pre-
hospital settings. Works primarily in advanced life support units affiliated with fire departments, police
departments, rescue squads, hospitals, or private ambulance services under the off-site supervision of a physician,
usually through radio communication, is usually the senior level member of a two person team, working in
conjunction with a Basic EMT.
Accepts primary responsibility for all aspects of advanced life support given to the patient, including use of
advanced life support equipment and administration of medication that includes narcotics; responsible for
thorough written documentation of all activity related to patient care and medication dispensation. Successfully
completes continuing education and refresher courses required by employers, medical direction, and licensing or
certifying agencies. Meets qualifications within the functional job analysis.
-1999 NATIONAL STANDARD DOT EMT-PARAMEDIC CURRICULUM
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A.12 | PARAMEDIC PROGRAM TECHNICAL STANDARDS
As a student in the American/Backus Paramedic Program Consortium Paramedic Program, you should be aware
that certain physical and mental abilities are needed to successfully complete portions of your classroom, clinical
and field internship requirements. The following technical standards describe the physical and mental abilities
necessary to complete the Paramedic program and to practice as a Paramedic in the field.
A Paramedic student must possess the physical capability, mental capacity and sufficient strength and motor
coordination required to perform the following:
1. Lift, carry and balance a minimum of 125 lbs (250 with assistance) for the purpose of frequently lifting
patients and stretchers often over uneven ground and footing.
2. Demonstrate manual dexterity, good motor skills, eye-hand coordination skills, and sensory functions
using both upper and lower extremities. You must be able to perform these skills in confined spaces or
under time constraints as well.
3. See and hear in a manner sufficient to respond to emergencies and assess patients while working alone
often in an environment with loud noises and flashing lights and other distractions. This includes reading
and interpreting both fine print and signs at a distance and under time constraint.
4. Drive an ambulance or rescue unit under emergency conditions, as well as at night and in adverse
weather conditions.
5. Stand and walk for sustained periods of time.
6. Write and orally communicate under stressful conditions promptly and effectively.
7. Express or exchange ideas and interact with patients, peers, and other medical staff in
person, or via portable radio in a professional manner in English.
8. Work with frequent interruptions and respond appropriately to unexpected situations. Work throughout
an entire work shift with wide variations in workload and stress levels.
9. Cope with personal stresses (e.g. mood changes, loss of concentration) in a way that does not interfere
with performance.
10. Demonstrate appropriate judgment and decision-making skills under highly stressful situations.
Essential Functions and Standards for Successful Performance
To successfully complete the classroom and clinical components of the Paramedic program, the Paramedic
student must, either independently or with reasonable accommodation, be able to perform all of the following
essential functions within a limited time frame:
1. Speech: Establish interpersonal rapport and communicate verbally and in writing with clients,
physicians, peers, family members, and the health care team from a variety of social, emotional,
cultural, and intellectual backgrounds.
2. Hearing: Auditory acuity sufficient to respond to verbal instruction, perceive and interpret various
equipment signals, use the telephone, and hear faint body sounds.
3. Vision: Visual acuity sufficient to identify and distinguish colors, read handwritten orders and any
other handwritten or printed data such as medication records or scales, chart data, and provide for
the safety of clients' condition by clearly viewing monitors and other equipment in order to correctly
interpret data.
4. Mobility: Stand and/or walk eight-twelve hours daily in the clinical or field setting. Bend, squat, or
kneel. Assist in lifting or moving clients of all age groups and weights. Assist in lifting and transporting
the ambulance stretcher. Perform cardiopulmonary resuscitation (move around client to manually
compress chest and ventilate). Work with arms fully extended overhead. Work in non-climate
controlled environments.
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5. Manual Dexterity: Demonstrate eye/hand coordination sufficient to manipulate equipment (syringes,
infusion pumps, EKG machines, etc.).
6. Fine Motor Ability: Ability to use hands for grasping, pushing, pulling, and fine manipulation. Tactile
ability sufficient for physical assessment.
7. Mentation: Maintain reality orientation for at least a twelve-hour period of time.
8. Assimilate, organize and apply knowledge and skills acquired through lectures, discussions, and
readings.
9. Smell: Olfactory ability sufficient to monitor and assess health needs.
10. Writing: Ability to organize thoughts and present them clearly and logically in writing.
11. Reading: Ability to read and understand written directions, instructions and comments in both
classroom and clinical setting
In summary, the general environmental conditions in which the Paramedic works cannot be adequately assessed
in an indoor evaluative environment. Because of the variance in climate, environmental conditions and locations
in the United States and the infinite possibilities in which a Paramedic is expected to provide advanced life
support, working conditions, at best, may be less than optimal. The Paramedic must be able to focus on providing
the best care possible in often adverse and dangerous situations. This can include servicing neighborhoods known
to have high crime rates and performing optimally in situations where multiple incidents and trauma exist, i.e. a
major highway accident that involves numerous persons and vehicles. The Paramedic may be required frequently
to walk, climb, crawl, bend, push, or lift and balance over less than ideal terrain, such as an icy highway, muddy
ground, dilapidated stairs/flooring, and any other scenario or combination of scenarios. There may be exposure
to a variety of noise levels, which at times can be quite high, particularly when multiple sirens are sounding, and
crowds/bystanders/ families are upset and may be screaming, crying hysterically, and making demands that may
or may not be reasonable.
Applicants who feel they may be deficient in one or more of the areas mentioned above should speak with the
Director of Education and Training. We will seriously consider applicants who are deficient in any of these
areas providing the deficiency can be remedied or reasonably accommodated.
When the program faculty and the Medical Director of the Paramedic Program recommend a student for licensing
or certification examinations as part of graduation, the faculty is verifying that the student has met all of the
requirements of the school, the National Standard Curriculum and National Education Standards and can safely
perform at the level of a Paramedic. There are accommodations that are not allowed in the program because
they are not in compliance with the essential job functions of a paramedic as outlined in the Functional Job
description above. These include but may not be limited to:
1. Students are not allowed additional time for skills with specific time frames. Obviously patients would
suffer due to life threatening conditions in emergency situations if treatment were delayed.
2. Students are not allowed unlimited time to complete a written exam. This request is not considered
reasonable because a candidate should be able to complete a test (problem solve) within a finite amount
of time. Time frame allowed will depend on the length of the test.
3. Students are not allowed to have written exams given by an oral reader. The ability to read and
understand small English print is an essential function of the profession, and written exams are designed,
at least in part, to measure that ability.
4. Students are not provided a written exam with a reading level of less than grade eight. The EMS
profession requires a reading level of at least grade eight to work safely and efficiently. Text books used
may exceed this reading level.
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5. Students must answer all written test questions as written. No explanation of the question can be
provided by the test proctor or any other individual. Additional descriptions of test questions would not
be a reasonable accommodation because reading and understanding written English is an essential part of
EMS communications. Student must be able to understand and converse in medical terms appropriate to
the profession.
6. Students must complete some skills under certain conditions designed to mimic realistic situations. The
ability to operate in physically and mentally demanding or stressful situations is an essential function of
the profession.
Because of the critical nature of the tasks needed in emergency situations, accommodation requests are
considered very carefully, on a case-by-case basis. The safety and welfare of the community must be insured
while providing full protection of the certification applicant’s rights. The main question to be considered is: with
the accommodation being requested, can this individual perform the essential functions of the job safely and
efficiently?
A.13 | PARAMEDIC PROGRAM CURRICULUM
We recognize that many of our Paramedic students are already practicing members of the Emergency Medical
Services (EMS) community either in career or volunteer roles. Taking this into consideration, along with part and
full-time job commitments and family and home responsibilities, our program is designed for working adult
learners. With flexibility and choices built into our programs, students can more easily attain their goal of
becoming a paramedic. However, this philosophy requires that the student is self-directed and self-motivated.
Time management is a key responsibility of the student and is essential to successful completion of the program.
This program will follow the National Standard Curriculum and will meet and surpass all objectives and goals
established by the National Highway Transportation Safety Administration (NHTSA), the National Registry of EMTs
(NREMT) and the Committee on Accreditation of Educational Programs for the Emergency Medical Services
Professions (CoAEMSP).
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A.14 | PARAMEDIC 1 SYLLABUS
Program Description
This course provides students with an introduction to the foundations of paramedic, as well as provides students
with a more comprehensive view of EMS systems and careers. This course covers components of basic
preparatory paramedic knowledge, critical decision-making, airway management, medication administration,
electrocardiogram interpretation and cardiac care. Obtaining an American Heart Association Advanced
Cardiovascular Life Support certification is a requirement of this course. A laboratory component provides
students with an opportunity to practice and develop required competencies in skills including BLS, airway
management, IV access, medication administration and cardiac care. (Approximately 190 hours)
Purpose
To provide a safe and affective learning environment that allows the student to achieve, to the best of their
ability, the didactic and practical standards set forth by applicable regulatory guidelines. The goal of this course is
to provide the framework for competent, entry-level paramedics.
Prerequisites
▪ Have a high school diploma or GED;
▪ Be at least 18 years of age;
▪ Hold a current, non-encumbered, state or national certification as an Emergency Medical
Technician or higher;
▪ Hold a current Health Care Provider or equivalent CPR Certification;
▪ Submit all components of the application package;
▪ Successfully complete an interview process after the application packet has been reviewed;
▪ Submit proof of completion of NIMS 700, ICS 100 and ICS 200.
Program Location
American Professional Educational Services
One American Way, Norwich, CT 06360
Program Times
Mondays, Wednesdays, & Thursdays 6p-10p
All class dates and times are per the course schedule
Required Text
Nancy Caroline’s Emergency Care in the Streets, 8th Edition (Jones and Bartlett)
Anatomy and Physiology for Healthcare Professionals, 2nd Edition (Jones and Bartlett)
Advanced Cardiovascular Life Support, 2015 (American Heart Association) - Provided
Required Equipment
-Textbooks
-Notebook
-Writing utensil
-Stethoscope
-Wristwatch
Weather Cancellation
See 4.31 in Student Handbook.
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Attendance Requirement
Missing more than 12 hours of class time may result in dismissal from the course.
Student Evaluation
This course will include quizzes, medication tests, exams, specialty course exams and a research paper.
Research Paper
This course requires a written research paper on a topic approved by program administration. This minimum of
five (5) page paper, must be written in APA format and must cite a minimum of three (3) reputable sources. All
topics must be approved by program administration. Your article must be typed, double-spaced on standard-
sized paper (8.5" x 11") with 1" margins on all sides, using size 12pt Times New Roman Font. The research paper
will be processed through an electronic plagiarism detection resource.
