Syllabus for EMT Basic

Duration: 280 hours

PART 1.
Introduction to Pre-Hospital Emergency Medical Care:
1. The History of Pre-Hospital Emergency Medical Care.
2. Components of an Emergency Medical Services System.
3. The Role and Responsibilities of the Emergency Medical Technician.
4. Levels of Emergency Medical Technician Training.
5. Professional Limitations, Legal Aspects, and Medical Ethics.
6. The P.S.E.M.T.
7. The E.M.T. Code of Conduct.
8. Health Hygiene and Fitness.
9. Health and Safety at Work.
PART 2.
Operational Control and Ambulance Response Procedures:
1. Receiving the call for help.
2. The role of the Emergency Medical Dispatcher.
3. Control Procedures.
4. Operating the Ambulance.
5. Positioning the Ambulance at the scene of the emergency.
6. Routine, Urgent and Emergency Calls.
7. Long Distance Transfers.
PART 3.
Introduction to the Ambulance Vehicle and Equipment:
1. The Ambulance Vehicle.
2. Equipment and Supplies.
3. General Care Of Ambulance Vehicle and Equipment.
4. Daily checks Of Ambulance Vehicle and Equipment.

5. The Vital Role of Cleanliness.

PART 4.
Infection Control and the Emergency Medical Technician:
1. The importance of Infection Control.
2. Modes of Infection
3. Prevention of Infection.
4. Barrier Devices.
PART 5. Anatomy and Physiology of the body Systems:
1. Basic Cell Structure, Tissues, Glands and Organs.
2. Topographic Anatomy.
3. The Musculoskeletal System.
4. Body Regions and Cavities.
5. The Respiratory System.
6. The Lymphatic System.
7. The Cardiovascular System.
8. The Nervous System.
9. The Digestive System.
10. The Genitourinary System.
11. The Endocrine System.
12. The Reproductive System.
13. The Special Senses.
14. Medical Terminology.
PART 6.
Patient Examination and Assessment:
1. The Overall Approach.
2. Field Assessment / Taking a History.
3. The Sequence of Patient Assessment.

4. The Primary Survey.

5. The Secondary Survey.
6. Mechanism of Injury.
7. Triage
8. Reporting Methods.
PART 7.
Basic Life Support:
1. Clinical and Biological Death.
2. The A, B, Cs of Basic Life Support.
3. Pulmonary Resuscitation.
4. Cardiopulmonary Resuscitation.
5. Partial and Complete Airway Obstruction.
6. Management of Airway Obstruction.
7. Basic Airway Management.
8. CPR in a Moving Ambulance.
9. Introduction to Manual and Mechanical Resuscitators / Ventilators.
PART 8.
The Automated External Defibrillator ( AED ):
1. Principles of Defibrillation.
2. Using a Defibrillator Safely.
3. The Importance of Early Defibrillation.
4. The Electrocardiogram.
5. Life Threatening Arrhythmia's.
6. Automatic and Semi - automatic Defibrillators.
PART 9.
Breathing Aids and Oxygen Therapy:
1. Hypoxia

2. Artificial Ventilation Adjuncts (Barrier Devices).

3. Airway Adjuncts.
4. The Importance of Supplemental Oxygen.
5. Oxygen Therapy Equipment.
6. Oxygen Therapy Procedures.
7. The Hazards of Oxygen Therapy.
8. Suction Equipment.
9. Suction Techniques.
10. Mechanical Resuscitators / Ventilators.
PART 10.
Heamorrhage and Shock:
1. Types of Haemorrhage - Internal / External.
2. Haemorrhage from Arteries / Veins / Capillaries.
3. The Effects of Haemorrhage.
4. The Control of Haemorrhage.
5. Shock.
6. Classifications of Shock.
7. Basic Shock Management.
8. Use of the M.A.S.T. Suit - Indications / Contraindications.
9. Introduction to Advanced Shock Management.
PART 11.
Management of Trauma:
1. Initial Management.
2. Secondary Management.
3. Head Injuries.
4. Maxillo-Facial Injuries.
5. Spinal Injuries: Cervical. Thoracic. Lumbar. Sacro-Coccygeal.

