ems 153 syllabus lp 2017pems.bcfdmo.com/.../uploads/2019/01/ems-153-syllabus-lp-2017p.pdf · 4)...

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Paramedic Education ProgramEMS 153 Course Syllabus

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Course Number: EMS 153

Course Title: Field Airway Management 1

Term / Block / Dates / Schedule:2017-P01 Block 1 August 16-December 13 class days

Course Director / Contact Information:Bryant Gladney, B.S., EMT-P, EMS Education Division Manager, Paramedic Program Director Phone: 573-303-2597 Email: [email protected]

Course Medical Director:Dr. William Womack, D.O., FACEP, FAAEM

Course Location: Boone County Fire Protection District Headquarters (Northeast Classrooms)

Course Structure and Format: Hybrid (part online / independent study and part lab)

Contact Hours: 40 contact hours (24 online / independent, 16 lab)

Credit Hours: 2 credit hours

Catalog Description: This course is the first of a two-part series designed to help paramedic students become competent and confident airway managers in the field environment. Part of the course is delivered in the Moodle Learning Management System. This online / independent study is supplemented by two-hour lab sessions during each face-to-face meeting of the course. During the lab sessions, students will engage in activities and discussions with faculty and peers designed to assess their knowledge level as well as to practice applicable skills.

Prerequisites:EMS 111, 112, 113 (the “EMT Program”) or valid Missouri EMT License

Co-requisites:none although typically taken together with EMS 150, EMS 151, EMS 154

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mailto:[email protected]

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�Paramedic Education Program Mission and Program Goals:

EMS Education Division Mission: To deliver a valid and effective educational environment wherein students and active EMS providers can develop professionally.

Paramedic Education Program Goal: To prepare competent entry-level Paramedics in the cognitive (knowledge), psychomotor (skills), and affective (behavior) learning domains.

EMS 153 Course Goals:

To prepare First Block Paramedic Students with the foundational airway management and artificial ventilation skills needed as they progress into the EMS Scenarios, Simulated EMS Cases and Trauma Cases courses and the Paramedic Hospital Clinical Experience and Paramedic Field Internship.

Paramedic Education Program Learning Outcomes:

Expectations for graduates of the Paramedic Education Program are grouped into the categories of Medical Knowledge (the cognitive domain), Patient Care (the psychomotor skills domain) and Professionalism (the affective domain). Paramedic program graduates are expected to:

Medical Knowledge:MK 1: Describe social, behavioral and psychological aspects of emergency medical care.MK 2: Demonstrate the ability to evaluate, diagnose, and treat emergency medical conditions in patients across the lifespan.MK 3: Demonstrate the ability to analyze the information available in an emergency patient care situation while taking into account the potential for conflicting and incomplete data in order to arrive at a safe and effective care plan.

Patient Care:PC 1: Demonstrate the ability to provide patient-centered care characterized by compassionate and respectful relationships with patients and their families.PC 2: Perform medical, surgical and scene management procedures appropriate to a Paramedic entering the profession.

Professionalism: PR 1: Describe the role of the Paramedic including professional, ethical, legal, and regulatory standards regarding the Paramedic profession.PR 2: Demonstrate professional relationships characterized by empathy, ethical practices, respect, compassion, accountability, and integrity when interacting with patients, families, supervisors, physicians, nurses and other members of the health care team.PR 3: Use effective communication skills demonstrating sensitivity and responsiveness to culture, age, gender and abilities in order to promote an ethically sound and therapeutic relationship with patients and their families.PR 4: Demonstrate initiative, flexibility and tolerance of ambiguity and anxiety.PR 5: Demonstrate self-reflection to recognize and appropriately address personal biases, gaps in medical knowledge, and limitations in themselves and others while striving to continually improve their ability to provide safe and effective patient care.

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Course Learning Outcomes Linkage to Program Outcomes:

Course Learning Outcomes:

Graduates will demonstrate the following capabilities on a summative written assessment:

EMS 153-1: Knowledge of the key anatomical landmarks involved in field airway management.