Students must submit a topic proposal with the rational for topic choice, an outline and a final draft for this paper.
The final draft will constitute an exam grade. The topic proposal and outline will constitute quiz grades.
Grading Policy
This course is the first of five (5) semesters and is representative of 20% of the students overall grade. Grading
scales and weights are set in the Student Handbook.
Grading Scale A+
97 - 100% A
94 - 96.9% A-
90 - 93.9% B+
87 - 89.9% B
84 - 86.9% B-
80 - 83.9% C+
77 - 79.9% C
75 - 76.9% F
0 - 74.9%
Grade Weights 40%
Exams 20%
Affective 20%
Medication Tests 20%
Quizzes
Minimum Grade
Students must achieve and maintain the following minimum scores:
▪ Research Paper (exam grade) 75%
▪ Airway Exam 75%
▪ Cardiology 75%
▪ Advanced Cardiovascular Life Support 84%
▪ Paramedic 1 Exam 75%
▪ Paramedic 1 Practical Exam 75%
▪ Maintain an average grade of 75% or higher at all times.
▪ A course average of 75% is required to be eligible for the final exam.
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Practical Examination
All skills will be evaluated utilizing NREMT and CoAEMSP standards for points, success and critical failures.
Practical Examination grade will be determined by averaging together all individual skill assessments. Any failed
station must be retested and completed successfully. The maximum score for a retested skill assessment is 75%.
Practical examination grading will be as follows: 100%
▪ All possible points and no critical failures 85%
▪ Above minimum allowable points but less than all possible 75%
▪ Minimum allowable points or successful retest 50%
▪ Less than minimum allow allowable points or critical failure
Student Behavior
Students are expected to conduct themselves in accordance with the highest healthcare standards of
professionalism. Students must follow the standards set forth in the Student Handbook.
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A.15 | PARAMEDIC 2 SYLLABUS
Program Description
This course builds on the knowledge obtained from Paramedic 1. Students will further their knowledge on the
recognition and treatment of medical and trauma emergencies. Students will also further their knowledge of
anatomy, physiology and pathophysiology. A laboratory component provides students with an opportunity to
practice and develop required competencies in skills and patient assessment. (Approximately 204 hours)
Purpose
To provide a safe and affective learning environment that allows the student to achieve, to the best of their
ability, the didactic and practical standards set forth by applicable regulatory guidelines. The goal of this course is
to provide the framework for competent, entry-level paramedics.
Prerequisites
▪ Successful completion of Paramedic 1 in most recent session;
▪ Have a high school diploma or GED;
▪ Be at least 18 years of age;
▪ Hold a current, non-encumbered, state or national certification as an Emergency Medical
Technician or higher;
▪ Hold a current Health Care Provider or equivalent CPR Certification and ACLS certification.
Program Location
American Professional Educational Services
One American Way, Norwich, CT 06360
Program Times
Mondays, Wednesdays, & Thursdays 6p-10p
All class dates and times are per the course schedule
Required Text
Nancy Caroline’s Emergency Care in the Streets, 8th Edition (Jones and Bartlett)
Anatomy and Physiology for Healthcare Professionals, 2nd Edition (Jones and Bartlett)
Prehospital Trauma Life Support, 9th Edition (Jones and Bartlett) - Provided
Required Equipment
-Textbooks
-Notebook
-Writing utensil
-Stethoscope
-Wristwatch
Weather Cancellation
See 4.31 in Student Handbook.
Attendance Requirement
Missing more than 12 hours of class time may result in dismissal from the course.
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Student Evaluation
This course will include quizzes, medication tests, exams, specialty course exams and a research article.
Research Article
This course requires a written research article on a topic approved by program administration. This minimum of
five (5) page article, must be written in APA format and must cite a minimum of five (5) reputable sources. All
topics must be approved by program administration. Your article must be typed, double-spaced on standard-
sized paper (8.5" x 11") with 1" margins on all sides, using size 12pt Times New Roman Font. The research article
will be processed through an electronic plagiarism detection resource.
Students must submit a topic proposal with the rational for topic choice, an outline and a final draft for this
article. The final article will constitute an exam grade. The topic proposal and outline will constitute quiz grades.
Grading Policy
This course is the second of five (5) semesters and is representative of 20% of the students overall grade. Grading
scales and weights are set in the Student Handbook.
Grading Scale A+
97 - 100% A
94 - 96.9 A-
90 - 93.9 B+
87 - 89.9 B
84 - 86.9% B-
80 - 83.9 C+
77 - 79.9 C
75 - 76.9 F
0 - 74.9%
Grade Weights 40%
Exams 20%
Affective 20%
Medication Tests 20%
Quizzes
Minimum Grade
Students must achieve and maintain the following minimum scores:
▪ Research Article (exam grade) 75%
▪ Trauma Exam 75%
▪ Medical Exam 75%
▪ Prehospital Trauma Life Support 76%
▪ Paramedic 2 Exam 75%
▪ Paramedic 2 Practical Exam 75%
▪ Maintain an average grade of 75% or higher at all times.
▪ A course average of 75% is required to be eligible for the final exam.
Practical Examination
All skills will be evaluated utilizing NREMT and CoAEMSP standards for points, success and critical failures.
Practical Examination grade will be determined by averaging together all individual skill assessments. Any failed
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station must be retested and completed successfully. The maximum score for a retested skill assessment is 75%.
Practical examination grading will be as follows:
▪ All possible points and no critical failures 100%
▪ Above minimum allowable points but less than all possible 85%
▪ Minimum allowable points or successful retest 75%
▪ Less than minimum allow allowable points or critical failure 50%
Student Behavior
Students are expected to conduct themselves in accordance with the highest healthcare standards of
professionalism. Students must follow the standards set forth in the Student Handbook.
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A.16 | PARAMEDIC 3 SYLLABUS
Program Description
This course builds on the knowledge obtained from Paramedic 1 and 2. Students will further their knowledge on
the recognition and treatment of medical and trauma emergencies as well as incorporating knowledge of
obstetric and pediatric emergencies. This course will also cover other operational components as set by
regulatory agencies. Obtaining an American Heart Association Pediatric Advanced Life Support certification and a
National Association of Emergency Medical Technicians Prehopsital Trauma Life Support certification are
requirements of this course. This course also includes a research paper and presentation. A laboratory
component provides students with an opportunity to practice and develop required competencies in skills and
patient assessment. (Approximately 156 hours)
Purpose
To provide a safe and affective learning environment that allows the student to achieve, to the best of their
ability, the didactic and practical standards set forth by applicable regulatory guidelines. The goal of this course is
to provide the framework for competent, entry-level paramedics.
Prerequisites
▪ Successful completion of Paramedic 1 & 2 in most recent sessions;
▪ Have a high school diploma or GED;
▪ Be at least 18 years of age;
▪ Hold a current, non-encumbered, state or national certification as an Emergency Medical
Technician or higher;
▪ Hold a current Health Care Provider or equivalent CPR Certification, ACLS certification and PHTLS
certification.
Program Location
American Professional Educational Services
One American Way, Norwich, CT 06360
Program Times
Mondays, Wednesdays, & Thursdays 6p-10p
All class dates and times are per the course schedule
Required Text
Nancy Caroline’s Emergency Care in the Streets, 8th Edition (Jones and Bartlett)
Anatomy and Physiology for Healthcare Professionals, 2nd Edition (Jones and Bartlett)
Pediatric Advanced Life Support, 2015 (American Heart Association) – Provided
Advanced Medical Life Support, 2nd Edition (Jones and Bartlett) - Provided
Required Equipment
-Textbooks
-Notebook
-Writing utensil
-Stethoscope
-Wristwatch
Weather Cancellation
See 4.31 in Student Handbook.
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Attendance Requirement
Missing more than 12 hours of class time may result in dismissal from the course.
Student Evaluation
This course will include quizzes, medication tests, exams, specialty course exams, a research paper and a research
presentation.
Research Paper
This course requires a written research paper on a topic approved by program administration. This minimum of
ten (10) page article, must be written in APA format and must cite a minimum of six (6) reputable sources. All
topics must be approved by program administration. Your article must be typed, double-spaced on standard-
sized paper (8.5" x 11") with 1" margins on all sides, using size 12pt Times New Roman Font. The research paper
will be processed through an electronic plagiarism detection resource.
Students must submit a topic proposal with the rational for topic choice, an outline and a final draft for this paper.
The final draft will constitute an exam grade. The topic proposal and outline will constitute quiz grades.
The student must complete a presentation on the researched topic following the research presentation goals and
objectives. This presentation will constitute an exam grade that is in addition to the research paper grade. The
overall project will constitute two (2) exam grades.
Grading Policy
This course is the third of five (5) semesters and is representative of 20% of the students overall grade. Grading
scales and weights are set in the Student Handbook.
Grading Scale A+
97 - 100% A
94 - 96.9 A-
90 - 93.9 B+
87 - 89.9 B
84 - 86.9% B-
80 - 83.9 C+
77 - 79.9 C
75 - 76.9 F
0 - 74.9%
Grade Weights 40%
Exams 20%
Affective 20%
Medication Tests 20%
Quizzes
Minimum Grade
Students must achieve and maintain the following minimum scores:
▪ Research Paper (exam grade) 75%
▪ Research Presentation (exam grade) 75%
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▪ Advanced Medical Life Support 76%
▪ Pediatric Advanced Life Support 84%
▪ OB/Pediatrics Exam 75%
▪ Paramedic 3 Exam 75%
▪ Paramedic 3 Practical Exam 75%
▪ Maintain an average grade of 75% or higher at all times.
▪ A course average of 75% is required to be eligible for the final exam.
Practical Examination
All skills will be evaluated utilizing NREMT and CoAEMSP standards for points, success and critical failures.
Practical Examination grade will be determined by averaging together all individual skill assessments. Any failed
station must be retested and completed successfully. The maximum score for a retested skill assessment is 75%.
Practical examination grading will be as follows: 100%
▪ All possible points and no critical failures 85%
▪ Above minimum allowable points but less than all possible 75%
▪ Minimum allowable points or successful retest 50%
▪ Less than minimum allow allowable points or critical failure
Student Behavior
Students are expected to conduct themselves in accordance with the highest healthcare standards of
professionalism. Students must follow the standards set forth in the Student Handbook.
