Georgia Health Sciences University's CCEMTP Satellite Program
Critical Care Emergency Medical Transport Program

 The Critical Care Emergency Medical Transport Paramedic (CCEMTP) program is owned by the University of Maryland Baltimore County (UMBC). The CCEMTP program is conducted as a satellite program on the Georgia Health Sciences University campus. 

 

Course Learning Objectives

Module A

CONCEPTS AND COMPONENTS OF CRITICAL CARE TRANSPORT
Describe the history of ambulance transports.  Name three examples of Critical Care Transport Team composition configuration.  Identify and describe the preferred qualifications of a Critical Care Transport Paramedic.  Name six advanced procedures performed by a Critical Care Transport Team.  Differentiate between routine and specialty equipment found on a Critical Care Transport unit.  Discuss the three modes of transport for the critically ill or injured.  Identify indications for critical care transport.  Describe the interfacility transfer process.

MEDICOLEGAL ASPECTS OF CRITICAL CARE TRANSPORT
Apply the essential legal principles necessary to the practice of emergency medicine to the job of the critical care paramedic.  Recognize and discuss the legal risks and liabilities involved in critical care transportation.  Apply basic risk management principles to critical care transport.  Discuss the fundamental elements of litigation, hearings and peer-review proceedings.  Understand EMTALA and the implications for EMS  State the appropriate steps for accepting a patient transfer  State the appropriate steps in assessing and preparing for transfer  State CCEMT-P responsibilities during transfer  State the role of other health care providers who accompany the patient  State the appropriate steps to transfer care to the receiving facility  Appropriately document the transfer  Identify areas of potential liability  State methods to minimize risk  Be familiar with current case law regarding transport

LABORATORY DATA INTERPRETATION
Describe the relationship between laboratory medicine and the diagnosis and treatment of patients.  Describe the common problems associated with specimen collection and ways to avoid these problems.  Identify mean lab values and deviations for the complete blood count, the differential blood count, and platelet values.  Interpret arterial blood gas data.  Interpret chemistry studies.  Interpret urinalysis.  Describe the purpose of culture and sensitivity tests.  Interpret miscellaneous lab studies.

SHOCK
Define shock. Discuss the major pathophysiologies of shock.  Describe how assessment techniques can help identify shock.  Describe the general management principles for the patient in shock.  Describe pharmacological intervention in different types of shock.

MULTI-SYSTEM ORGAN FAILURE
Define multisystem organ failure.  List the history, signs, and symptoms of the patient with sepsis.  Describe the management of the patient with sepsis.  List the history, signs, and symptoms of the patient with acute respiratory distress syndrome (ARDS).  Describe the management of the patient with ARDS.  List the history, signs, and symptoms of the patient with disseminated intravascular coagulation (DIC).  Describe the management of the patient with the management of the patient with DIC.

INFECTION CONTROL & COMMUNICABLE DISEASES
Describe proper infection control procedures that the Critical Care Transport Paramedic should take when treating patients.  Identify the mode of transmission and precautions to follow when treating a patient with the following infectious diseases: HIV  Hepatitis  Multiple-Antibiotic Resistant Bacteria  Tuberculosis  Meningitis

Module B

BREATHING ASSESSMENT AND PULMONARY PHYSIOLOGY
Assess oxygen saturation using a pulse oximeter.  Assess carbon dioxide levels using an end tidal C02detector.  Identify the categories of information obtained through an ABG analysis.  Describe the technique for drawing an ABG.  Describe important landmarks and anatomical structures of the chest wall and respiratory system.  Describe two factors important. in the generation of breath sounds.  Describe how to assess breath sounds for duration, pitch, and intensity.  Identify auscultatory sites for breath sounds assessment.  Define normal and adventitious breath sounds.  Define consolidation.  Perform vocal and tactile fremitus assessments of lung fields.  Define and describe abnormal respiratory patterns.  Define and describe respiration and ventilation abnormalities.  Perform a complete respiratory assessment.

PLEURAL DECOMPRESSION
Identify indications for pleural decompression.  Discuss methods for pleural decompression assessment.  Describe the procedure for pleural decompression.  Differentiate between normal and abnormal assessment findings.  Identify transport complications associated wiffi pleural decompression.

CHEST TUBE MANAGEMENT
Identify indications and purpose for chest tubes.  Discuss methods for chest tube assessment.  Differentiate between normal and abnormal assessment findings.  Describe the procedure for chest tube placement.  Identify transport complications for chest tubes.

PORTABLE VENTILATORS
Identify indications and purpose for portable ventilators.  Discuss methods for ventilator assessment.  Differentiate between normal and abnormal assessment findings.  Describe the procedure for placing a patient on a portable ventilator.  Identify transport complications of portable ventilators.

