EMT-Basic Course Overview

Module 1 - EMS Systems & the EMT Role

• History of EMS and the EMS system structure
• Roles and responsibilities of the EMT
• Medical/legal and ethical issues (consent, refusal, DNR, HIPAA)
• Well-being of the EMT (stress management, infection control, PPE)
• Medical terminology basics

Module 2 - Airway Management

• Anatomy of the upper and lower airway
• Opening and maintaining the airway (head-tilt chin-lift, jaw thrust)
• Suctioning
• Oxygen delivery devices (nasal cannula, non-rebreather mask)
• Bag-valve mask (BVM) ventilation
• Airway adjuncts: OPA and NPA
• Pulse oximetry and capnography basics

Module 3 - Patient Assessment

• Scene size-up (BSI, scene safety, MOI/NOI, resources)
• Primary survey (ABCDE: Airway, Breathing, Circulation, Disability, Expose)
• Rapid full-body scan vs. focused assessment
• Baseline vital signs (BP, HR, RR, SpO2, pupils, skin)
• SAMPLE history (Signs/Symptoms, Allergies, Medications, Past history, Last oral intake, Events)
• Secondary assessment and reassessment

Module 4 - Shock & Resuscitation

• Pathophysiology of shock (hypoperfusion)
• Types: hemorrhagic, distributive (septic, neurogenic, anaphylactic), obstructive, cardiogenic
• Recognition and management of shock in the field
• CPR and automated external defibrillator (AED) use
• Adult, pediatric, and infant CPR differences

Module 5 - Medical Emergencies

• Respiratory: asthma, COPD, pulmonary edema, pneumothorax
• Cardiac: chest pain, ACS (angina/MI), cardiac arrest
• Neurological: stroke (FAST/Cincinnati Stroke Scale), seizures, altered mental status
• Diabetic: hypoglycemia vs. hyperglycemia, oral glucose administration
• Allergic/Anaphylaxis: epinephrine auto-injector (EpiPen)
• Toxicology: overdose, poisoning, activated charcoal, naloxone (Narcan)
• Behavioral/Psychiatric: agitation, restraint considerations
• Abdominal: acute abdomen, GI bleeding
• GU/OB: obstetric emergencies, normal delivery, complications

Module 6 - Trauma

• Kinematics and mechanism of injury (blunt vs. penetrating)
• Bleeding control: direct pressure, tourniquets, wound packing
• Soft tissue injuries: open/closed wounds, burns (rule of nines, BSA)
• Musculoskeletal trauma: fractures, dislocations, splinting principles
• Head, spine, and c-spine precautions; spinal motion restriction
• Chest trauma: pneumothorax, rib fractures, flail chest, hemothorax
• Abdominal and pelvic trauma
• Multi-system trauma / trauma patient priority

Module 7 - Special Populations

• Pediatrics: anatomy differences, pediatric assessment triangle (PAT), common emergencies
• Geriatrics: common presentations, falls, medication considerations
• Obstetrics: labor stages, field delivery, postpartum hemorrhage
• Patients with special challenges: developmental disabilities, hearing/vision impairment, home care patients

Module 8 - EMS Operations

• Air and ground transport: when to call for ALS or air transport
• Ambulance operations: driving, safety, loading/unloading
• Incident Command System (ICS) and NIMS
• Mass Casualty Incidents (MCI) and START triage
• Hazmat awareness
• Rescue operations basics

NREMT Exam Tips

How We'll Work Through This

• Which module do you want to start with?
• Or say "start from the beginning" and we'll go in order.

Module 1 - EMS Systems & the EMT Role

1. What is EMS?

• Public access (911 system)
• First responders (police, fire, bystanders with CPR/AED training)
• EMTs and Paramedics (you)
• Medical direction (physician oversight)
• Receiving facilities (ERs, trauma centers, specialty hospitals)

2. Levels of EMS Training

3. Medical Direction

• Authorizes your scope of practice
• Creates protocols (standing orders) you follow in the field
• Provides online medical control (real-time physician contact by radio/phone)
• Provides offline medical control (protocols, training, quality improvement)

Key point: When in doubt in the field, call medical control.

4. The EMT's Roles & Responsibilities

• Personal safety first - you cannot help anyone if you become a patient
• Scene safety assessment - before approaching any scene
• Patient assessment and care - within your scope of practice
• Safe transport - to the appropriate facility
• Patient advocacy - acting in the patient's best interest
• Documentation - accurate, objective, and timely PCR (Patient Care Report)
• Professionalism - maintaining patient dignity, confidentiality, and composure

5. Medical/Legal Concepts

Consent

Refusal of Care

• A competent adult has the right to refuse treatment or transport
• Must be informed of the risks of refusal
• Document thoroughly and have patient sign a refusal form
• If in doubt about competence - treat

Abandonment vs. Duty to Act

• Duty to act: Once you respond and make patient contact, you are legally obligated to provide care
• Abandonment: Leaving a patient without transferring care to someone of equal or higher training - this is illegal

Negligence (4 elements - all must be present)

1. Duty - you had a responsibility to the patient
2. Breach - you failed to meet the standard of care
3. Causation - your breach caused harm
4. Damages - actual harm resulted

DNR / Advance Directives

• A Do Not Resuscitate (DNR) order must be written and present to be honored
• If no DNR is present, begin resuscitation
• Follow your local protocols for advance directives

6. Confidentiality & HIPAA

• Patient information is private - do not discuss cases publicly
• You may share information with other healthcare providers involved in care
• Exceptions: mandatory reporting (abuse, gunshot wounds, certain communicable diseases)

7. Well-Being of the EMT

Stress & Critical Incident Stress

• CISD (Critical Incident Stress Debriefing) - structured group process after traumatic calls
• Warning signs of burnout: irritability, sleep disturbance, emotional numbness
• Seek help - peer support, EAP, mental health professionals

Body Substance Isolation (BSI) / Standard Precautions

• Treat all body fluids as potentially infectious
• Always use: gloves (minimum), mask + eye protection when splatter risk, gown when needed
• Handwashing is your single most effective infection control measure

Physical Well-Being

• Proper lifting mechanics (back straight, lift with legs)
• Adequate sleep, nutrition, exercise

Quick Review - Module 1 Key Points

1. EMS is a system - you are one part of it
2. You work under physician medical direction at all times
3. Know the 4 levels of EMS providers and their scope
4. Competent adults can refuse care - document it
5. Negligence requires all 4 elements: duty, breach, causation, damages
6. BSI first - always protect yourself before approaching a patient
7. DNR must be written and present to be honored

Module 1 Practice Questions