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A.17 | PARAMEDIC 4 SYLLABUS
Program Description
This course is comprised a clinical practicum that provides students with in-hospital paramedic clinical
experiences. All in-hospital clinical rotations will be performed under the supervision of an instructor. Upon
completion of this course, students will be able to demonstrate proficiency in the application of patient care
theory and psychomotor skills. Throughout the course, students will attend rotations in the emergency
department, same day surgery, critical care unit, labor and delivery, and the operating room. This course
culminates with adaptive, computer-based exams on medical emergencies, trauma emergencies and
cardiovascular emergencies. (Approximately 250-350 hours)
Purpose
To provide a safe and affective learning environment that allows the student to achieve, to the best of their
ability, the didactic and practical standards set forth by applicable regulatory guidelines. The goal of this course is
to provide the framework for competent, entry-level paramedics.
Prerequisites
▪ Successful completion of Paramedic 1 in most recent session;
▪ Have a high school diploma or GED;
▪ Be at least 18 years of age;
▪ Hold a current, non-encumbered, state or national certification as an Emergency Medical
Technician or higher;
▪ Hold a current Health Care Provider or equivalent CPR and ACLS Certifications;
▪ Submitted all health and immunization information;
▪ Attended clinical site orientation;
▪ Authorization by clinical site to attend clinicals at their location.
Program Location
American Professional Educational Services
One American Way, Norwich, CT 06360
William W. Backus Hospital
326 Washington St, Norwich, CT 06360
Program Times
As scheduled by student and Clinical Coordinator.
Required Text
Student Handbook Appendix B – Paramedic Clinical Internship Guide.
Required Equipment
-Notebook
-Writing utensil
-Stethoscope
-Wristwatch
Weather Cancellation
See 4.31 in Student Handbook.
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Attendance Requirement
Attendance requirements are set in the Student Handbook. Attendance is vital for program completion.
Student Evaluation
This course includes Unit Exams that must be completed successfully prior to course completion.
Grading Policy
This course is the fourth of five (5) semesters and is representative of 20% of the students overall grade. Grading
scales and weights are set in the Student Handbook
Grading Scale A+
97 - 100% A
94 - 96.9 A-
90 - 93.9 B+
87 - 89.9 B
84 - 86.9% B-
80 - 83.9 C+
77 - 79.9 C
75 - 76.9 F
0 - 74.9%
Grade Weights
Exams 60%
Affective 40%
Minimum Grade
Students must achieve a score of 75% or higher on all exams, or the grade set by the sanctioning body for
specialty exams. Students must maintain an average grade of 75% at all times. Students must complete three (3)
unit exams and a final course exam. See Student Handbook for further information.
Student Behavior
Students are expected to conduct themselves in accordance with the highest healthcare standards of
professionalism. Students must follow the standards set forth in the Student Handbook.
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A.18 | PARAMEDIC 5 SYLLABUS
Program Description
This course is the capstone of the students education in paramedicine and is comprised a clinical practicum that
provides students with out-of-hospital paramedic clinical experiences. This component is considered a field
internship. All internship rotations will be performed under the supervision of a paramedic preceptor. All
paramedic preceptors have completed a formal course on student precepting. Upon completion of this course,
students will be expected to operate as competent, entry-level paramedics. This course culminates with adaptive,
computer-based exams on obstetric and pediatric emergencies, airway management and EMS system operations.
A final comprehensive exam must be completed once the student has completed all aspects of this course. This
final exam is the standard to authorizing a student to test for the national certification exam. (Approximately 250-
350 hours)
Purpose
To provide a safe and affective learning environment that allows the student to achieve, to the best of their
ability, the didactic and practical standards set forth by applicable regulatory guidelines. The goal of this course is
to provide the framework for competent, entry-level paramedics.
Prerequisites
▪ Successful completion of Paramedic 1, 2 & 4 in most recent sessions;
▪ Have a high school diploma or GED;
▪ Be at least 18 years of age;
▪ Hold a current, non-encumbered, state or national certification as an Emergency Medical
Technician or higher;
▪ Hold a current Health Care Provider or equivalent CPR Certification, ACLS certification and PHTLS
certification.
▪ Submitted all health and immunization information;
▪ Attended clinical site orientation;
▪ Authorization by clinical site to attend clinicals at their location.
Program Location
American Professional Educational Services
One American Way, Norwich, CT 06360
Field Internship locations as assigned.
Program Times
As scheduled by student and Clinical Coordinator.
Required Text
Student Handbook Appendix C – Paramedic Field Internship Guide.
Required Equipment
-Notebook
-Writing utensil
-Stethoscope
-Wristwatch
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Weather Cancellation
See 4.31 in Student Handbook.
Attendance Requirement
Attendance requirements are set in the Student Handbook. Attendance is vital for program completion.
Student Evaluation
This course includes Unit Exams, as well as a comprehensive exam, that must be completed successfully prior to
course completion.
Grading Policy
This course is the fifth of five (5) semesters and is representative of 20% of the students overall grade. Grading
scales and weights are set in the Student Handbook
Grading Scale A+
97 - 100% A
94 - 96.9 A-
90 - 93.9 B+
87 - 89.9 B
84 - 86.9% B-
80 - 83.9 C+
77 - 79.9 C
75 - 76.9 F
0 - 74.9%
Grade Weights
Exams 60%
Affective 40%
Minimum Grade
Students must achieve a score of 75% or higher on all exams, or the grade set by the sanctioning body for
specialty exams. Students must maintain an average grade of 75% at all times. Students must complete three (3)
unit exams and a final course exam. See Student Handbook for further information.
Student Behavior
Students are expected to conduct themselves in accordance with the highest healthcare standards of
professionalism. Students must follow the standards set forth in the Student Handbook.
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APPENDIX B | CLINICAL INTERNSHIP
B.01 | INTRODUCTION
The Paramedic clinical internship is a structured schedule of rotations in which the Paramedic student will visit
and participate in patient care at off-campus clinical facilities. This will occur under the direct supervision of a
designated preceptor or instructor. Individual instructors will vary from clinical site to clinical site, from unit to
unit and from time to time. Paramedic students are required to attend a mandatory orientation at their clinical
site prior to the start of their clinical internship. At this orientation, the rules and regulations of the specific
clinical site will be explained along with any information that is unique to that clinical site.
The Paramedic student will frequently be involved in patient care situations ranging in acuity from routine to
urgent and life-threatening. In each situation, the Paramedic student is responsible for:
Being attentive
Applying clinical protocols
Exercising common sense
Recognizing his or her own limitations
Participating assertively in the patient’s management and care
Acting courteous, professional and appropriate at all times with the patient and the staff
B.02 | PATIENT CONFIDENTIALITY
Protected health information (or “PHI”), under the US Health Insurance Portability and Accountability Act
(HIPAA) is any information about health status, provision of health care, or payment for health care that can be
linked to a specific individual. Confidentiality of protected health information is the responsibility of all
healthcare providers, inclusive of Paramedic students.
Paramedic students will be cautious whenever they discuss protected health information, taking into
consideration their location (e.g., public areas) and who they discuss this information with. It is appropriate to
discuss such information with preceptors and other healthcare providers who are and were previously involved
with that patient’s care. Paramedic students are also encouraged to discuss interesting clinical cases
encountered during their internship with peers and faculty; however, at no time should the names of patients or
any other identifying information be divulged.
No part of the patient’s medical records may be copied or taken from the clinical site. The only exception is
ECGs, and only after they have been de-identified (redaction should be accomplished using a wide black pen or
marker and subsequently photocopying the result).
Any discussion of protected health information or discussion of clinical encounters outside these guidelines may
result in disciplinary action and/or dismissal from the Paramedic education program.
B.03 | PROFESSIONAL BEHAVIOR
Paramedic students will conduct themselves in a professional manner at all times. They will treat patients, their
families and hospital staff with the utmost respect. Paramedic students should remember they will not only be
evaluated on psychomotor performance, but also continually evaluated on their affect. Behavior that is
unprofessional will be immediately and severely dealt with.
Paramedic students are expected to exhibit a moderate amount of assertiveness in approaching hospital staff
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regarding the performance of skills. You should neither be overbearing nor timid. During the clinical internship,
you should not expect the staff and instructors to be aggressive in finding you for skills and assessments. Once
you have become acquainted with your clinical site’s staff and they become familiar with you and your
capabilities, your internship will become more productive.
Paramedic students are encouraged to discuss their performance with instructors and staff. Use the information
learned during these discussions to improve your productivity and aptitude. Listen carefully to criticisms and use
them constructively. Any discussion or criticism by staff or instructors that you feel is malicious should be
reported to program administration.
Paramedic students should never forget the reasons behind a clinical internship. It is a learning experience. It
should not be considered “just another hurdle” towards your paramedic certification. You should not be satisfied
with the program’s minimum requirements. If an instructor or hospital staff member approaches you to perform
skills, the offer should be turned down courteously only if you are occupied with another task. It is never
acceptable to decline a skill by saying, “I already have enough of those skills, thanks.”
Remember that you never get a second chance to make a good first impression.
B.04 | GOALS OF THE CLINICAL INTERNSHIP EXPERIENCE
Provide the student with an opportunity to perform assessment and treatment skills learned in
the didactic and laboratory portion of the program.
To expose the student to the most current concepts in emergency care.
To allow the student to develop a working relationship with other members of the health care
team.
B.05 | OBJECTIVES OF THE CLINICAL INTERNSHIP EXPERIENCE
Perform a comprehensive assessment on patients of all ages, to include:
• Newborns
• Infants
• Toddlers
• Preschoolers
• School age
• Adolescents
• Adults
• Geriatrics
Report the assessment information in a brief, organized and accurate manner.
Correctly and concisely document assessment information.
Describe the pathophysiology, signs and symptoms, and appropriate prehospital care for a
patient encountered in the clinical setting.
Demonstrate correct knowledge of basic and advanced airway management procedures.
Demonstrate and describe correct resuscitation procedures.
Take and properly record accurate vital signs.
Identify normal and abnormal lung sounds.
Perform venipuncture.
Safely administer medications, while understanding all indications, contraindications, adverse
effects, and routes.
Effectively ventilate a patient.
Safely perform endotracheal intubation.
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Initiate, maintain, and discontinue intravenous therapy.
Prepare and administer medications by intravenous, intramuscular, subcutaneous, endotracheal,
intraosseous and nebulized / inhaled routes.
Accurately interpret ECG rhythms and determine appropriate treatment.