6. Chest Injuries.
7. Abdominal Injuries.
8. Pelvic Injuries
9. Back Injuries (Musculoskeletal).
10. Genitalia Trauma.
11. Extremity Trauma.
12. Traumatic Amputations.
13. Trauma to Pregnant Patients.
PART 12.
Burns and their Management:
1. Classification of Burns.
2. Types of Burns.
3. The Rule of Nines.
4. Management of Burns.
5. Complications of Burns.
6. Inhalation Injuries.
7. Transportation of Burns cases.
PART 13.
Environmental Emergencies - Heat / Cold / Water and Ice:
1. Heat Exhaustion and Heat Stroke.
2. Hypothermia.
3. Frostbite.
4. Drowning and Near-Drowning.
5. Decompression Sickness and Barotrauma.
6. Bites and Stings.
7. Man made Hazards.

PART 14.
Medical Emergencies - Cardiovascular:
1. The Nature of Cardiovascular Disorders.
2. Angina Pectoris.
3. Myocardial Infarction.
4. Congestive Heart Failure.
5. Pacemaker Failure.
6. Stokes Adams Attacks.
7. Pericarditis.
8. Hypertension.
9. Cardiac Tamponade.
10. Aortic Aneurysms.
11. Management of Cardiovascular Medical Emergencies.
PART 15.
Medical Emergencies Respiratory:
1. The Nature of Respiratory Disorders.
2. Asthma.
3. Chronic Obstructive Pulmonary Disease.
4. Pulmonary Edema.
5. Pulmonary Embolism.
6. Pneumonia.
7. Pleurisy.
8. Management of Respiratory Medical Emergencies.
PART 16.
Medical Emergencies Neurological Disorders:
1. The Nature of Neurological Disorders.
2. Transient Ischaemic Attacks.

3. Cerebro-Vascular Accidents (CVA's).

4. Epilepsy.
5. Seizures.
PART 17.
Medical Emergencies Misc.,
1. Diabetic Emergencies.
2. The Acute Abdomen.
3. Gastrointestinal Bleeding.
4. Ulcerations.
5. Eosophagitis.
6. Cholecystitis.
7. Poisoning - Accidental / Non Accidental.
8. Allergic Reactions.
9. Sepsis.
10. Dehydration.
11. Urinary Colic.
PART 18.
Emergency Childbirth, Obstetric and Gynecological Emergencies:
1. Emergency Childbirth
2. Complications of Pregnancy.
3. Complications of Delivery.
4. Evaluation of the Mother.
5. Evaluation of the Newborn Baby - The Apgar Scale.
6. Pre-Delivery Emergencies.
7. Post Delivery Emergencies.
8. Resuscitation of the Newborn Baby.
9. Premature Babies and Incubators.

10. Stillborn Infants.

11. Babies and Oxygen.
PART 19.
Pediatric Emergencies:
1. Parental Response
2. Child's Response.
3. The ill or Injured Child - Special Considerations.
4. Assessment of the Pediatric Patient.
5. Physical Assessment Techniques.
6. Assessing Pain in Children.
7. Neurological Assessment in Children.
8. Common Emergencies in Children: Obstructed Airway. Acute Asthmatic Attack. Status
Asthmaticus. Bronchiolitis. Epiglotitis. Croup. Infantile Convulsions.
9. Common Childhood Diseases: Measles. Rubella. Chickenpox. Mumps. Tonsillis
10. Assessment and Management of Pediatric Trauma.
11. Sudden Infant Death Syndrome.
12. Child Abuse and Neglect.
13. Solvent Abuse.
PART 20.
Infectious Diseases:
1. Infectious Diseases - General.
2. Infectious Diseases - Categories 1 & 11.
3. Infectious Diseases - Category 111.
4. The Aids and Hepatitis B Virus.
5. Management of the Infectious Patient
PART 21.
Behavioral Emergencies and Special Conditions:
1. Psychological Emergencies - General Principles.