EMS 153-2: Knowledge of the techniques for direct laryngoscopy, video laryngoscopy, blind intubation, endotracheal tube suctioning, nasogastric and orogastric tube management and restricted access intubation techniques.

Graduates will demonstrate the following capabilities on a practical skills performance assessment:

EMS 153-3: The ability to accurately and swiftly prepare for intubation.

EMS 153-4: The ability to safely and properly place laryngoscopes and obtain a view of the larynx.

EMS 153-5: The ability to orally intubate a manikin using direct laryngoscopy in a non-complicated case.

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EMS 153 Course Learning Outcomes / Program Learning Outcomes

Course Learning Outcome MK-1 MK-2 MK-3 PC-1 PC-2 PR-1 PR-2 PR-3 PR-4 PR-5

EMS 153-1 x

EMS 153-2 x

EMS 153-3 x x x

EMS 153-4 x x x x

EMS 153-5 x x x

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�Instructional Objectives:

Graduates of this course will be able to demonstrate on a written assessment with 100% accuracy the ability to:

1) Describe the proper procedure for obtaining a pulse oximetry reading including how to properly assess the signal strength and how to manage finger nail polish or false nails.

2) Define minute volume.3) Discuss the structure and function of the pleura.4) Define the terms pneumothorax, simple pneumothorax, tension pneumothorax and

hemothorax.5) Discuss the production of carbon dioxide in the body and the measurement of its elimination

via capnography.6) Define the four Cormack-Lehane Grades and identify each in photographs or diagrams.7) Define and locate on photographs or diagrams the epiglottis, the vallecula, the arytenoid

(posterior) cartilages and the inter-arytenoid notch.8) List and describe each element of the “Airway Prep Sequence” as defined by our program.9) Define the term “epiglottoscopy” and explain why Dr. Levitan suggests that it is the best

practice.10) Discuss the difference in appearance and utilization for the various types of direct

laryngoscope blades.11) Describe proper methods for estimating the depth of insertion for an ET tube.12) Describe the various parts of an ET tube, how to determine the size and type of ET tube and

how to prepare the tube for intubation.13) Discuss the use of stylets and bougies.14) Discuss nasal intubation including when to use the technique, equipment needed and the

steps to perform.15) Discuss digital intubation including when to use the technique, equipment needed and the

steps to perform.16) Discuss face-to-face intubation including when to use the technique, equipment needed and

the steps to perform.17) Discuss blind intubation using a SALT airway including when to use the technique,

equipment needed and the steps to perform.18) Discuss the differences in the procedure and potential challenges when performing

intubation while maintaining spinal motion restriction.19) Explain how to proceed when faced with a Cormack-Lehane Grade 3 view.20) Explain how to proceed when faced with a Cormack-Lehane Grade 4 view.21) Discuss the use of supraglottic airways including sizing, insertion, securing, troubleshooting

and contraindications.

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Graduates of this course will be able to demonstrate on a skills performance assessment with 100% accuracy the ability to:22) Demonstrate proper bag-mask ventilation using the sniffing position, jaw thrust and proper

ventilation rate, volume and pressure.23) Demonstrate proper intubation in all ages using the oral route with both direct and video

laryngoscopy and in cases with spinal motion restriction on standard airway manikins.24) Demonstrate proper SALT, digital, face-to-face and nasal intubation techniques on standard

adult airway manikins.25) Demonstrate proper techniques for placement of gastric tubes using both the oral and nasal

routes in standard adult airway manikins.26) Demonstrate proper techniques for suctioning ET tubes in standard adult airway manikins.

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�National EMS Education Standards: applicable to this course:

9) Airway Management, Respiration and Artificial Ventilation: Integrates complex knowledge of anatomy, physiology, and pathophysiology into the assessment to develop and implement a treatment plan with the goal of assuring a patent airway, adequate mechanical ventilation, and respiration for patients of all ages.

A) Airway Management C&C: Within the scope, anatomy, assessment, techniques of assuring a patent airway

23) Psychomotor Skills:Safely and effectively perform all psychomotor skills within the National EMS Scope of Practice Model AND state Scope of Practice at this level.