Identify and demonstrate the correct procedures for treating fractures and hemorrhage.
Develop and maintain rapport with health care professionals.
Demonstrate sensitivity to and provide support for the physical and emotional needs of both the
patient and the family.
B.06 | AFFECTIVE DOMAIN OBJECTIVES
Develop a respect for death, injury and illness, and the dying process.
Demonstrate punctuality by being on time and ready to start.
Demonstrate the ability to treat preceptors and fellow students with respect.
Demonstrate the ability to work with others by working as a team in given patient scenarios and
situations.
Demonstrate critical thinking skills by applying information learned in class and determining the
proper action necessary to give competent and compassionate patient care.
Demonstrate acceptable ethical and moral standards.
Demonstrate confidence, assertiveness, and a respect for the instructor / preceptor and others
by participating in every opportunity.
B.07 | CLINICAL TIME REQUIREMENTS
The program does not set an amount of time in the clinical Emergency Department or Operating Room. Instead, a
minimum amount of contacts, higher than nationally required, are required by the program. Minimum amounts
of time are set for the Obstetric and Critical Care Units. Below are required and estimated time requirements by
department.
Emergency Department – No hour requirement (Approximately 250 hours)
Operating room – No hour requirement (Approximately 40 hours)
Obstetrics – Minimum of 16 hours (3 births)
Critical Care Unit – Minimum of 16 hours (8 Hours with Respiratory Therapy)
Behavioral/Detoxification (SCADD) - Minimum of 16 hours (agreement pending)
B.08 | ATTENDANCE
Clinical shifts are at a premium, as they require a clinical instructor. Tardiness and absence from a clinical shift will
not be tolerated. Any absence from a clinical shift requires notification of program administration as soon as
possible. Students are encouraged to seek out their classmates to cover any clinical shift they will be absent for.
Missing more than 32 hours of clinical time may result in dismissal from the course.
B.09 | UNIVERSAL PRECAUTIONS
Paramedic students functioning in the clinical environment are at risk for exposure to blood borne pathogens
and infectious diseases. All body substances should be considered potentially infectious. Personal Protective
Equipment (PPE) is readily available at each clinical site and should be used whenever appropriate. The minimum
recommended PPE includes:
Gloves: Disposable gloves should be worn before initiating patient care when there is any risk of
exposure to body substances. This includes any invasive procedures (e.g., starting intravenous
lines). Sterile gloves may be required for some procedures. The same gloves should not be worn
with more than one patient. Always remove gloves when leaving a patient’s room or area. You
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should always endeavor to wash hands with soap and warm water after gloves have been
removed; however, using wall-mounted antibacterial gel may be an appropriate substitute if
authorized by the clinical site.
Masks and protective eyewear: Protective eyewear and facemasks should always be worn when
there is a risk of splashing or spattering of blood or other bodily fluids. Examples of this include
intubation and airway management, childbirth and open wounds or fractures. Healthcare
providers should wear appropriate respirators or masks whenever there is potential for airborne
transmission of disease. Standard corrective eyeglasses do not provide sufficient splash
protection from fluids; most medical protective eyewear or masks can accommodate corrective
eyewear.
Gowns: Gowns should always be worn when there is a risk of splashing or spattering of blood or
other bodily fluids, as described in the previous section.
Hand sanitization: Hand sanitizing is mandatory prior to and following any patient contact, using
the restroom, or eating a meal. Conventional soap and warm water or antibacterial gels are both
acceptable, if allowed by the specific clinical site. It is the policy of each clinical site to have the
Paramedic follow the Hand Sanitation policy and lack of compliance may result in dismissal from
the clinical site.
Any student who is exposed to a patient's bodily fluids should immediately decontaminate themselves, report
the incident to their instructor and program administration and follow the hospital’s post-exposure protocols. In
addition, the student will need to complete an exposure packet which can be obtained from the program.
B.10 | DOCUMENTATION
Complete and accurate documentation is fundamental to both your clinical internship and career in the EMS
profession. You should complete all documentation as if you were a practicing Paramedic. Please review and
ensure that your documentation complies with all the statements below.
Skills and assessments may only be signed by the instructor or preceptor who assigned and
observed your performance of the skill.
Falsification of any documentation is grounds for corrective action, up to and including dismissal
from the program.
Any errors made in documentation of time or skills must be brought to the attention of the
program administration as soon as they are discovered.
Print all entries clearly and legibly; any unclear or illegible entries may be discarded.
Program instructors, registered Nurses (RN), physicians (MD, DO), physician assistants (PA), nurse
practitioners (NP) and CRNA’s are the only individuals allowed to sign your clinical
documentation.
Only original documents will be accepted; you are allowed to make copies for back-up purposes.
The only allowable correction method is a single line written through the error, and initialed by
the corrector; the correction is then made on a separate line, in a separate entry.
Each entry must be completely filled out and signed (e.g., no “ditto” marks).
Use 24-hour notation to document time.
All shifts must be scheduled in FISDAP prior to the start of the shift.
Documentation must be entered into FISDAP and completed within 96 hours of the clinical shift.
If there are issues with FISDAP data entry, program administration should be contacted as soon
as possible.
In the event that your paperwork is found to be inaccurate, fraudulent or unreadable, the
student may be responsible for fixing errors. Any activity deemed inappropriate or unprofessional
in regard to paperwork, may result in dismissal from the program.
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Paramedic students must complete all required post-shift evaluations in FISDAP for each shift.
B.11 | SKILL PERFORMANCE
Please remember that you must be didactically educated, practically trained, and signed off on each skill by
program faculty before you are allowed to perform any skill in the clinical setting. All skills must be performed on
live, human patients, unless otherwise noted. You must successfully complete clinical and field skills in the
presence of a qualified instructor or preceptor.
You are permitted to perform the following skills in your clinical practicum. Although paramedic students are
expected to perform beyond minimum expectations, for reference the minimum number of skills is provided for
each.
Assessment of adult patients – 50
Assessment of geriatric patients – 30
Assessment of pediatric patients – 30
• Assessment of newborn patients – 2
• Assessment of infant patients – 2
• Assessment of toddler patients – 4
• Assessment of preschooler patients – 4
• Assessment of school age patients – 4
• Assessment of adolescent patients – 4
Assess and plan treatment of trauma patients – 40
Assess and plan treatment of medical patients – 60
• Assess and plan treatment of abdominal pain – 20
• Assess and plan treatment of pediatric respiratory – 10
• Assess and plan treatment of change in responsiveness – 10
• Assess and plan treatment of headache or blurred vision – 5
• Assess and plan treatment of dizziness– 10
• Assess and plan treatment of weakness – 10
• Assess and plan treatment of breathing problems – 30
• Assess and plan treatment of altered mental status – 30
• Assess and plan treatment of chest pain – 35
• Assess and plan treatment of respiratory complaints – 30
• Assess and plan treatment of stroke – 10
• Assess and plan treatment of psychiatric complaints – 20
• Assess and plan treatment of cardiac patients– 35
• Assess and plan treatment of obstetric patients – 15
• Assess and plan treatment of cardiac arrest – 2
• Assess and plan treatment of abdominal complaints – 20
Medication administration – 50
Intravenous cannulations – 150
Live intubations – 10
Live supraglottic airway insertions – 4
Ventilations – 20
Airway management – 50
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B.12 | ELIGIBILITY TO PARTICIPATE
The following pre-requisites must be satisfied for any Paramedic student to participate in the clinical internship:
Maintain current state or NREMT EMT or AEMT certification.
Maintain current American Heart Association cardiopulmonary resuscitation credentials
(healthcare provider level).
Maintain current ACLS, PALS and PHTLS certifications (once provided in course).
Be in good academic standing.
Completed Paramedic 1 successfully.
Be in good financial standing with American Professional Educational Services.
Receive authorization from the program to initiate clinical rotations.
All points on behavioral evaluations must be deemed ‘Competent’ to begin or stay in the clinical
rotation
B.13 | DRESS CODE
Excellent personal appearance in the clinical setting is vital. Paramedic students shall present themselves in the
uniform required by the program, unless otherwise dictated by a particular clinical setting (such as the operating
room rotations).
An identification badge, which will be issued to students prior to the start of clinical internship, must be worn at
all times. It must be worn outward facing so that the student’s first name and the title, “Paramedic Student” is
visible. All paramedic education program policies and procedures are in effect during your clinical practicum; as
such please refer to those for explicit instructions regarding dress code.
All dress code polices will be strictly enforced during clinical times. The student must be dressed and appear in a
uniform that is neat, clean and in good working order for the clinical shift. Violations of this policy will result in
you being sent home from the clinical shift and possible other corrective actions.
B.14 | MALPRACTICE INSURANCE
insurance is a requirement for clinical and field internship rotations and is provided by American Professional
Educational Services.
B.15 | IMMUNIZATIONS
All immunization documentation must be submitted per the Student Handbook and clinical site requirements.
Failure to submit immunization documentation will result in a potential delay or inability to participate in a
clinical rotation.
B.16 | MISCELLANEOUS POINTS
Students must respond to all appropriate requests made by an appropriate representative of the
hospital or clinical site. If a question or perceived conflict with the program’s policies and
procedures exist, contact program administration immediately.
Adhere to all rules and procedures of the program and specific clinical site concerning smoking,
parking, breaks, use of facilities, dress codes, etc.
Keep all critical opinions concerning hospital staff members or EMS providers to yourself. If
necessary and appropriate, relate your opinions only to program administration.
Students may not enter, nor participate, in any patient care area of a health care facility except
the area to which they are currently assigned. It may be possible to temporarily participate in
another area if explicit permission is obtained from both your instructor and an authorized staff
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member in the unit to which you wish to go. (An example of this is an opportunity for an
obstetrical delivery during your ER rotation).
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BEHAVIORAL/DETOXIFICATION (D-1)
Behavioral/detoxification shifts are Monday through Friday and begin at 0700. Shifts last eight (8) hours.
Students should consult FISDAP for shift start time and arrive prior to that time at the Behavioral/detoxification
Charge Nurse’s Desk. A program clinical instructor will be present at this location. Students meet their clinical
instructor prior to any clinical activities. Shifts are scheduled based on student and instructor availability.
B.17 | BEHAVIORAL/DETOXIFICATION - PURPOSE
The purpose of the behavioral/detoxification rotation is to enable paramedic students to develop skills and
knowledge necessary to competently manage patients presenting with a variety of behavioral health and
substance abuse conditions.