2. Emotional Response to Illness or Injury.

3. Communication with the Emotionally Disturbed Patient.
4. Anxiety and Phobias.
5. The Depressive Patient.
6. The Suicidal Patient.
7. Paranoid Patients.
8. Schizoid Patients.
9. Rage, Hostility and Violent Behavior.
10. Restraining the Physically Aggressive Patient.
11. Physical Disorders that resemble Psychological Disturbances.
12. The Blind Patient.
13. The Deaf Patient.
14. The Geriatric Patient.
15. The Renal Patient.
16. Amputees and Artificial Limbs.
17. Alcohol abuse and the Alcoholic Patient.
PART 22.
Pain Relief:
1. Introduction to Analgesia.
2. Pre-Hospital Analgesia.
3. The Advantages of effective pain relief during transport.
4. Entonox / Nitronox Therapy.
PART 23.
Multiple Casualty Incidents and Disaster Management:
1. What is a Major Incident.
2. Pre-Planning and Preparedness.
3. Establishing a Plan.

4. Scene Assessment and Management.

5. Rescue and Extrication.
6. Setting up Triage.
7. Triage Techniques.
8. The Importance of Effective Communications.
9. Staging and Transportation.
10. Special Considerations.
11. Emotional Factors of Major Incident Involvement.
PART 24.
Hazardous Substances and Hazmed Procedures:
1. Chemical, Radioactive and Biological Substances.
2. Legal Requirements for the Manufacture, Storage and Transportation of Hazardous Substances.
3. Regulations, Warning Signs and Sources of Information.
4. Hazmed Procedures for dealing with the Incidents Involving Hazardous Substances.
5. Explosives.
6. The Contaminated Patient.
7. Decontamination Procedures and Transport of Patients.
PART 25.
Civil Disturbances:
1. Types of Incidents.
2. The Role of the Ambulance Service during Civil Disturbance.
3. Neutrality and Discipline.
4. Protective Clothing.
5. General Guidelines for Operation.
PART 26.
Suspected Death and Management of Human Remains:
1. Legal Requirements for the Certification of Death.

2. Handling the Dead Body.

3. Handling Distressed Relatives.
4. Co-operation with other Services and Officials.
5. Mortuary Procedures.
PART 27.
Lifting and Moving Patients:
1. The Kinetics of Lifting.
2. Emergency Moves: Log Roles. Clothes Drag. Blanket Drag. Fireman's Drag. Fireman's Carry.
Human Crutch Method.
3. Non-Emergency Moves: Seat Carry. Extremity Lift. Chair Lifts. Stretcher Lifts.
4. Using Ambulance Lifting Equipment: Ambulance Trolley Cot. Orthopaedic Stretcher. Carrying
Chair. Carrying Sheets. Poles / Canvas / Spreaders. Basket Stretchers. Spinal Vacuum Mattress.
Rescue Stretchers.
5. Use of the Blanket.
6. House Removals.
7. Patient Handling Techniques.
8. Patient Positioning.
9. Ambulance Loading and Off-Loading.
PART 28.
Patient Stabilization and Extrication:
1. Road Traffic Accidents.
2. Survey of the Scene.
3. Safety of the Scene.
4. Gaining Access to the Incident.
5. Light Rescue Techniques.
6. Triage.
7. Preparing the Patient for Extrication:
8. Extrication Devices. Vacuum Mattress

9. Extrication Techniques. Vehicle Airbags.

PART 29.
Special Transfers:
1. High Dependency Patients.
2. Patients with Spinal Injuries.
3. Transferring the Violent Patient.
4. Patients with Infectious Diseases.
PART 30.
Introduction to Helicopter Emergency Medical Services (HEMS):
1. Working with Helicopters.
2. Organization and Operation of the H.E.M.S. Unit.
3. Air Rescue.
4. Interhospital Transfers.
5. Personnel and Equipment.
6. Clinical Considerations.
7. Use of the Helicopter in Disaster Situations.
PART 31.
Communications and reports:
1. Personal Communication / Communication with Patients.
2. Radio Communications.
3. Patient Report Forms.
4. Other EMS Reports.
5. Liaison and Communications with Hospitals.

