N.J. Admin. Code § 8:41A-2.6

Current through Register Vol. 56, No. 21, November 4, 2024

Section 8:41A-2.6 - Specific clinical objectives: Category II/Specialty Care Division

(a) Upon successful completion of the Intensive Care/Coronary Care Unit and Emergency Department training experiences, the student shall be able to:

1. Document the performance of 20 complete patient histories/assessments using the appropriate clinical sign off sheet. These histories/assessments shall include a minimum of five neurological and five trauma assessments;

2. Demonstrate medication administration by the intramuscular, subcutaneous, sublingual, topical, intraosseous and IV routes. Utilization of appropriate medication administration equipment and the correct drug calculations are required. The student shall document all medication administrations performed on the patient's chart, as per hospital policy and on the appropriate clinical sign off sheet. Only those medications identified at 8:41-6.1 shall be administered;

3. Identify the actions, indications, normal dosage range, side effects and contraindications of all medications administered;

4. Submit one case study from each patient care area. This shall include the chief complaint, patient history, past medical history, current medications, clinical presentation, treatment modalities, response to care and patient outcome;

5. Prepare a minimum of 10 medication cards on medications other than those approved for utilization by EMTs-Paramedic, as set forth at 8:41-6.1, and which were identified during the student's critical care experience. Each card shall include the generic and trade names, actions, indications, contraindications, dosage range, routes of administration and adverse reactions;

6. Demonstrate the proper application and utilization of an external cardiac pacemaker;

7. Demonstrate the proper application and utilization of an AED;

8. Document a rhythm strip from every monitored patient displaying a dysrhythmia and/or abnormal electrocardiogram in each clinical care area. Each strip shall be interpreted and the treatment modalities documented on the appropriate clinical sign off sheet;

9. Document the participation and/or observation of a minimum of one cardiac arrest on the appropriate clinical sign off sheet. Prior to the conclusion of the training experience, the student shall have participated in a minimum of five cardiac arrest resuscitations;

10. Demonstrate the appropriate technique and situations for the application of defibrillation and cardioversion. By the end of the training experience, the student shall have performed a minimum of five defibrillations and/or synchronized cardioversions;

11. Demonstrate appropriate treatment modalities for the patient in cardiac arrest using the Advanced Cardiac Life Support Guidelines 2001 edition published by the American Heart Association, incorporated herein by reference, as amended and supplemented. Copies may be obtained by writing to the American Heart Association National Center, 7272 Greenville Avenue, Dallas, Texas 75231-4596;

12. Document the insertion, or observation of the insertion, of a nasogastric tube on the appropriate clinical sign off sheet. If the student has inserted the nasogastric tube, document the insertion on the patient's chart, in accordance with hospital policy. If the student has performed the insertion, the student shall document the proper utilization of equipment and technique during the procedure;

13. Demonstrate the application of and discuss the principles of utilization of the pneumatic anti-shock garment (PASG);

14. Identify etiologies, clinical presentation and treatment modalities of the following: angina pectoris, acute myocardial infarction, congestive heart failure, ventricular and aortic aneurysm, cardiogenic shock, myocardial trauma, acute hypertensive crisis, diabetic emergencies, poisonings and overdoses, hypovolemic shock, acute respiratory failure, chronic obstructive pulmonary diseases (copd), asthma, pneumonia, head injury and coma, cerebral vascular accident, seizures, burns, infectious diseases, acute abdomen, renal failure, fractures, septic shock, neurogenic shock, pulmonary edema, pulmonary embolism and anaphylaxis; and

15. As an optional experience, review and demonstrate the utilization of Doppler, infusion pumps and the observation of the insertion of internal pacemakers.

(b) Upon successful completion of the Labor/Delivery/Newborn Nursery training experience, the student shall be able to:

1. Document the observation of a minimum of five vaginal deliveries on the appropriate clinical sign off sheet;

2. Identify the normal stages of labor;

3. Assist in the care of a newborn infant and the post partum mother. Document the experiences on the appropriate clinical sign off sheet;

4. Identify the etiologies, clinical presentations and treatment modalities for abnormal and common complications of deliveries; and

5. Optional experience may include observation of the care of newborn in the neonatal intensive care unit.

(c) Upon successful completion of the Pediatric Unit training experience, the student shall be able to:

1. Document a minimum of five pediatric patient histories/assessments on the appropriate clinical sign off sheet. These histories/assessments shall be done at various stages of development;

2. Identify normal vital signs for each developmental milestone of childhood;

3. Identify the correct procedure for the administration of medications and IV fluids to the pediatric patient;

4. Identify the correct pediatric patient drug dosages for all medications identified at 8:41-6.1;

5. Submit one pediatric patient case study; and

6. As an optional experience, review/demonstrate the operation of a pediatric intensive care unit, well baby clinic and apnea monitor.

(d) Upon successful completion of the Psychiatric Unit or Crisis Center training experience, the student shall be able to:

1. Document the observation of any crisis interviews and/or interventions on the appropriate clinical sign off sheet. If this experience is unavailable to the student, the EMS Educator or his or her designee may orient the student to the procedures followed during these activities;

2. Submit one case study after observing a crisis interview or intervention. If the required experience is not available, the EMS Educator may substitute the requirement of having the student write a synopsis of the procedures followed during a crisis interview or intervention; and

3. Prepare a minimum of five medication cards on psychiatric drugs. These cards are to include the generic and trade name, actions, indications, contraindications, dosage range, routes of administration and adverse reactions.

(e) Each EMS Educator shall develop an evaluation examination covering all of the Category II training objectives. Each student shall take and pass that examination prior to proceeding to Category III.

N.J. Admin. Code § 8:41A-2.6