This experience shall be facilitated by a designated preceptor from the clinical site (see below). The student
can maximize the learning potential of this opportunity by:
Observing, and when appropriate, participating in the care of behavioral/detoxification patients.
Asking pertinent questions of the clinical site team.
Applying academic concepts presented in class to the care of actual patients and learning how
they can contextualize behavioral health and detoxification care to the prehospital environment.
B.18 | BEHAVIORAL/DETOXIFICATION - PRIOR ACADEMIC PERPARATION
Prior to starting the clinical unit rotations, students will have completed the preparatory elements of the
Paramedic program education standards including basic and advanced airway and ventilatory management,
oxygen delivery, pharmacology, vascular access, medication administration, and introduction to general
patient assessment. Student’s will have an understanding of substance abuse and psychiatric conditions as
well as emergency treatments for these conditions
B.19 | BEHAVIORAL/DETOXIFICATION - SCOPE OF PRACTICE AND NEED FOR SUPERVISION
A student enrolled in the Paramedic program, while fulfilling the clinical training requirements mandated for
licensure, may perform prescribed procedures under the direct supervision of a physician licensed to practice
medicine or a qualified registered nurse.
Clinical instructors are not present in this clinical setting; therefore, students may not provide any
advanced life support/invasive skill on a patient.
Students may not administer medications to patients.
Students are not authorized to restrain patients in any way.
B.20 | BEHAVIORAL/DETOXIFICATION - BEHAVIORAL OBJECTIVES: STUDENTS
Upon completion of the behavioral/detoxification rotation, a Paramedic student will perform each of the
following within their scope of practice and without critical error:
Observe and participate in dynamic patient care interactions as members of the health care
team.
Develop communication skills by:
• Engaging the patient and family members using the various strategies of
communication.
• Observing the interaction of patients, significant others, and the clinical site staff.
Gain competence and strengthen patient assessment skills.
Practice performing the steps of inspection, palpation, and auscultation.
Recognize the importance of frequent reassessments in planning patient care.
Question the preceptor about the patient’s clinical presentation and how they arrived at their
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decisions to intervene.
Develop diagnostic skills by observing the process followed by the preceptor in arriving at his/her
impression or medical diagnosis based on information gathered from the history and physical
exam. Learn to reason critically in making a differential diagnosis based on clinical presentation
and history.
Observe comprehensive care of behavioral/detoxification patients. Discuss the patient’s
treatment plan with the preceptor. Psychiatric and substance abuse care medicine is a multi-
faceted field with a wide variety of patients presenting to the facility. By observing total patient
care, the student will achieve greater knowledge of disease processes and definitive interventions
that will improve the quality of care provided in the field.
Observe the effects and side effects of drugs/medications taken by, or administered, to the
patient. Assist in calculating any medication doses.
Observe and perform BLS skills as directed.
B.21 | BEHAVIORAL/DETOXIFICATION - BEHAVIORAL OBJECTIVES: PRECEPTORS
During the behavioral/detoxification clinical rotation, the preceptor will:
Provide the student with a brief unit orientation and take them on a brief tour identifying the
location of patient rooms, diagnostic/treatment supplies and/or equipment, staff lounge, utility
rooms, waiting rooms, etc. that will facilitate their adaptation to the site.
Provide a place to store belongings. Inform them of your anticipated break and meal times, so
they can correlate their schedule to yours.
Review clinical objectives with the student. Mutually determine their level of participation, and
how and where you can be found to validate their paperwork before leaving the unit.
Assist the student in gaining clinical expertise by encouraging patient contact whenever possible
and appropriate.
Provide immediate feedback on any patient history, assessment or intervention performed by the
student to help improve their technique.
Serve as a source of reference in answering the student’s questions.
Resolve any potential conflict situations in favor of the patient's welfare and restrict the student's
activities until any incidents can be investigated by program administration.
B.22 | BEHAVIORAL/DETOXIFICATION - EVALUATIONS
The Daily Hospital Evaluation Form and Daily Clinical Internship Affective Evaluation Form must be completed by
the student and preceptor. It is preferred that these forms be digitally uploaded to FISDAP as an attachment for
that shift. Forms should also be turned in to program administration in a timely fashion.
B.23 | BEHAVIORAL/DETOXIFICATION - PROFESSIONAL BEHAVIOR AND DRESS
Students shall wear their school and clinical site issued ID badges at all times while on the unit.
Students must adhere to program and hospital uniform and appearance policies at all times.
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CRITICAL CARE UNIT (CCU)
Critical Care Unit shifts are Monday through Friday and begin at 0700. Shifts last eight (8) hours. Students should
consult FISDAP for shift start time and arrive prior to that time at the CCU Charge Nurse’s Desk. A program
clinical instructor will not be present at this location and the student will be assigned to a nurse for their shift.
B.24 | CCU - PURPOSE
The purpose of the Critical Care Unit (CCU) clinical experience is to enable Paramedic students to observe and
participate in the clinical assessments and interventions for acutely ill or injured patients within their scope of
practice.
This experience shall be facilitated by a designated preceptor from the hospital (see below). The student can
maximize the learning potential of this opportunity by:
Observing, and when appropriate, participating in the care of critically ill and injured patients.
Assessing airway, ventilatory and gas exchange parameters, breath sounds, circulation/perfusion
markers, and neuro status of as many patients as possible.
Asking pertinent questions of the CCU team.
Applying academic concepts presented in class to the care of actual patients and learning how
they can contextualize hospital-based care to the prehospital environment.
B.25 | CCU - PRIOR ACADEMIC PERPARATION
Prior to starting the clinical unit rotations, students will have completed the preparatory elements of the
Paramedic program education standards including basic and advanced airway and ventilatory management,
oxygen delivery, pharmacology, vascular access, medication administration, and introduction to general
patient assessment.
B.26 | CCU - SCOPE OF PRACTICE AND NEED FOR SUPERVISION
A student enrolled in the Paramedic program, while fulfilling the clinical training requirements mandated for
licensure, may perform prescribed procedures under the direct supervision of a physician licensed to practice
medicine or a qualified registered nurse.
Clinical instructors are not present in this clinical setting; therefore, students may not provide any
advanced life support/invasive skill on a patient.
B.27 | CCU - BEHAVIORAL OBJECTIVES: STUDENTS
Upon completion of the CCU rotation, a Paramedic student will perform each of the following within their
scope of practice and without critical error:
Observe and participate in dynamic patient care interactions as members of the health care
team.
Develop communication skills by:
• Engaging the patient and family members using the various strategies of
communication.
• Observing the interaction of patients, significant others, and the CCU staff.
Gain competence and strengthen patient assessment skills. This can best be accomplished by
working with a physician, mid-level practitioner, or RN preceptor.
Practice performing the steps of inspection, palpation, and auscultation.
Correlate the kinematics of injury or the nature of the illness with the patient’s history to form an
impression of their current status.
Recognize the importance of frequent reassessments in planning patient care.
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Question the preceptor about the patient’s clinical presentation and how they arrived at their
decisions to intervene.
Develop diagnostic skills by observing the process followed by the preceptor in arriving at his/her
impression or medical diagnosis based on information gathered from the history and physical
exam. Learn to reason critically in making a differential diagnosis based on clinical presentation
and history.
Observe comprehensive care of acutely ill and injured patients. Discuss the patient’s treatment
plan with the preceptor. Critical care medicine is a multi-faceted field with a wide variety of
patients presenting to the CCU. By observing total patient care, the student will achieve greater
knowledge of disease processes and definitive interventions that will improve the quality of care
provided in the field.
Observe the effects and side effects of drugs/medications taken by, or administered, to the
patient. Assist in calculating any medication doses.
Enhance knowledge of anatomy, physiology, and pathophysiology by asking the preceptor to
explain the significance of various diagnostic tests and abnormal results. Accompany patients to
special procedures, e.g., CT scans, angiography, ultrasound, cath lab, surgery, etc. whenever
possible.
Observe and perform BLS skills as directed.
B.28 | CCU - BEHAVIORAL OBJECTIVES: PRECEPTORS
During the CCU clinical rotation, the unit preceptor will:
Provide the student with a brief unit orientation and take them on a brief tour identifying the
location of patient rooms, diagnostic/treatment supplies and/or equipment, staff lounge, utility
rooms, waiting rooms, etc. that will facilitate their adaptation to the unit.
Provide a place to store belongings. Inform them of your anticipated break and meal times, so
they can correlate their schedule to yours.
Review clinical objectives with the student. Mutually determine their level of participation, and
how and where you can be found to validate their paperwork before leaving the unit.
Assist the student in gaining clinical expertise by encouraging patient contact whenever possible.
Provide immediate feedback on any patient history, assessment or intervention performed by the
student to help improve their technique.
Serve as a source of reference in answering the student’s questions.
Resolve any potential conflict situations in favor of the patient's welfare and restrict the student's
activities until any incidents can be investigated by program administration.
B.29 | CCU - EVALUATIONS
The Daily Hospital Evaluation Form and Daily Clinical Internship Affective Evaluation Form must be completed by
the student and preceptor. It is preferred that these forms be digitally uploaded to FISDAP as an attachment for
that shift. Forms should also be turned in to program administration in a timely fashion.
B.30 | CCU - PROFESSIONAL BEHAVIOR AND DRESS
Students shall wear their school and clinical site issued ID badges at all times while on the unit.
Students must adhere to program and hospital uniform and appearance policies at all times.
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EMERGENCY DEPARTMENT (ED)
Emergency Department shifts are seven (7) days a week and typically begin at 0700 and 1500. All Emergency
Department shifts last for eight (8) hours. Students should consult FISDAP for shift start time and arrive prior to
that time. Students meet their clinical instructor prior to any clinical activities. Shifts are scheduled based on
student and instructor availability.
B.31 | ED - PURPOSE
The purpose of the Emergency Department (ED) clinical rotation is to enable Paramedic students to observe and
participate in the assessment and interventions for acutely ill or injured patients within their scope of practice.
The student can maximize the learning potential of this experience by seeking out learning experiences, observing
the assessments and/or care of as many acutely ill and injured patients as possible and asking pertinent questions
of the ED team.
B.32 | ED - PRIOR ACADEMIC PREPARATION
Prior to starting the clinical unit rotations, students will have completed the preparatory elements of the
Paramedic program education standards including basic and advanced airway and ventilatory management,
oxygen delivery, pharmacology, vascular access, medication administration, and introduction to general patient
assessment. Skill competencies must be validated by program staff prior to skills being performed in the clinical
setting.