ET TUBE AND TRACHEAL SUCTIONING
Identify indications for ET tube and tracheal suctioning.  Describe the procedure for ET tube and tracheal suctioning.  Identify complications of ET tube and tracheal suctioning.

RAPID SEQUENCE INDUCTION/ INTUBATION
Identify indications and purpose for rapid sequence induction (RSI).  Identify pharmacologic agents utilized in RSI.  Describe why sedative medications should usually accompany the use of paralytic agents.  Outline the technique for RSI.  Identify transport considerations for patients intubated with the RSI technique.

Module C

TRACHEOSTOMIES
Identify indications and purposes for a tracheostomy.  Identify criteria for tracheostomy assessment.  Differentiate between normal and abnormal assessment findings  Describe the procedure for tracheostomy placement.  Identify transport complications of tracheostomies.

NEEDLE CRICOTHYROTOMY
Identify indications and purpose for needle cricothyrotomy.  Identify criteria for needle cricothyrotomy assessment  Describe the procedure for needle cricothyrotomy.  Differentiate between normal and abnormal assessment findings.  Identify transport complications for needle cricothyrotomy.

SURGICAL CRICOTHYROTOMY
Identify indications and purpose for surgical cricothyrotomy.  Identify criteria for surgical cricothyrotomy assessment  Describe the procedure for surgical cricothyrotomy.  Differentiate between normal and abnormal assessment findings.  Identify transport complications for surgical cricothyrotomy.

RETROGRADE INTUBATION
Discuss the indications and purpose for retrograde intubation.  Identify criteria for retrograde incubation.  Describe the procedure for retrograde intubation.  Differentiate between normal and abnormal assessment findings.  Identify transport complications for retrograde intubation.

Module D

INVASIVE LINES
Differentiate between types of invasive lines  Identify indications for invasive lines  Discuss methods for assessing invasive lines  Differentiate between normal and abnormal assessment findings  Identify transport complications of invasive lines

HEMODYNAMIC MONITORING
|Identify hemodynamic monitor controls  Interpret hemodynamic readings  Identify alarm indications  Discuss alarm troubleshooting procedures  Identify transport complications of hemodynamic monitors  Define: preload, afterload, contractility, systemic vascular resistance, cardiac output, cardiac index  List two purposes for invasive hemodynamic monitoring  Identify the function of each component of a PA catheter including: length markings, balloon inflation port, thermistor port, PA distal port, RA proximal port, auxiliary RA port  List normal hemodynamic pressures and identify normal pressure waveforms for the RA, RV, PA, PCWP, LA and peripheral arterial sites  Interpret SVO2 monitoring data and discuss appropriate theraputic modalities to treat abnormal values  Discuss indications of measuring cardiac output and cardiac index  Describe problems commonly encountered in measuring PA pressures and state appropriate interventions  List at least 5 potential complications associated with PA insertion

BLOOD ADMINISTRATION
Differentiate between antigens, natural antibodies and acquired antibodies  Identify antibodies and antigens associated with specific blood types  Define Rh factor  Identify seven types of blood component therapy  Identify indications for blood administration  Describe the procedure for blood administration  Identify the signs and symptoms of transfusion reactions  Describe the management procedures for transfusion reactions  Describe the indications for administration of whole blood and packed red blood cells  Describe the indications for typing, screening and cross matching blood  Describe the ABO system for matching blood  Describe the characteristics of blood products  Describe the procedure for administration of whole blood or packed red blood cells.

Module E

12-LEAD ELECTROCARDIOLOGY
Describe the difference between monitoring and assessing a patient using an ECG machine  Demonstrate proper lead placement for a 12 Lead ECG  Using a simple chart and leads I,II,and III, determine the electrical axis and the presence of fascicular blocks (hemiblocks)  Using lead V1(MCL1), determine bundle branch blocks  Describe the clinical significance of hemiblocks and bundle branck blocks in the cardiac patient  Describe the strategy for identifying V-Tach in wide complex tachycardia  On a 12-Lead or Multi-Lead ECG, identify ST and T wave changes relative to myocardial ischemia, injury and infarction.  Describe a systematic "assessment" of a 12-Lead ECG  Describe possible complications of various infarct locations

IMPLANTABLE CARDIOVERTER DEFIBRILLATORS
Discuss the incidence of sudden cardiac death and the population at risk  Describe how and Implantable Cardioverter Defibrillator (ICD) works, its components and its functions  Identify the potential complications associated with the ICD and location of placement in the chest wall  Describe the procedure for deactivating an ICD with a magnet

CARDIAC PACEMAKERS
Understand the basic concepts underlying cardiac pacemaker technology  Understand the current code system used for cardiac pacing  Understand and troubleshoot the potential rhythms that indicate forms of pacemaker malfunctions