A) Airway and Breathing : Oral and nasal endotracheal intubation, direct laryngoscopy, NG/OG tube

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Topical Outline:• Fundamentals and BLS Airway Management Units• Airway Prep Sequence Unit• Laryngoscopy Unit• Endotracheal Tube Unit• Blind and Restricted Access Units• Supraglottics and Support Units

Textbook Resources:• Mosby’s Paramedic Text 4th edition (Sanders) Chapters 15• PHTLS 8th edition Chapter 8

Moodle LMS Online Resources:EMS 153 Paramedic Assessment and Treatment Course

Lab Resources: Paramedic Classroom Skills Lab

Clinical Resources: n/a

Methods of Evaluation: written assessments and skills performance assessments

Grade Determination: Five proctored quizzes are given in sequence with 100% score on each required in order to move on to the next followed by one proctored written final examination. Five emailed assignments are due at various times throughout the course. The course grade is based on the final examination score (80%), completion of the five quizzes (10%) and five assignments (10%). The following grading scale will be used:

A 90-100 B 80-89 C 70-79 F ≤69

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�Policies and Procedures:

Attendance: Students are expected to be in attendance and ready for class to begin at each and every session by the designated start time. Attendance is recorded via a roster that requires each student to sign and to note their time in and time out. Students are expected to return from breaks at the designated time and to stay in attendance at each session until dismissed. Excessive attendance issues are an indicator of professionalism problems and require student counseling. Students who are not in attendance for the equivalent of 10 percent of the sessions (for any reason) may be dismissed from the course. Performance in this area is recorded in the “Professionalism” grade category.

Cancellations / schedule adjustments: Extreme weather conditions or other unforeseen emergency situations may necessitate that a class session be cancelled or rescheduled. Students should expect to monitor the email address they gave at registration for schedule changes. Students who wish to also be notified by text message may provide their contact information at the first class session.

Participation: Students are expected to participate in classroom management activities including equipment checks, supply stocking, general cleaning duties and classroom discussions or work assignments. Performance of these duties is recorded in the “Professionalism” grade category.

Safety: Students will receive a safety briefing as appropriate at each class session and prior to any change in conditions in the instructional area. Students will receive a safety briefing by their clinical preceptor during clinical experience sessions. Any injury during classroom, lab, simulation, clinical sessions or the field internship must be immediately reported to the Paramedic Program Director. Performance in this area is recorded in the “Professionalism” grade category.

Assessments: Student performance will be assessed using a variety of methods and criteria. In all cases, students will be provided with the criteria in advance of the assessment. Performance in this area is recorded in the “Capabilities” grade category.

Office Hours: The Faculty Team will maintain “office hours” at various times and using various formats to assist students who need remediation. Given that many students travel from a considerable distance for face-to-face class sessions, options exist for office hours to be conducted via phone or video conference as needed. Office Hours are for students who desire additional assistance with a specific topic. Students who miss class sessions should NOT rely on Office Hours as a mechanism to make up missed work.

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�Appearance: Students are expected to be in uniform for all sessions of any course in

the Paramedic Education Program. The default uniform will be the same uniform that is required for the Clinical Experience portion of the program. Practical lab sessions are integrated into the course and students should expect to be involved in activities consistent with actual patient care at anytime. Students may elect to wear their department uniform to class as an option. For BCFPD members, this uniform would be a Class C or Fire District “polo” shirt. A professional appearance is a requirement for participation in the Paramedic Education Program. Students should wear the appropriate uniform to each class session. The uniform must be clean and neat, present a professional appearance at all times and meet the criteria detailed below. Performance in this area is recorded in the “Professionalism” grade category. The uniform and appearance requirements include:

• Hair should be tied back if longer than shoulder length.

• Beards and mustaches must be neatly trimmed (it may be required that beard and possibly mustaches be shaven for the internships allowing for proper fitting of HEPA masks).

• Tattoos and body art must be covered.