B.33 | ED - SCOPE OF PRACTICE AND NEED FOR SUPERVISION
A student enrolled in the Paramedic program, while fulfilling the clinical training requirements mandated for
licensure, may perform prescribed procedures under the direct supervision of a physician licensed to practice
medicine or a qualified registered nurse.
Students may not provide any advanced life support/invasive skill on a patient without a clinical
instructor or preceptor immediately observing and coaching their technique to ensure patient
safety.
Students may not perform any skills that are outside of their scope of practice as defined by the
National EMS Education Standards or program policies and procedures.
B.34 | ED - BEHAVIORAL OBJECTIVES: STUDENTS
Goals of the ED rotation:
Observe and participate in dynamic patient care interactions as members of the health care
team.
Develop communication skills by:
• Engaging the patient and family members using the various strategies of
communication.
• Evaluating on-line medical control calls to the ED from field units for clarity and
thoroughness of data transmission.
• Observing the interaction of patients, significant others, and the ED staff.
Participate in gathering the patient history and performing the physical exam.
Develop diagnostic skills by:
• Observing the process followed by the preceptor in arriving at his/her impression or
medical diagnosis.
• Synthesizing a prehospital impression / differential diagnosis based on information
gathered from the history and physical exam.
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Discuss the patient’s treatment plan with the preceptor. By observing total patient care, the
student will achieve greater knowledge of disease processes and definitive interventions that will
improve the quality of care provided in the field.
Observe the effects and side effects of drugs/medications taken by, or administered, to the
patient. Assist in calculating any medication doses.
Perform competencied psychomotor skills, under direct supervision of a qualified clinical
instructor or preceptor.
Enhance knowledge of anatomy, physiology, and pathophysiology by asking staff to explain the
significance of various diagnostic tests and abnormal results. Accompany patients to special
procedures, e.g., CT scans, angiography, ultrasound, cath lab, surgery, etc. whenever possible.
Observe and perform BLS skills as directed.
Observe and perform ALS skills as directed under DIRECT supervision after they have been
competencied in class.
B.35 | ED - BEHAVIORAL OBJECTIVES: INSTRUCTORS
During the ED clinical rotation, the unit preceptor will:
Provide the student with a brief unit orientation/tour.
Review clinical objectives with the student, mutually determine level of participation, your
anticipated break and meal times; how and where you can be found to validate their paperwork
before leaving shift.
Assist the student in gaining clinical expertise by encouraging patient contact whenever possible
and directly observing and coaching while the student performs approved skills.
Provide immediate feedback on any patient history, assessment or intervention performed by the
student.
Serve as a source of reference in answering the student’s questions.
Resolve any potential conflict situations in favor of the patient's welfare and restrict the student's
activities until any incidents can be investigated by program administration.
B.36 | ED - EVALUATIONS
The Daily Hospital Evaluation Form and Daily Clinical Internship Affective Evaluation Form must be completed by
the student and clincial instructor. It is preferred that these forms be digitally uploaded to FISDAP as an
attachment for that shift. Forms should also be turned in to program administration in a timely fashion.
B.37 | ED - PROFESSIONAL BEHAVIOR AND DRESS
Students shall wear their school and clinical site issued ID badges at all times while on the unit.
Students must adhere to program and hospital uniform and appearance policies at all times.
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LABOR AND DELIVERY (L&D)
Labor and Delivery shifts are Monday through Friday and begin at 0700. Shifts last eight (8) hours. Students
should consult FISDAP for shift start time and arrive prior to that time at the L&D Charge Nurse’s Desk. A
program clinical instructor will not be present at this location and the student will be assigned to a nurse for their
shift.
B.38 | L&D - PURPOSE
The purpose of the Labor & Delivery clinical rotation is to enable paramedic students to observe and gain
competence in monitoring patients in labor and participating in a variety of birth situations in preparation of
doing these assessments/interventions independently in the out-of-hospital environment.
B.39 | L&D - PRIOR ACADMIC PREPARATION
Prior to starting the OB clinical unit rotations, Paramedic students will have completed the preparatory elements
of basic and advanced airway and ventilatory management, oxygen delivery, pharmacology, vascular access,
medication administration, general patient assessment, respiratory and cardiac emergencies (ECG interpretation),
cardiac arrest management, obstetrics, and neonatal care.
B.40 | L&D - SCOPE OF PRACTICE AND NEED FOR SUPERVISION
A student enrolled in the Paramedic program, while fulfilling the clinical training requirements mandated for
licensure, may perform prescribed procedures under the direct supervision of a physician licensed to practice
medicine or a qualified registered nurse.
Clinical instructors are not present in this clinical setting; therefore, students may not provide any
advanced life support/invasive skill on a patient.
B.41 | L&D - BEHAVIORAL OBJECTIVES: STUDENTS
Upon completion of the L&D rotation Paramedic students will
Perform OB patient assessments consistent with National EMS Education standards. At a
minimum, patient assessments should include a review of significant past medical and OB history
to include gravida, para; PMH; gestational age in weeks; onset/duration of labor; timing/strength
of contractions and current progress of labor, determining when delivery is imminent, taking vital
signs, assessing fetal movement, auscultating fetal heart tones (and noting deceleration
patterns); and assisting patients with positioning to maximize fetal well-being and maternal
comfort.
Observe labor and participate in uncomplicated and complicated vaginal deliveries as directed.
EMS Education Standards specifically require students to gain understanding of how to intervene
in deliveries complicated by abnormal presentations (breach), shoulder dystocia, nuchal cord,
prolapsed cord, fetal distress, pre-term labor, premature rupture of membranes, and meconium
aspiration. The patient and physician must consent to a student's presence during labor and
delivery.
Participate in general unit activities that may include helping the nursing staff with setting up for
delivery, clean up following deliveries, and transporting patients.
Focus on the postnatal care given the newborn, which may include observing and participating as
directed in initial efforts to dry, warm, suction, stimulate, and/or provide resuscitative
interventions to the infant.
• Note how the time of birth is recorded.
• Correctly calculate APGAR scores.
• Assist in transporting infant to the nursery and observing admission physical exam.
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Observe and assist with post-partum care of the mother.
• Identify stable versus unstable vital signs.
• Differentiate by palpation a tonic versus atonic uterus.
• Observe and differentiate normal lochia from hemorrhage.
• Perform fundal massage as directed.
Observe C-sections if the opportunity presents, with consent of the patient, the obstetrician, and
the anesthesiologist, although this skill is not part of the paramedics scope of practice.
Use the time between patients/deliveries as productive study time. Bring study materials to the
unit with you.
B.42 | L&D - BEHAVIORAL OBJECTIVES: PRECEPTORS
During the OB clinical rotation, the unit preceptor will:
Take the student on a brief tour identifying the location of patient rooms, diagnostic/treatment
supplies, and/or equipment, staff lounge, utility rooms, waiting rooms, etc., that will facilitate
their adaptation to the unit. Show students where they can store personal belongings during the
shift.
Describe the routine patient flow patterns and the responsibilities usually assumed by nurses,
physicians, and ancillary personnel.
Review the clinical objectives with the student and mutually determine the level of participation
expected of them during the clinical assignment.
Assist the student in gaining clinical expertise by encouraging patient contact whenever possible
and offering coaching while the student observes and/or performs listed skills. The patient and
physician must consent to a student's presence during labor and delivery. It is the responsibility
of the preceptor to obtain this consent. It is helpful to obtain consent as early as possible rather
than waiting until delivery is imminent.
Serve as a source of reference in answering specific questions posed by the student regarding
unit policy, patient evaluation or treatment rendered.
Resolve any potential conflict situations in favor of the patient's welfare and restrict the student's
activities until any incidents can be reviewed and investigated by program administration.
Specific areas of content to review:
Explain the three (3) stages of labor and appropriate interventions for each.
• Fetal monitor usage and the information it provides.
• Assist students to manually time and determine strength of uterine contractions.
• Assist students in listening to FHTs.
• Have students verbalize their EMS criteria for field delivery preparation versus rapid
transport. Add to this any information that may enhance their ability to anticipate and
prepare for delivery.
• Explain uncomplicated delivery steps and those interventions that may be useful in
deliveries complicated by abnormal presentation (breach), fetal distress, pre-term
labor, premature rupture of membranes, shoulder dystocia, nuchal cord, prolapsed
cord, and meconium aspiration.
• Discuss/demonstrate resuscitation and immediate care of the newborn, including
proper use of bulb syringes and ensuring adequate ventilations and gas exchange;
drying and stimulation techniques, how to preserve body warmth, APGAR scoring
(listening to fetal HR), and clamping the umbilical cord. Stress that babies are slippery
and the importance of maintaining airway, ventilations, HR, and warmth. Once the
infant's condition is stable, instruct and allow students in how to use the bulb syringe
for oral suctioning.
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• Discuss post-partum care of the mother including observing for atonic uterus, fundal
massage, comfort measures, and delivery of the placenta.
Preceptors are encouraged to use the following educational methods: demonstration / return
demonstration, verbal coaching, and question/answer.
B.43 | L&D - EVALUATIONS
The Daily Hospital Evaluation Form and Daily Clinical Internship Affective Evaluation Form must be completed by
the student and preceptor. It is preferred that these forms be digitally uploaded to FISDAP as an attachment for
that shift. Forms should also be turned in to program administration in a timely fashion.
B.44 | L&D - PROFESSIONAL BEHAVIOR AND DRESS
Students will be provided scrubs to wear, according to the host hospital’s policy.
Students shall wear their school and clinical site issued ID badge at all times while on the unit.
Students must adhere to program and hospital uniform and appearance policies at all times.
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OPERATING ROOM (OR)
Operating Room shifts are Monday through Friday and typically begin at 0600 or 0630. Shifts last six (6) to eight
(8) hours depending on surgical cases. Students should consult FISDAP for shift start time and arrive prior to that
time at the Anesthesia Office. Students meet their clinical instructor prior to any clinical activities. Shifts are
scheduled based on student and instructor availability.
B.45 | OR - PURPOSE
The purpose of the Operating Room clinical rotation is to enable Paramedic students to participate in airway
managment and intubation of as many patients as possible in order to gain entry level competency as a
Paramedic in performing advanced airway procedures.
The student can maximize the learning potential of this experience by:
Observing the assessments performed and information gathered by the anesthesiologist prior to
advanced airway placement.
Asking pertinent questions of the anesthesiologist or CRNA.