PART 32.
Introduction to Defibrillation:

1. Anatomy of the Heart.

2. The Conductive Pathways of the Heart.
3. Ventricular Fibrillation.
4. Ventricular Tachycardia.
5. Electrical Defibrillation of the Heart.

MINUMUM REQUIREMENTS:
Twelve Months appropriate experience.
Evidence of a minimum of sixty hours Continuous Medical Education.
Minimum of six hundred and forty hours active Emergency Medical Services Duty, with full exposure to
emergency cases.
Submission of a log of experience gained.
EVALUATION:

Examination - One Hour Multiple-Choice Paper.

Examination - One Hour Short Answer Paper.
Examination - One Hour Essay Paper.
Examination - Written and Practical Test in Basic Life Support (BLS).
Examination - Eight Station Practical Test on General E.M.T. Skills.

Syllabus EMT Defibrillator trained

Duration: 60 hours
PART 1.
Role of the EMT(D):
1. Role of the Emergency Medical Technician, Defibrillation Trained as a part of the Cardiac Care
System.
2. Laws governing Electrical Defibrillation of the heart, death and dying.
3. Medical Ethics concerning Defibrillation.
PART 2.
Review of Basic Life Support:
1. Special considerations in Basic Life Support.
2. Re-certification in Basic Life Support.
PART 3. Review of Anatomy and Physiology of the Cardiovascular System:

1. Structure and Function of the Cardiovascular System.

2. Focus on the Pathophysiology of the Heart.
3. Conduction pathways of the heart.
4. The Autonomic Nervous System and the Heart.
PART 4.
Assessment of the Cardiac Patient:
1. The importance of the History in the Cardiac Patient.
2. The Physical Examination of the Cardiac Patient.
3. The Electrocardiograph:
4. Application of Monitoring Electrodes.
5. The 12 Lead ECG.
6. Interpretation of Basic Rhythms: Normal Sinus Rhythm. Sinus Arrhythmia. Sinus Arrest. Sinus
Bradycardia. Sinus Tachycardia. Wandering Atrial Pacemaker. Premature Atrial Contractions.
Paroxysmal Supraventricular Tachycardia. Atrial Flutter. Atrial Fibrillation. Premature Junctional
Contractions. First Degree AV Block. Second Degree AV Block (Type 1 & 2). Third Degree
(Complete) AV Block. Bundle Branch Blocks. Premature Ventricular Contractions. Ventricular
Tachycardia. Ventricular Fibrillation. Asystole. Pacemaker Rhythms. ECG Artifacts.
PART 5.
Introduction to Advanced Cardiac Life Support and Defibrillation:
1. Philippine Heart Association Protocols.
2. The importance of early Defibrillation.
3. Cardiac arrest and Defibrillation.
4. How Defibrillation works.
5. Shockable Rhythms.
6. Non-Shockable Rhythms.
7. The Importance of Expediency.
PART 6.
Defibrillation Equipment:
1. The Automated External Defibrillator: Generic Protocols. Algorithms.
2. Introduction to the Semi Automated External Defibrillator: Generic Protocols. Algorithms.

3. Introduction to the Manually Operated Defibrillator. Generic Protocols. Algorithms.

PART 7.
Attaching the Defibrillator to the patient:
1. Anatomy of the chest.
2. Correct Location of Pads/Paddles.
3. Safety Measures concerning Defibrillation.
4. The Importance of Equipment Checks.
PART 8.
Post Resuscitative Care and Transportation:
1. The Transport Decision.
2. Patient Handling.
3. Ongoing Observations During Transportation Phase.
PART 9.
Medical Culpability for Defibrillation:
1. Medical Control.
2. Quality Assurance and Improvement.
3. Reports and Documentation.

MINIMUM REQUIREMENTS:

Four hundred and eighty hours active Emergency Medical Services Duty post "Basic
Emergency Medical Technician Qualification EMT(B)" with full exposure to emergency cases.
Evidence of forty hours clinical exposure in ICU, CCU, or Emergency Room.
Successful completion of selection interview / examinations.
EVALUATION:
Examination Thirty Minute Multiple Choice Paper.
Examination One Hour Short Answer Paper.
Examination One Hour Practical Test In Basic Life Support and Defibrillation
Techniques.

