Laredo Community College
Emergency Medical Services Program
Clinical Handbook
Introduction:
The clinical rotations are perhaps the most exciting and the most challenging part of a student's training. To make this experience positive and rewarding, the student must be well prepared. The clinical handbook is designed to keep the student focused on the clinical portion of the Emergency Medical Services Program.
This manual provides the student with a means of reporting and monitoring each experience. The Clinical Coordinator will be available by telephone or by pager.
Enjoy your clinical and field internship rotations!
TABLE OF CONTENTS
Introduction………………….………………………….………1
Table of Content………………………………………………..2
EMT-Basic Clinical Hours……………………………………..3
EMT-Intermediate Clinical Hours……………………………...3
EMT-Paramedic Clinical Hours………...... 4
Professional Behavior…………………………………………..5
Confidentiality……………………………………………….....5
Clinical Scheduling……………………………………………..5
Attendance Policy……………………………………………....6
Personal Emergencies…………………………………………..6
Clinical Equipment…………………………………………...... 7
Clinical Grading…………………………………………...……7
Inclement Weather…………………………………………...…7
Meal Breaks………………………………………………….....8
Parking………………………………………………………….8
Specifics Relating to Hosp. Rotation…...... 8-9
Specifics Relating to Amb. Rotation………………………...... 9
Dress Code…………………………………………………….10
Skills & Objectives………………………………………...11-24
Medical Abbreviations…………………………………….25-31
Fire Station Locations…………………………………………32
Hospital Location…………………………………………...…33
Clinical Time Tracing Form…………………………...……...34
Clinical Grading Form………………………………………...35
Clinical Agreement……………………………………………36
EMT - Basic
Clinical Requirements
Hospital Rotation:
48 Hours Emergency Room documentation at least three (3) patients per shift
16 Hours Obstetrics
64 Subtotal Hours
Ambulance Rotation:
64 Hours - Document at least three (10) Basic Life Support transports to a hospital facility
128 Total Hours
The student must complete all the stated clinical requirements before they will be allowed to take the National Registry EMT Basic Exam.
EMT – Intermediate
Clinical Requirements
Hospital Rotations:
40 Hours Emergency Room documentation at least three (3) patients per shift
16 Hours Operating Room and Recovery
8 Hours Obstetric
8 Hours Respiratory
8 Hours Phlebotomy
80 Subtotal Hours
Ambulance Rotations:
50 Hours- Document at least five (10) Advance Life Support transports to a hospital facility
130 Total Hours
The EMSP student must document at least five (10) successful Intravenous Therapy that the student has initiated in the hospital or ambulance rotation.
Student must be eligible to take National Registry EMT Basic Exam to continue into the EMT-Intermediate and must be EMT Basic certification to attend clinical rotations. The student who does not complete Laredo Community College requirements will not be eligible to set for the National Registry Intermediate Exam. All course and clinical requirements must be completed prior to the National Registry Exam.
EMT - Paramedic
Clinical Requirements
Hospital Rotations:
96 Hours Emergency Room documentations at least three (3) patients per shift
48 Hours Intensive Care Unit/Telemetry
40 Hours Operating Room and Recovery
16 Hours Obstetric
16 Hours Respiratory
8 Hours Cath Lab
224 Subtotal hours
Ambulance Rotations:
100 Hours-Document at least five (10) MICU transports to hospital facility with ECG strips.
324 Total Hours
The EMSP student must document at least ten (20) successful Intravenous Therapies that the student has initiated in the hospital or ambulance rotations.
All Laredo Community College EMSP courses and clinical requirements must be completed prior to the taking the National Registry Paramedic Exam. The student who does not complete Laredo Community College requirements will not be eligible to set for the National Registry Paramedic Exam.
Professional Behavior
The student must maintain a professional demeanor at all times and respect the client, his/her family, and the medical personnel with whom he/she will be working. Failure to act in a professional manner may result in dismissal from the clinical area and/or a delay in testing for certification. Please be aware that other students will follow you into these training sites and they may be judged by the impressions you leave behind. Remember you are a guest in a sensitive environment, please maintain the welcome.