Observing advanced airway insertion performed by the anesthesiologist and assisting with as
many intubation procedures as possible.
B.46 | OR - PRIOR ACADEMIC PERPARATION
Prior to participating in the OR clinical rotation students will have completed didactic presentations and
advanced airway practice labs; performed the critical steps of intubation on manikins including the following:
Anatomy and physiology of the pulmonary system as it relates to advanced airway insertion and
ventilating a sedated patient.
Purpose, indications, and contraindications for intubation and advanced airway placement.
Identifying patients who may pose a difficult intubation.
Selection and preparation of equipment.
Patient preparation/positioning; preoxygenation/suction techniques.
Medications used for airway management.
Intubation techniques.
Confirming tracheal placement: EtCO2 detector, capnography, 5 point auscultation, confirming
appropriate tube depth.
Securing airway devices.
Head/neck stabilization.
Ventilating patient with BVM before and after airway insertion.
Complications of intubation.
Monitoring patients during and after intubation procedures.
Intravenous cannulation.
B.47 | OR - SCOPE OF PRACTICE AND NEED FOR SUPERVISION
A student enrolled in the Paramedic program, while fulfilling the clinical training requirements mandated for
licensure, may perform prescribed procedures under the direct supervision of a physician licensed to practice
medicine or a qualified registered nurse.
Students may not provide any advanced life support/invasive skill on a patient without a clinical
instructor or preceptor immediately observing and coaching their technique to ensure patient
safety.
Students may not perform any skills that are outside of their scope of practice as defined by the
National EMS Education Standards or program policies and procedures.
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B.48 | OR - BEHAVIORAL OBJECTIVES: STUDENTS
Upon completion of the OR rotation, a Paramedic student will perform each of the following within their scope of
practice and without critical error:
Assist in performing endotracheal intubations on a variety of surgical patients (range of age,
health status, anatomy) in a controlled environment, under the direct supervision and guidance
of a licensed anesthesiologist or CRNA. Assist means performing direct manual glottic
visualization using a laryngoscope, inserting the ET tube, and verifying correct tube placement
under the direct supervision of an anesthesiologist or CRNA.
Develop communication skills by observing interactions between patients, significant others, and
staff.
Enhance their ability to obtain a pertinent history and pre-procedure exam relative to advanced
airway management.
Observe the effects and side effects of drugs/medications taken by, or administered to, the
patient, before, during, and after induction of sedation and/or anesthesia; assist in calculating
any medication doses.
Perform competencied psychomotor skills, under direct supervision of a qualified instructor or
preceptor.
Enhance knowledge of anatomy, physiology, and pathophysiology by asking the preceptor to
explain the significance of various assessment findings and airway access challenges and
outcomes.
B.49 | OR - BEHAVIORAL OBJECTIVES: INSTRUCTORS
During the OR clinical rotation, the clinical instructor will:
Provide the student with a brief unit orientation and tour. Provide a place to store belongings.
Review clinical objectives with the student. Mutually determine the level of participation, and
how and where you can be found to validate their paperwork before leaving the unit.
Assist the student in gaining airway managment opportunities by encouraging patient contacts
and introducing them to anesthesiologists who enjoy bedside teaching whenever possible.
Resolve any potential conflict situations in favor of the patient's welfare and restrict the student's
activities until any incidents can be investigated by program administration.
Anesthesiologist/CRNA will:
Directly observe and coach while the student assists in performing the approved skills.
Provide immediate feedback to help students improve their technique on any procedure(s)
performed.
Serve as a resource in answering the student’s questions on advanced airway access.
Intervene when appropriate.
B.50 | OR - EVALUATIONS
The Daily Hospital Evaluation Form and Daily Clinical Internship Affective Evaluation Form must be completed by
the student and clincial instructor. It is preferred that these forms be digitally uploaded to FISDAP as an
attachment for that shift. Forms should also be turned in to program administration in a timely fashion.
B.51 | OR - PROFESSIONAL BEHAVIOR AND DRESS
Students will be provided scrubs to wear in the OR, according to the host hospital’s OR policy.
Students shall wear their school and clinical site issued ID badge at all times while on the unit.
Students must adhere to program and hospital uniform and appearance policies at all times.
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APPENDIX C | FIELD INTERNSHIP
C.01 | INTRODUCTION
The Paramedic field internship is a structured schedule of field rotations responding to out-of-hospital
emergencies. Through field experience in the emergency ambulance, the paramedic student will develop a
more comprehensive understanding of the pathophysiology of disease and trauma, rationale for treatments
rendered, and how specific treatment alters disease or injury. Technical skills necessary to render advanced
pre-hospital patient care will also be enhanced. This will occur under the direct supervision of a designated
Field Training Officer. Paramedic students may be required to attend a mandatory orientation at their internship
site prior to the start of their field internship.
The Paramedic student will be involved in patient care situations ranging in acuity from routine to urgent and
life-threatening. In each situation, the Paramedic student is responsible for:
Being attentive
Applying clinical protocols
Exercising common sense
Recognizing his or her own limitations
Participating assertively in the patient’s management and care
Acting courteous, professional and appropriate at all times with the patient and the staff
C.02 | PATIENT CONFIDENTIALITY
Protected health information (or “PHI”), under the US Health Insurance Portability and Accountability Act
(HIPAA) is any information about health status, provision of health care, or payment for health care that can be
linked to a specific individual. Confidentiality of protected health information is the responsibility of all
healthcare providers, inclusive of Paramedic students.
Paramedic students will be cautious whenever they discuss protected health information, taking into
consideration their location (e.g., public areas) and who they discuss this information with. It is appropriate to
discuss such information with preceptors and other healthcare providers who are and were previously involved
with that patient’s care. Paramedic students are also encouraged to discuss interesting clinical cases
encountered during their internship with peers and faculty; however, at no time should the names of patients or
any other identifying information be divulged.
No part of the patient’s medical records may be copied or taken from the internship site. The only exception is
ECGs, and only after they have been de-identified (redaction should be accomplished using a wide black pen or
marker and subsequently photocopying the result).
Any discussion of protected health information or discussion of clinical encounters outside these guidelines may
result in disciplinary action and/or dismissal from the Paramedic education program.
C.03 | PROFESSIONAL BEHAVIOR
Paramedic students will conduct themselves in a professional manner at all times. They will treat patients, their
families, hospital and internship staff with the utmost respect. Paramedic students should remember they will
not only be evaluated on psychomotor performance, but also continually evaluated on their affect. Behavior that
is unprofessional will be immediately and severely dealt with.
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Paramedic students are expected to exhibit a moderate amount of assertiveness in their field internship. You
should neither be overbearing nor timid. During the field internship, you should not expect the staff and Field
Training Officers to be aggressive in finding you opportunities if you are not attempting to do so yourself. Once
you have become acquainted with your internship site’s staff and they become familiar with you and your
capabilities, your internship will become more productive.
Paramedic students are encouraged to discuss their performance with Field Training Officers. Use the
information learned during these discussions to improve your productivity and aptitude. Listen carefully to
criticisms and use them constructively. Any discussion or criticism by staff or Field Training Officers that you feel
is malicious should be reported to program administration.
Paramedic students should never forget the reasons behind a field internship. It is a learning experience. It
should not be considered “just another hurdle” towards your paramedic certification. You should not be satisfied
with the program’s minimum requirements.
Remember that you never get a second chance to make a good first impression.
C.04 | GOALS OF THE FIELD INTERNSHIP EXPERIENCE
Provide the student with an opportunity to perform assessment and treatment skills learned in
the didactic, laboratory and clinical portions of the program.
To expose the student to the most current concepts in emergency care.
To allow the student to develop a working relationship with other members of the health care
team.
To culminate the knowledge and skills obtained and become a competent, entry-level Paramedic.
C.05 | OBJECTIVES OF THE FIELD INTERNSHIP EXPERIENCE
Upon completion of the field internship, the Paramedic intern will be able to effectively and accurately:
Understand his or her roles and responsibilities within an EMS system, and how these roles and
responsibilities differ from other levels of providers.
Understand and value the importance of personal wellness in EMS and serve as a healthy
role model for peers.
Integrate the implementation of primary injury prevention activities as an effective way to
reduce death, disabilities, and healthcare costs.
Understand the legal issues that impact decisions made in the out-of-hospital
environment.
Apply the general concepts of pathophysiology for the assessment and management of
emergency patients.
Integrate pathophysiological principles of pharmacology and assessment findings to
formulate a field impression and implement a pharmacologic management plan.
Access the venous circulation and administer medications.
Integrate the principles of therapeutic communication to effectively communicate with any
patient while providing care.
Integrate the physiological, psychological, and sociological changes throughout human
development with assessment and communication strategies for patients of all ages.
Establish and/or maintain a patent airway, oxygenate, and ventilate a patient.
Use the appropriate techniques to obtain a medical history from a patient.
Explain the pathophysiological significance of physical exam findings.
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Integrate the principles of history taking and techniques of physical exam to perform a patient
assessment.
Apply a process of clinical decision making to use the assessment findings to help form a field
impression.
Follow an accepted format for dissemination of patient information in verbal form, either in
person or over the radio.
Document the essential elements of patient assessment, care, and transport.
Integrate the principles of kinematics to enhance the patient assessment and predict the
likelihood of injuries based on the patient’s mechanism of injury.
Integrate pathophysiological principles and assessment findings to formulate a field
impression and implement the treatment plan for the patient with:
• Shock or hemorrhage
• Soft tissue trauma
• A burn injury
• A suspected head injury
• A suspected spinal injury
• A thoracic injury
• Abdominal trauma
• Musculoskeletal injury
Integrate pathophysiological principles and assessment findings to formulate a field
impression and implement the treatment plan for the patient with:
• Respiratory problems
• Cardiovascular disease
• A neurological problem
• An endocrine problem
• An allergic or anaphylactic reaction
• A gastroenterological problem
• A renal or urologic problem
• A toxic exposure
• An environmentally induced or exacerbated medical or traumatic condition
• Infectious and communicable diseases
Integrate the pathophysiological principles of the hematopoietic system to formulate a field
impression and implement a treatment plan.
Describe and demonstrate safe empathetic competence in caring for patients with behavioral
emergencies.
Utilize gynecological principles and assessment findings to formulate a field impression and
implement the management plan for the patient experiencing a gynecological emergency.
Apply an understanding of the anatomy and physiology of the female reproductive system to
the assessment and management of a patient experiencing normal or abnormal labor.