• Wedding bands/sets are permitted. No other jewelry is permitted.

• Clinical uniform shirts are issued by BCFPD and become the property of the student. Costs are included in the course tuition. All uniform shirts must be clean, pressed (wrinkle-free) and worn tucked in at all times.

• Dark blue or black uniform pant or dark blue BDU pant. If a BDU pant is chosen, the pant legs are to be worn over the boots rather than “bloused” in the style common for military or SWAT roles. No jeans are allowed. Pants are to be obtained by the student and the cost is not included in the course fee because many students already own acceptable pants.

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� Academic Honesty: The Paramedic Education Program develops professionals who

are committed to the standards of the profession. Academic dishonesty violates the ethical standards of our community and stunts students’ intellectual and personal development. We have therefore adopted an academic dishonesty policy that imposes penalties for students who commit acts of academic dishonesty. Academic dishonesty includes but is not limited to the following:

o Committing plagiarism. Plagiarism means presenting another person’s work as one’s own. The work in question could be research data, a text of any kind, a performance, musical composition, design, work of visual art, photograph, film, video, or any other type of intellectual property, whether copyrighted or not. This includes buying another person’s work from any source and presenting it as one’s own.

o Cheating. Cheating means engaging in any dishonest behavior on examinations, tests, quizzes, assignments, or any other academic activity. This includes use or attempted use of unauthorized assistance, collaboration (unless expressly permitted by the instructor), and unauthorized possession of examinations or other academic materials belonging to a member of the college faculty or staff.

o Engaging in activities that disadvantage another student, including destruction, defacement, alteration or unauthorized removal of resource materials, or sabotaging another student’s work.

o Turning in substantially the same work for more than one course (unless expressly permitted by the instructors).

o Misrepresenting oneself or one’s circumstances in order to obtain an advantage in academic activities.

o Using copyrighted material without obtaining the appropriate rights or permissions. The material in question could be a computer program, a text of any kind, a performance, musical composition, design, and work of visual art, photograph, film, video, choreography, or any other type of copyrighted material.

o Fabricating or falsifying any data, information, or citation in an academic activity.

o Aiding another student in any act of academic dishonesty. Academic dishonesty is not tolerated in the Paramedic Education Program and the consequence for any offense may be dismissal from the program. Any instance of academic dishonesty will be addressed according to policy in the Paramedic Education Program Student Handbook.

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� Accommodations for Disabilities: If you require reasonable disability-related

accommodations, please register your official ADA-approved documentation with the Course Director. Retroactive accommodations will not be provided. Additionally, please inform the course director immediately if you need to disclose emergency medical information or need to make arrangements in the event the classroom and/or classroom building must be evacuated.

Syllabus Changes: Every effort will be made to adhere to the contents of this syllabus. However, this document is subject to change in the event of unforeseen circumstances or in order to best serve the students. Students will be notified as soon as possible if changes in the syllabus become necessary.

Time to Complete: Students have one calendar year from the beginning of any Course in the Program to complete the requirements for that Course. Extensions may be granted at the discretion of the Dean (Bureau Director—Operations and Training) in extraordinary cases. The expected time for completion of this course is 16 weeks from its beginning.

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�Course Schedule

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Week Assignment / Activity Date (Section T)

Date (Section A)

Date (Section F)