Confidentiality
While at any training site or while participating in any training activity strict patient confidentiality must be maintained. Do not discuss a patient's condition with the family, with bystanders, with the media, or any other non-medical personnel. Do not discuss a patient's condition or prognosis outside of class. Violation of confidentiality rules will result in the student's withdrawal from the course.
All Clinical Rotations
The student must be prompt for all clinical rotations. The student may only be in the clinical setting at the times assigned.
Clinical Scheduling
1. The liability insurance ONLY covers the student during scheduled rotations.
2. Students attending any shift that is not scheduled with the clinical coordinator will be counseled and may be dropped from the program.
3. The student must have on file a current American Heart Association Healthcare Provider CPR card, current immunization record and physical examination, negative criminal background, negative drug test and completed HBV series prior to attending any clinical rotation.
4. Once a clinical rotation schedule on FISDAP, the student cannot alter his/her assignments. The student must comply with the clinical rotation as posted on the clinical schedule.
5
Revised 8/06,7/08,6/08
Attendance
- Classroom attendance follows the policy as stated in the LAREDO COMMUNITY COLLEGE catalog.
- Clinical Rotation:
a) Requires 100% attendance. Tardiness and leaving before the end of the assigned time is equivalent to an absence. Students must remember that completion of required objectives and competencies must be met while the assigned clinical preceptors or clinical instructor is on duty. Failure to make up missed time or complete the assigned requirements will result in an “F” (Failure) for clinical rotation.
b) Cancellation of clinical rotation regardless of the reason the student must notify the clinical coordinator before the scheduled shift.
c) Any student that fails to notify clinical coordinator of a cancellation of their scheduled clinical rotation will result in counseling with possible student dismissal from the EMS program.
d) Student may not sleep during their clinical rotation nor should the student enter any sleeping area of clinical facility.
e) Student must have at least 8 hours of rest before entering the clinical rotation.
f) Maximum hospital hours will be 16 hours (Two 8 hour shifts)
g) Maximum ambulance hours will be 14 hours (Two 7 hour shifts)
h) Prompt arrival at the designated clinical site and in the prescribed attire is required. If the student arrives late this is grounds for the student to be sent home. The student will have to make up the hours at the discretion of the EMS Instructor.
- Clinical
- Clinical practicum grades will be withheld until all sections of the practicum have been completed satisfactorily.
- The student needing more training in a specific clinical area will reenter that area for a specified length of time to be determined in consultation with the clinical coordinator, program coordinator and student. The student will receive a grade of incomplete (I*) at the end of the semester until the training is complete. The student must complete the training as soon as possible, but no later than four months. If the time exceeds four months, a grade of incomplete (I*) will changed to an “F” by the instructor.
- The student failing to achieve a satisfactory evaluation after more training will be asked to take the corresponding semester length course remediation. Remediation will also include more time at the clinical site.
- The student can make copies of their completed clinical documentation for their personal records. Student must submit the original clinical documentation with the original signature of clinical preceptor. It is the student’s responsibility to make sure they are signed up for the adequate amount of clinical hours.
Personal Emergencies
Should a personal emergency arise that would require the student to leave a clinical site, the student must notify the Clinical Instructor, or EMSP Coordinator.
Clinical Equipment
The student will need the following items for each clinical rotation.
· Stethoscope
· Watch with a second hand
· Trauma scissors
· Penlight
· Pen (Black Ink)
· Note pad
· Clinical Notebook with required Texas Department of State Health Services paperwork
Clinical Grading
Clinical grades will be based on the Clinical Report Grading Form.
Refer to page 35 to view a copy of the clinical report grading form.
If the student does not demonstrate satisfactory performance in the clinical areas, the student will be counseled and additional clinical time will be required. If there is no improvement demonstrated the student will receive a failing grade for the clinical course and dismissal from the EMS Program.
If the student does not turn in their clinical documentation by the due date and time the student will receive an “F” for the clinical class.
If the student misplaces their clinical paper work they must redo all the hours and turn in the clinical documentation by the due date and time.
Inclement Weather
If inclement weather conditions arise that would make it dangerous for a student to travel, notify the Clinical Instructor as soon as possible. The Clinical Instructor will reschedule the student at a time and date convenient for the clinical site.