Integrate pathophysiological principles and assessment findings to formulate a field
impression and implement the treatment plan for the following:
• Neonatal patient
• Pediatric patient
• Geriatric patient
• Patient who has sustained abuse or assault
Integrate pathophysiological and psychosocial principles to adapt the assessment and
treatment plan for diverse patients and those who face physical, mental, social, and
financial challenges.
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Integrate the pathophysiological principles and the assessment findings to formulate a field
impression and implement a treatment plan for the acute deterioration of a chronic care
patient.
Integrate the principles of assessment-based management to perform an appropriate
assessment and implement the management plan for patients with common complaints.
Understand standards and guidelines that help ensure safe and effective ground and air medical
transport.
Integrate the principles of general incident management and multiple casualty incident
(MCI) management techniques in order to function effectively at major incidents.
Integrate the principles of rescue awareness and operations to safely rescue a patient from
water, hazardous atmospheres, trenches, highways, and hazardous terrain.
Evaluate hazardous materials emergencies, call for appropriate resources and work in the cold
zone.
Have an awareness of the human hazard of crime and violence and the safe operation at crime
scenes and other emergencies.
C.06 | AFFECTIVE DOMAIN OBJECTIVES
Develop a respect for death, injury and illness, and the dying process.
Demonstrate punctuality by being on time and ready to start.
Demonstrate the ability to treat patients and fellow healthcare providers with respect.
Demonstrate the ability to work with others by working as a team in given patient scenarios and
situations.
Demonstrate critical thinking skills by applying information learned in class and hospital clinical
rotations to determine the proper action necessary to give competent and compassionate patient
care.
Demonstrate acceptable ethical and moral standards.
Demonstrate confidence, assertiveness, and a respect for fellow healthcare providers by
participating in every opportunity.
C.07 | INTERNSHIP TIME AND REQUIREMENTS
The program does not set an amount of time for the Field Internship. Instead, a minimum amount of contacts,
higher than nationally required, are required by the program. Below are the requirements to complete the field
internship:
75 ALS Team Lead calls.
• Minimum of 65 transported ALS emergencies. These contacts must be transported
patients at the ALS level. ALS to BLS downgrades, ALS assessment without transports,
or refusals will not count as a patient contact.
• Maximum of 10 ALS Inter-Facility Transfers.
• An ALS Inter-Facility transfer must consist of intravenous medication infusion via
intravenous pump or utilization of a mechanical ventilator. Acceptance of all ALS
Inter-Facility transfers are at the discretion of program administration.
C.08 | ATTENDANCE
Field internship shifts are at a premium, as you must ride with a program endorsed Field Training Officer.
Tardiness and absence from a clinical shift will not be tolerated. Any absence from a field internship shift requires
notification of program administration as soon as possible. Missing more than 72 hours of ride time may result in
dismissal from the course.
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C.09 | UNIVERSAL PRECAUTIONS
Paramedic students functioning in the field environment are at risk for exposure to blood borne pathogens and
infectious diseases. All body substances should be considered potentially infectious. Personal Protective
Equipment (PPE) is readily available at each clinical site and should be used whenever appropriate. The minimum
recommended PPE includes:
Gloves: Disposable gloves should be worn before initiating patient care when there is any risk of
exposure to body substances. This includes any invasive procedures (e.g., starting intravenous
lines). Sterile gloves may be required for some procedures. The same gloves should not be worn
with more than one patient. Always remove gloves when leaving a patient’s room or area. You
should always endeavor to wash hands with soap and warm water after gloves have been
removed; however, using wall-mounted antibacterial gel may be an appropriate substitute if
authorized by the clinical site.
Masks and protective eyewear: Protective eyewear and facemasks should always be worn when
there is a risk of splashing or spattering of blood or other bodily fluids. Examples of this include
intubation and airway management, childbirth and open wounds or fractures. Healthcare
providers should wear appropriate respirators or masks whenever there is potential for airborne
transmission of disease. Standard corrective eyeglasses do not provide sufficient splash
protection from fluids; most medical protective eyewear or masks can accommodate corrective
eyewear.
Gowns: Gowns should always be worn when there is a risk of splashing or spattering of blood or
other bodily fluids, as described in the previous section.
Hand sanitization: Hand sanitizing is mandatory prior to and following any patient contact, using
the restroom, or eating a meal. Conventional soap and warm water or antibacterial gels are both
acceptable, if allowed by the specific clinical site. It is the policy of each clinical site to have the
Paramedic follow the Hand Sanitation policy and lack of compliance may result in dismissal from
the clinical site.
Any student who is exposed to a patient's bodily fluids should immediately decontaminate themselves, report
the incident to their instructor and program administration and follow the hospital’s post-exposure protocols. In
addition, the student will need to complete an exposure packet, which can be obtained from the program.
C.10 | DOCUMENTATION
Complete and accurate documentation is fundamental to both your field internship and career in the EMS
profession. You should complete all documentation as if you were a practicing Paramedic. Please review and
ensure that your documentation complies with all the statements below.
Skills and assessments may only be signed by the Field Training Officer who assigned and
observed your performance of the skill.
Falsification of any documentation is grounds for corrective action, up to and including dismissal
from the program.
Any errors made in documentation of time or skills must be brought to the attention of the
program administration as soon as they are discovered.
Print all entries clearly and legibly; any unclear or illegible entries may be discarded.
Program endorsed Field Training Officers are the only individuals allowed to sign your clinical
documentation.
Only original documents will be accepted; you are allowed to make copies for back-up purposes.
The only allowable correction method is a single line written through the error, and initialed by
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the corrector; the correction is then made on a separate line, in a separate entry.
Each entry must be completely filled out and signed (e.g., no “ditto” marks).
Use 24-hour notation to document time.
All shifts must be scheduled in FISDAP prior to the start of the shift.
Documentation must be entered into FISDAP and completed within 96 hours of the field shift.
If there are issues with FISDAP data entry, program administration should be contacted as soon
as possible.
In the event that your paperwork is found to be inaccurate, fraudulent or unreadable, the
student may be responsible for fixing errors. Any activity deemed inappropriate or unprofessional
in regard to paperwork, may result in dismissal from the program.
Paramedic students must complete all required post-shift evaluations required in FISDAP for each
internship shift.
C.11 | ELIGIBILITY TO PARTICIPATE
The following pre-requisites must be satisfied for any Paramedic student to participate in the field internship:
Maintain current state or NREMT EMT or AEMT certification.
Maintain current American Heart Association cardiopulmonary resuscitation credentials
(healthcare provider level).
Maintain current ACLS, PALS and PHTLS certifications (once provided in course).
Be in good academic standing.
Completed Paramedic 1, Paramedic 2 and Paramedic 4 successfully.
Be in good financial standing with American Professional Educational Services.
Receive authorization from the program to initiate the field internship.
All points on behavioral evaluations must deemed ‘Competent’ to begin or stay in the field
internship.
C.12 | DRESS CODE
Excellent personal appearance in the clinical setting is vital. Paramedic students shall present themselves in the
uniform required by the program, unless otherwise dictated by a particular clinical setting (such as the operating
room rotations).
An identification badge, which will be issued to students prior to the start of the field internship, must be worn
at all times. It must be worn outward facing so that the student’s first name and the title, “Paramedic Student” is
visible. All paramedic education program policies and procedures are in effect during your clinical practicum; as
such please refer to those for explicit instructions regarding dress code.
All dress code polices will be strictly enforced during the field internship. The student must be dressed and
appear in a uniform that is neat, clean and in good working order for the shift. Violations of this policy will result
in you being sent home from the shift and possible other corrective actions.
C.13 | MALPRACTICE INSURANCE
insurance is a requirement for clinical and field internship rotations and is provided by American Professional
Educational Services.
C.14 | IMMUNIZATIONS
All immunization documentation must be submitted per the Student Handbook and internship site
requirements. Failure to submit immunization documentation will result in a potential delay or inability to
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participate in the field internship.
C.15 | MISCELLANEOUS POINTS
Students must always function as a third-rider and never as a member of the crew.
While you are working, you may not perform skills or assessments for internship credit.
You may not get credit for ride time hours while you are working.
When getting credit towards ride time requirements, you must always be in uniform.
Print all entries legibly and clearly. Any illegible items may be disregarded!
The Field Training Officer must be at your side when you are performing a skill.
Only Paramedics who have been certified, and practicing full-time, for at least one (1) or more
years are authorized to be Field Training Officers.
You should never ride on the same ambulance as another Paramedic intern.
In the event that your paperwork is found to be inaccurate, fraudulent or unreadable, the
student may be responsible for fixing errors. Any activity deemed inappropriate or unprofessional
in regard to paperwork, may result in program dismissal without opportunity for resolution.
Paramedic students must complete a post-shift evaluation for each ride time shift.
Any and all incidents or unusual events must be reported to program administration. Hearing
about an event from a Field Training Officer or ambulance service without prior knowledge is not
looked upon favorably.
All shifts must be scheduled in FISDAP BEFORE the shifts occur.
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AMERICAN AMBULANCE SERVICE INC.
Shifts at American Ambulance are seven (7) days a week and begin at varied times. Shifts last eight (8), ten (10)
and twelve (12) hours. Students should consult FISDAP for shift start time and arrive prior to that time at the
American Ambulance Supervisor’s Office.
C.16 | AASI - LOCATION
American Ambulance is located at One American Way, Norwich, CT 06360. Parking is available on High Street or
in the American Professional Educational Services parking lot.
C.17 | AASI - FIELD TRAINING OFFICER
You are assigned to a Field Training Officer when your shift is scheduled. Changes in the Field Training Officer are
only allowed with authorization of program administration. Students and/or supervisors at American Ambulance
can not change the assignment without authorization of program administration. In the event that the assigned
Field Training Officer is absent for the shift, and there are not any other Field Training Officers available, the
student will be dismissed from the shift without penalty.
C.18 | AASI - SCHEDULING
All scheduling is done through the ALS Program Coordinator. Students are not to self-schedule shift with the
internship site.
C.19 | AASI - MANDATORY COMMUNICATION
Students are required to call the American Ambulance Supervisor at (860)886-1463 one (1) hour prior to the start
of the shift. This will ensure that a Field Training Officer is available. In the event of scheduling changes, or
operational issues, the supervisor may cancel the shift. All cancelled shifts are investigated by American
Ambulance operations management and program administration.
92 STUDENT HANDBOOK
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2019 PARAMEDIC HANDBOOK
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