1 Class Session 1 (1200-1400) Course Introduction, Lab A 8/15/17 8/16/17 8/18/17

2 Assignment 1 Emailed by 0800 hrs, Prep Lab B 8/22/17 8/23/17 8/25/17

3 Class Session 2 (1200-1400) Quiz 1, Lab B 8/29/17 8/30/17 9/1/17

4 Assignment 2 Emailed by 0800 hrs, Prep Lab C 9/5/17 9/6/17 9/8/17

5 Class Session 3 (1200-1400) Quiz 2, Lab C 9/12/17 9/13/17 9/15/17

6 Assignment 3 Emailed by 0800 hrs, Prep Lab D 9/19/17 9/20/17 9/22/17

7 Class Session 4 (1200-1400) Quiz 3, Lab D 9/26/17 9/27/17 9/29/17

8 Assignment 4 Emailed by 0800 hrs, Prep Lab E 10/3/17 10/4/17 10/6/17

9 Class Session 5 (1200-1400) Quiz 4, Lab E 10/10/17 10/11/17 10/13/17

10 Assignment 5 Emailed by 0800 hrs, Prep Lab F 10/17/17 10/18/17 10/20/17

11 Class Session 6 (1200-1400) Quiz 5, Lab F 10/24/17 10/25/17 10/27/17

12 Prep for Lab Final 10/31/17 11/1/17 11/3/17

13 Class Session 7 (1200-1400) Lab Final 11/7/17 11/8/17 11/10/17

14 Review and Final Exam Preparation 11/14/17 11/15/17 11/17/17

15 Thanksgiving Break

16 Class Session 8 (1200-1400) Final Exam 12/5/17 12/6/17 12/8/17

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�Skills Lab Schedule

Lab A

1) Airway Prep Sequence Unit

Lab B

2) Laryngoscopy Unit3) Adult DL x 1 rep4) Pediatric DL x 1 rep5) Adult VL x 1 rep6) Endotracheal Tube Unit

Lab C

7) Adult DL x 1 rep8) Adult VL x 1 rep9) Pediatric DL x 1 rep

Lab D

10) Blind Intubation Unit11) Nasal Intubation x 1 rep12) SALT Airway x 1 rep13) Digital Intubation x 1 rep

Lab E

14) Restricted Access Unit15) Face-to-Face Intubation x 1 rep16) Pediatric Trauma Intubation x 1 rep17) Adult Trauma Intubation x 2 rep

Lab F

18) Supraglottic Airway Unit19) Support Tactics Unit20) King, Combitube and LMA x 1 rep each21) Nasogastric Tube x 1 rep22) ETT Suctioning x 1 rep

Lab Final

Adult non-trauma oral intubation.

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Lab A

• Prep work in Moodle not possible—this is the first session. (Coaching Notes in parentheses and italics)

• Table groups work FISDAP lab skill practice and peer formative assessment on:• Airway Prep Sequence lesson and practice activity (distribute cards, do walk-through)

• Coach students on Moodle work for next session and emphasize assignment due date (0800 one week later emailed to faculty email)

• Assignment 1 to be emailed to faculty email by 0800 hours on normal class day• Answer questions on worksheet. Download Word document to use from Moodle.

• Lab B Prep

• Units in Moodle• Laryngoscopy Unit• Endotracheal Tube Unit

Follow Up from Prior• Airway Prep sequence practice independently

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Date (Section A)

Date (Section F)

1 Class Session 1 (1200-1400) Course Introduction, Lab A 8/15/17 8/16/17 8/18/17


Date (Section A)

Date (Section F)

2 Assignment 1 Emailed by 0800 hrs, Prep Lab B 8/22/17 8/23/17 8/25/17

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Lab B

• Prep work in Moodle completed prior. (Coaching Notes in parentheses and italics)

• Table groups work FISDAP lab skill practice and peer formative assessment on:• Laryngoscopy Unit• Endotracheal Tube Unit• Adult DL x 1 rep (actively coached, deliberate practice for sequence—not speed)• Pediatric DL x 1 rep (actively coached, deliberate practice for sequence—not speed)• Adult VL x 1 rep (actively coached, deliberate practice for sequence—not speed)

• Give Quiz 1, self-grade, faculty review, scan and return.