INTRA-AORTIC BALLOON PUMPS
Identify indications for IABP  Define the primary physiological effects achieved by the inflation and deflation of the IAB  Describe the set up and operation of an IABP  Discuss the hemodynamic effects of proper balloon inflation and deflation  Identify the factors that affect diastolic augmentation and appropriate troubleshooting considerations  Identify proper timing and appropriate corrective action  Identify transport complications of IABP

Module F - Pharmacology

SEDATIVES
Identify the indications, mechanism of action, pharmacokinetics, dosing and side effects of haloperidol  Identify the mechanism of action of benzodiazepine drugs  Compare the dosing and side effects of diazepam, lorazepam and midazolam  Identify the indications, mechanism of action, pharmacokenetics, dosing and side effects of flumazenil  Identify the indications, mechanism of action, pharmacokinetics, dosing, side effects, drug interactions and administration considerations of propofol

ANALGESICS
Identify the mechanism of action, pharmacokinetics, and side effects of morphine  Identify the mechanism of action, pharmacokinetics, and side effects of naloxone

PARALYTICS
Identify the mechanism of action, pharmacokinetics, and toxicity of Succinylcholine  Identify the indications, mechanism of action, pharmacokinetics, side effects and drug interactions of pancuronium, vecuronium and atracurium  Identify the order of paralysis  Discuss the adverse effects of prolonged paralysis  Identify the role of "train of four" monitoring when using paralytics

ANTIHYPERTENSIVES
Compare the mechanism of action, dosing, pharmacokinetics, and adverse effects of captopril, nifedipine and clonidine  Identify the mechanism of action, pharmacokinetics, dosing, toxicity and administration considerations of nitroprusside  Identify the mechanism of action, pharmacokinetics, dosing and adverse effects of labetalol  Identify the pharmacology, pharmacokinetics, dosing and toxicity of diazoxide

VOLUME EXPANDERS
Compare the advantages and disadvantages of crystalloids and colloids  Compare the use, dose and adverse effects of albumin, plasma protein fraction, Hetastarch and Dextran

VASOPRESSORS
Identify the indications for vasopressors  Compare the effects, dosing and adverse effects of dopamine, epinephrine, norepinephrine (Levophed), phenylephrine and dobutamine

BRONCHODILATORS
Identify the pharmacology and effects of beta receptor stimulation for beta agonists  Compare the pharmacokinetics, dosing, delivery, and adverse effects of albuterol, epinephrine and terbutaline  Identify the pharmacology, metabolism, adverse effects, drug interaction and dosing of metoproterenol and theophylline  Identify the pharmacology and dosing of anticholinergics  Compare and contrast anticholinergics and beta agonists  Identify the pharmacology and uses of magnesium

ANTIARRHYTHMICS
Identify the mechanism of action, ECG effects, uses, pharmacokinetics, dosing and toxicity of Class IA antiarrhythmic drugs  Identify the mechanism of action, ECG effects, uses, pharmacokinetics, dosing and toxicity of Class IB antiarrhythmic drugs  Identify the mechanism of action, ECG effects, and uses of Class IC antiarrythmic drugs  Identify the mechanism of action, ECG effects, and uses of Class II antiarrythmic drugs  Identify the mechanism of action, ECG effects, uses, pharmacokinetics, adverse effects and drug interactions of Class III antiarrhythmic drugs  Identify the mechanism of action, ECG effects, and uses of Class IV antiarrythmic drugs  Compare the pharmacokinetics, dosing and adverse effects of verapamil and diltiazem  Identify the mechanism of action, ECG effects, uses, pharmacokinetics, administration considerations, drug interactions and toxicity of adenosine

ANTIANGINALS
Identify the pharmacology, dosage forms, pharmacokinetics, administration considerations, adverse effects, and tolerance considerations of nitrates  Identify the uses, side effects and patient selection criteria for beta blockers  Identify the uses, contraindications, and side effects of calcium channel blockers

THROMBOLYTICS
Identify the absolute and relative contraindications to thrombolytic therapy  Compare the pharmacology, pharmacokinetics, dosing and adverse effects of TPA, streptokinase and APSAC  Discuss the benefits of thrombolytic therapy

ANTICOAGULANTS
Identify the mechanism of action, dosing, and clinical trial findings of aspirin as an anticoagulant  Identify the mechanism of action, dosing, monitoring parameters, adverse effects and clinical trial results of heparin  Identify the pharmacology, indications, monitoring parameters, drug interactions and adverse effects of warfarin

ANTIBIOTICS
Identify the pharmacology and uses of antibiotics

ETOMIDATE
Identify the indications, mechanism of action, pharmacokinetics, and side effects of etomidate

Module G

GI, GU and RENAL ASSESSMENT
Identify GI/GU assessment criteria  Differentiate between normal and abnormal assessment findings

NG and OG FEEDING TUBES
Identify the indications for a nasogastric and oragastric tube  Discuss methods for nasogastric and orogastric assessment  Differentiate between normal and abnormal assessment findings  Describe procedure for placement of nasogastric and orogastric tubes  Identify transport complications associated with nasogastric and orogastric tubes.