Meals
Hospital: The student may eat in the hospital cafeteria or bring food to the cafeteria or designated lounge area. Student must plan meal breaks in the cafeteria based on operational hours of dining facility with the approval of the Clinical Instructor. (Meal breaks are 30 minutes).
Ambulance: If you intend to prepare food at the station ask permission to use the kitchen. Be sure to clean up when finished. If the station personnel invite the student to join them at their meals, be sure to compensate the staff. The student may also bring food from home.
For safety reasons the student is encouraged to remain at the clinical site during meal times.
Under no circumstances may a student borrow anyone's car at a clinical site to go and purchase food. Should the student need to leave the clinical site, he/she must request and be granted permission from the assigned preceptor and their clinical instructor. The student must notify the preceptor and clinical instructors upon his/her return to the clinical site.
Parking
Follow the parking guidelines set forth by the hospital and fire station.
Clinical Supervision
Specifics Relating to Hospital Rotation
Hospital:
The student must report to the in-charge nurse for that designated department. At that time, the student will be assigned a preceptor for that clinical site. The student will remain with the assigned clinical preceptor for the specified rotation period. The student cannot leave the clinical area without permission or instructions from the assigned preceptor. The student must notify the assigned preceptor when leaving for or returning from breaks and meals. The preceptor or clinical coordinator will make daily rounds of the clinical sites.
Hospital Documentation form
Each student is required to complete at least three (3) written patient assessments per shift in the Emergency Department. Clinical rotations in other department of the hospital will need at least one or more patient assessment per shift, if possible. The student may gather information from a variety of sources, but cannot copy information word for word from the patient's chart. The written assessments should reflect only the student's observations. The student can use one sheet or multiple sheets for the patient assessments. Follow the format in the example found in this handbook. Use black ink, write legibly, and complete the entire form. You must have one set of vital signs in your patient report and your clinical preceptor must sign your patient documentation form before you leave that rotation. DO NOT LEAVE BLANKS. DO NOT use patient names on any documentations, all information gained about your patient must be kept confidential.
Evaluation Forms:
The student will provide the evaluation form to their clinical preceptor who will complete and sign the evaluation form. The student is responsible for returning the signed evaluation form and all descriptive documentation to the Clinical Coordinator. All evaluation forms in clinical documentation packet must be completed by their clinical preceptor. (Refer to student documentation packet)
Clinical Supervision
Specifics Relating to Ambulance Rotations
Ambulance:
The EMSP student must notify the in-charge captain of that station as to his/her assignment. The student will be assigned to an in-charge EMT or PARAMEDIC for the specified ambulance. At this time the in-charge medic may want to orient you to the station rules and to the equipment on the ambulance.
The student is required to spend the specified number of hours on the ambulance and participate in the specified number and type of transports delineated by TDH. A transport is considered a case in which the ambulance transports a patient while providing treatment in route to the hospital regardless of the code status. If the student does not complete the required number of transports, the student must contact the Clinical Coordinator and schedule additional ambulance rotations until all requirements are met.
No student may be in the fire station after 22:00 hours to perform ambulance calls. If the student is on a call at 22:00 hours, the student will leave the station when the ambulance returns to the station. NO EXCEPTIONS
Ambulance Documentation forms
The EMT student must complete and document at least three (3) BLS transports. The EMT-I student must complete and document at least three (3) ALS transports. The EMT-P student must complete and document at least five (5) MICU transports. The student will be precepted by the in-charge EMT-P on the ambulance with unscheduled site visits by the Clinical Coordinator. You must have your preceptor sign your patient documentation form before you leave that rotation. Attentiveness to the rotation requirements and involvement in the rotation activities is highly recommended. DO NOT use patient names on any documentations, all information gained about your patient must be kept confidential.
Evaluation Forms:
The student will provide the evaluation to their clinical preceptor who will complete and sign the evaluation form. The student is responsible for returning the signed evaluation form and all descriptive documentation to the Clinical Coordinator. All evaluation forms in clinical documentation packet must be completed by their clinical preceptor. (Refer to student documentation packet)
(The student is expected to review all skills and required competencies prior to the ambulance rotations.)
Professional Dress Code
The student who is enrolled in the Laredo Community College EMS Program will adhere to the following dress code.