The student must have critical thinking abilities sufficient for clinical judgment such that the individual can make independent judgments in the absence of other medical team members and/or medical control; and determine methods and treatments to use when caring for patients with varying illnesses or injuries.

• Assess scene safety in uncontrolled environments.

• Assess patient’s physical condition and determine the severity of illness or injury.

• Assess patient’s current and past medical histories by asking questions appropriate to the illness or injury.

• Prioritize patient’s severity.

• Prioritize specific care modalities.

• Determine correct treatment modalities or algorithms.

• Determine appropriate exceptions to approved treatment modalities.

• Determine limits of acceptable span of control in ordinary and extraordinary circumstances.

The student must have the problem solving abilities to make a correct tentative diagnosis and assessment conclusions that allow selection and pursuit of accepted treatment protocols, and integrations of multiple protocols and modalities in single and multiple patient situations.

• Formulate correct decisions based on classic atypical clinical presentation\ histories.

• Integrate correct treatment protocol and\or multiple protocols based upon variable clinical presentation.

• Formulate an acceptable plan to provide patient care in typical and atypical case presentations utilizing basic life support skills and training to implement solutions to problems.

• Utilize standard accepted equipment in typical and atypical but effective clinical applications for safe patient care and movement.

The student must have interpersonal abilities sufficient to interact with individuals, families, groups, public safety personnel and other health care providers from a variety of social, emotional, cultural, and intellectual backgrounds.

• Establish and maintain supportive relationships with patients, family members, bystanders, public safety, media, political officials and other health care providers under stressful and non-stressful situations.

The student must have communication abilities sufficient for interaction with others in verbal and written form. This includes the ability to read, write, and understand the English language. Communication via face-to-face interaction and/or standard radio and telephone links as an integral requirement.

• Ask questions of current and past medical history of the patient or bystanders that are able to provide patient information.

• Receive and interpret information from patient(s) or bystanders regarding history, complaints, and response to treatments.

• Receive and interpret verbal orders from physicians via face-to-face interaction, standard radio or telephone links.

• Clarifies order(s) from a physician via standard radio and telephone links.

• Give verbal report to physicians and/or other health care personnel regarding patient(s) condition under varying circumstances (environmental and patient severity).

• Request orders via standard radio or telephone links.

• Provide accurate and legible written report of patient(s) in timely fashion.

• Provide accurate records of daily activities, runs, and skills.

• Provide accurate written incident documentation.

• Provide written or verbal deposition as required by law enforcement for crime scene investigation.

• The ability to read and understand written orders, advanced directives, instructions, protocols, prescriptions, and other pertinent patient information or data.

The student must have physical abilities sufficient to lift, balance, and carry, patients in excess of 125 lbs (250 lbs with the assistance of another person) from initial location to ambulance including negotiating stairs, hazardous terrain, and/or uneven terrain. Safely operate heavy manual/power equipment and drive large vehicles, under extreme environmental conditions.

• Enter/exit ambulance without assistance.

• Perform physical activities involved with EMS delivery for up to 24 continuous hours without a break.

• Negotiate hazardous scenes in all environmental extremes including but not limited to light/dark, heat/cold, wet/dry /frozen scenes.

• Must be able to don appropriate personal protective devices (PPDs) without assistance. Examples include but are not limited to gloves, masks, respirators, eyewear, and gowns.

The student must have the physical ability to perform gross and fine motor skills required in the normal duties of EMS. This includes but is not limited to CPR, bandaging, splinting, childbirth, extrication, oxygen and pharmacological administration, defibrillation, equipment relocation, and patient handling.

• Perform physical tasks requiring prolonged physical exertion including but not limited to CPR, walking for long periods of time while carrying equipment and/or patients, vehicle extrication, extrication of a victim from the confines of a structure (residence, business, industry, or mobile dwelling).

• Perform physical tasks requiring detailed activity.

• Perform physical tasks requiring walking, crawling, stooping, bending, kneeling, or working prone or supine including but not limited to patient transfer, movement, and extrication.

The student must have physical abilities sufficient to lift, balance, and carry, patients in excess of 125 lbs (250 lbs with the assistance of another person) from initial location to ambulance including negotiating stairs, hazardous terrain, and/or uneven terrain. Safely operate heavy manual/power equipment and drive large vehicles, under extreme environmental conditions.

• Implement universal precaution and other appropriate means of body substance isolation.

• Wear and function in personal protective clothing.

• Participate in stress management activities.

The student must have the auditory ability sufficient to assess and monitor patient’s health needs, to determine personal danger at emergency scenes, hear requests for aid, and hear verbal orders and instructions from members of the medical care team.

• Assess breath sounds (qualitative and quantitative)

• Assess blood pressure by auscultation

• Assess sounds associated with upper airway obstruction

• Hear physician orders via standard radio or telephone links

• Hear dangers/warnings associated with hazardous scenes

• Hear audible signals during rescue operation

• Hear voices under protective equipment

• Hear Dispatchers communication via standard radio and telephone links

• Hear preceptor’s instructions and directions

• Hear warning devices on other vehicles that may be encountered during the operation of an emergency vehicle. Examples include but are not limited to approaching sirens, backup alarms, and horns.

The student must have visual ability sufficient for assessment, observation, and implementation of patient care, for determination of scene hazards that potentially affect the well-being of self, patient, coworkers, and for driving an emergency vehicle.

• Read and understand orders and/or instructions

• Observe and identify patient signs including but not limiting to paleness (white), cyanosis (blue), erythema (redness), jaundice (yellow), ecchymosis (bruising), swelling, burns, blisters, deformity, hemorrhage, fluid and blood loss, pupillary response, reflexes, hives, and pitting edema.

• Observe patient responses to treatment.

• Read labels on medication

• Investigate scenes to determine cause and severity of injury/illness

• Prepare documentation

• Perform patient care techniques that require fine visual skills including but not limited to suctioning, pharmacological administration of patient’s medications, bandaging, and splinting.

• Perform patient care techniques that require visual skills necessary to prevent injury to other parties including but not limited to; defibrillation, patient handling, extrication, and rescue coordination.

• Perceive depth such as hives and pitting edema.

The student must have olfactory senses sufficient for maintaining environmental, patient, and personal/coworker safety.

• Determine smells contributory to patient assessment such as fruity odors, alcohol smell, and acetone.

• Determine smells contributory to self-preservation and safety of patients and coworkers including but not limited to smoke, burning materials, gasoline and noxious fumes.

The student must have tactile ability sufficient to assess physical health and perform activities requiring dexterity combined with tactile ability.

• Palpate pulses (quantitative and qualitative)

• Palpate blood pressure

• Palpate crepitus

• Palpate subcutaneous emphysema

• Palpate rigidity/guarding of abdomen

• Palpate edema

• Palpate anatomical structures to determine normalcy/abnormality

• Palpate masses

• Assess skin temperature and diaphoresis (presence/absence)

• Determine presence of fluid on patients in dark environments

• Safely handle sharps such as needles and lancets.

• Open medication containers such as prescription bottles and ampules.

The student must be able to deal effectively with stress produced by work and interaction situations. (“Deals with” or “Deals effectively with” is defined as maintaining ability to perform basic requirements of the job in an effective and professional manner at the time of the incident with the realization that counseling or debriefing may be required as soon as possible for the EMT).

• Deals with emotional situation that affect EMT directly.

• Deals with emotional situation that affect patients, their families, their friends, their coworker, bystanders, public, public safety personnel, other health care workers.