URINARY CATHETERS
Identify indications and purpose for Foley catheters  Discuss assessment methods for Foley catheters  Differentiate between normal and abnormal assessment findings  Describe procedure for Foley catheter placement  Identify transport complications for Foley catheters

OSTOMIES
Identify indications for an ostomy  Discuss methods for ostomy assessment  Differentiate between normal and abnormal assessment findings  Discuss methods for ostomy placement  Identify transport complications for ostomies

HEMODIALYSIS and PERITONEAL DIALYSIS
Identify indications and purpose for dialysis  Differentiate between hemodialysis and peritoneal dialysis  Describe the procedure for accessing arteriovenous shunts  Identify transport complications of dialysis patients

RECTAL CONSIDERATIONS
Describe the rectal anatomy and structures  Classify rectal bleeding: red, bright red, melena  Discuss incontinence, diarrhea and constipation management techniques  Demonstrate rectal temperature assessment technique  Describe decubitus ulcers

Module H

NEUROLOGICAL ASSESSMENT
Describe the major components of a neurological examination  Describe the differences in the neurological assessment between a brain injured or spinal injured patient  Perform a neurological examination  Describe the findings of a normal and abnormal neurological examination  Describe vital signs changes noted with neurological injuries  Identify transportation considerations for patients with neurological injuries

NEUROLOGICAL ASSESSMENT LAB
Correctly perform a neurological assessment  Document the findings of a neurological examination

INTRACRANIAL PRESSURE
Describe intracranial pressure (ICP)  Describe the pathophysiology of ICP  Define compliance  Explain herniation of the brain  Describe how to calculate cerebral perfusion pressure (CPP)  Identify signs and symptoms of increasing ICP  Identify factors that will increase ICP  Identify consequences of increased ICP on patient outcome  Identify strategies and methods for decreasing ICP during critical care transport

INTRACRANIAL PRESSURE MONITORING
Describe the reasons for ICP monitoring  Differentiate between normal and abnormal findings with ICP monitoring  Describe the advantages, disadvantages, and transport considerations for the following ICP monitoring devices:  Intraventricular catheter  Epidural catheter  Subdural/ subarachnoid monitoring devices  Fiber optic transducer tipped probe  Describe ICP waveform  Explain therapies to manage ICP

Module I

TRANSPORTS: START TO FINISH
Differentiate operational aspects of critical care transport and conventional prehospital care  Identify four major opportunities for positive interaction that exist during a critical care transport  Incorporate prospective medical control into the care of critical patients  Identify critical decision points in a transport event  Develop an event flowsheet  Identify essential patient perceptions of quality service  Understand the role of family members in critical care transport  Recognize situations warranting diversion or interception  Incorporate unique management tactics with moribund patients and families

AEROMEDICAL PHYSIOLOGY
Define Boyle's Law  Name the eight stressor's of flight  Name and describe three types of barotrauma  Explain how an unpressurized medical cabin can affect equipment  Explain "time of useful consciousness"  List the objective signs and symptoms of hypoxia  List the subjective signs and symptoms of hypoxia  Name six special considerations that should be taken with patients being air transported  Explain how a negative G-force affects the body  Define Dalton's law  Name three considerations in preventing hearing loss  List four contributing factors to crew member fatigue

Module J

CASE STUDIES
Integrate topics learned with case scenarios

PEDIATRIC CONSIDERATIONS
Identify various histories and general principles for pediatric assessment  Define the primary cause of cardiac arrest and list several risk factors  Describe principles of general treatment before and during the transport of a pediatric patient

OBSTETRICAL/GYNECOLOGICAL CONSIDERATIONS
Identify various histories and general principles for OB/GYN assessment  Define the primary cause of cardiac arrest and list several risk factors  Describe principles of general treatment before and during the transport of a OB/GYN patient

BURN MANAGEMENT
Identify and describe burn types, depth and estimate Body Surface Area according to Rule-of-Nines, "palm" scale and age appropriate guidelines. Identify principles and methods of burn treatment, analgesia, airway care and patient packaging for transport. Utilize American Burn Association categorizing for minor, moderate and severe burns. Describe the importance of maintaining fluid volume and body temperature. Describe methods to assure adequate fluid volume and body temp, describe theory and practice methods of pharmacologic therapy in burns

 

For more information, please contact Rebecca Roteat 706-721-3548 or email rrote@georgiahealth.edu.