• Lab C Prep

• Units in Moodle—all prior to this point


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Date (Section A)

Date (Section F)

3 Class Session 2 (1200-1400) Quiz 1, Lab B 8/29/17 8/30/17 9/1/17


Date (Section A)

Date (Section F)

4 Assignment 2 Emailed by 0800 hrs, Prep Lab C 9/5/17 9/6/17 9/8/17

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Lab C


• Table groups work FISDAP lab skill practice and peer formative assessment on:• Adult DL x 1 rep (actively coached, deliberate practice for sequence—not speed)• Pediatric DL x 1 rep (actively coached, deliberate practice for sequence—not speed)• Adult VL x 1 rep (actively coached, deliberate practice for sequence—not speed)




• Lab D Prep

• Units in Moodle• Blind Intubation Unit


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Date (Section A)

Date (Section F)

5 Class Session 3 (1200-1400) Quiz 2, Lab C 9/12/17 9/13/17 9/15/17


Date (Section A)

Date (Section F)

6 Assignment 3 Emailed by 0800 hrs, Prep Lab D 9/19/17 9/20/17 9/22/17

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Lab D


• Table groups work FISDAP lab skill practice and peer formative assessment on:• Nasal Intubation x 1 rep• SALT Airway x 1 rep• Digital Intubation x 1 rep




• Lab E Prep

• Units in Moodle• Restricted Access Unit


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Date (Section A)

Date (Section F)

7 Class Session 4 (1200-1400) Quiz 3, Lab D 9/26/17 9/27/17 9/29/17


Date (Section A)

Date (Section F)

8 Assignment 4 Emailed by 0800 hrs, Prep Lab E 10/3/17 10/4/17 10/6/17

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Lab E


• Table groups work FISDAP lab skill practice and peer formative assessment on:• Face-to-Face Intubation x 1 rep• Pediatric Trauma Intubation x 1 rep• Adult Trauma Intubation x 2 rep




• Lab F Prep

• Units in Moodle• Supraglottic Airway Unit• Support Tactics Unit


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Date (Section A)

Date (Section F)

9 Class Session 5 (1200-1400) Quiz 4, Lab E 10/10/17 10/11/17 10/13/17


Date (Section A)

Date (Section F)

10 Assignment 5 Emailed by 0800 hrs, Prep Lab F 10/17/17 10/18/17 10/20/17

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Lab F


• Table groups work FISDAP lab skill practice and peer formative assessment on:• King, Combitube and LMA x 1 rep each• Nasogastric Tube x 1 rep• ETT Suctioning x 1 rep



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Date (Section A)

Date (Section F)

11 Class Session 6 (1200-1400) Quiz 5, Lab F 10/24/17 10/25/17 10/27/17

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• Each student will perform an oral, non-trauma direct laryngoscopy and intubation on an adult manikin using a bougie and a properly sized endotracheal tube. This manikin is not one of the task trainers used prior to this point. This manikin will not have any anatomical abnormalities nor will there be any complicating factors.

• Students are expected to demonstrate near-perfect technique and perfect sequence. The time limit from last ventilation until next ventilation is extended past the normal standard for this examination. Students may have up to two attempts.

• Students are expected to accurately demonstrate the following key techniques:• Careful, deliberate and safe insertion of the laryngoscope blade• Use of the right hand for external laryngeal manipulation with the assistance of a BLS

assistant• Constantly maintaining visualization of the airway without looking up to receive the ET

tube• Placement of the ET tube just past the vocal cords without referencing tube depth

markings• Maintaining one hand firmly securing the ET tube to the patient’s face until it is secured

with a tube holder• Verbalization of checking for adequate chest rise and waveform on the capnography

prior to even considering the use of auscultation for confirmation that the tube is in the trachea

• Securing the ET tube properly• Auscultation of the epigastrium first followed next by the right mainstem bronchus and

then the left mainstem bronchus while controlling the ventilation rate

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Date (Section A)

Date (Section F)

12 Prep for Lab Final 10/31/17 11/1/17 11/3/17


Date (Section A)

Date (Section F)

13 Class Session 7 (1200-1400) Lab Final 11/7/17 11/8/17 11/10/17

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Date (Section A)

Date (Section F)

14 Review and Final Exam Preparation 11/14/17 11/15/17 11/17/17


Date (Section A)

Date (Section F)

15 Thanksgiving Break


Date (Section A)

Date (Section F)

16 Class Session 8 (1200-1400) Final Exam 12/5/17 12/6/17 12/8/17

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