Syllabus EMT Advanced

Duration: 360 hours
MODULE 1 : PREPARATION \ SELECTION:
PART 1.
Role of the Advanced EMT:
1. Overall Role of the Advanced Emergency Medical Technician.
2. Laws Governing Advanced Life Support Skills.
3. Issues Concerning the Health Professional :
Medical Ethics.
Death and Dying.
PART 2.
Human Systems - The Respiratory System:
1. Anatomy.
2. External and Internal Respiration.
3. Factors Influencing Carbon Dioxide in the Blood.
4. Factors Influencing Oxygen in the Blood.
5. Regulation of Ventilation.
6. Modified Forms of Respiration.
PART 3.
Human Systems - The Cardiovascular System:
1. Anatomy.
2. Cardiac Output.
3. Nervous and Chemical Control of the Heart.
4. The Electrical Conduction System of the Heart.
5. Basic Components of the E.C.G. Trace.
6. The Blood - Vascular System.
7. The Lymphatic System
PART 4.
Human Systems - The Nervous System:
1. Anatomy.
2. The Brain.
3. The Spinal Cord.
4. The Autonomic Nervous System.
5. The Peripheral Nervous System.
PART 5.
Human Systems - Review of Other Body Systems:
1. The Musculoskeletal System.
2. The Digestive System.
3. The Urinary System.
4. The Reproductive System.
5. The Endocrine System.

PART 6.
Patient Assessment - A Review.
1. The Overall Approach.
2. Taking the History.
3. The Physical Examination:
The Primary Survey.
General Appearance.
Vital Signs.
Examination of the Skin.
Examination of the Head and Neck.
Respiratory Assessment.
Cardiovascular Assessment.
Abdominal Assessment.
Assessment of the Extremities and Spine
Putting it all Together.
4. Presenting Medical Information.
PART 7.
Advanced Airway Management:
1. Hypoxia.
2. Oxygen Administration.
3. Adjunctive Equipment:
Airways.
Ventilation Devices for Patients Requiring Artificial Ventilation.
4. Suctioning:
Tracheal Suctioning in the Non- Intubated Patient.
Tracheal Suctioning in the Intubated Patient.
5. Management of Airway Obstruction.
6. Direct Laryngoscopy.
7. Endotracheal Intubation.
8. Chest Decompression Techniques.
9. The use of Positive End-Expiratory Pressure (Peep).
10. Cricothyrotomy.
11. Transtracheal Jet Insufflation.
PART 8.
Fluids and Shock:
1. Water and Electrolytes.
2. Osmosis.
3. Diffusion of Solutes.
4. The Electrolytes :
The Principal Cations.
The Principal Anions.
5. Acid - Base Balance :
Respiratory Acidosis.
Respiratory Alkalosis.
Metabolic Acidosis.
Metabolic Alkalosis.
6. Blood and its Components :
General Composition of Blood.
Formed Elements.

 Plasma.
Blood Typing.
Rh Factor.
7. Blood Preparations, Derivatives and Substitutes :
Whole Blood.
Packed Red Blood Cells.
Plasma.
Plasma " Substitutes ".
Crystalloids.
Complications of Blood Transfusion.
8. Abnormal States of Fluid and Electrolyte Balance :
Dehydration.
Overhydration.
Shock and Shock Types.
9. Peripheral Intravenous Infusion.
10. Complications of Intravenous Therapy.
11. Medical Anti-Shock Trousers :
Application of the MAST.
Indications and Contraindications of MAST.
Deflation of the MAST.
12. Central Venous Lines :
External Jugular Vein Cannulation.
Internal Jugular Vein Cannulation.
Subclavian Vein Cannulation.
Hazards and Complications of Jugular and Subclavian Cannulation.
PART 9.
Introduction to Advanced Cardiac Life Support:
1. Patient Assessment:
The History in the Cardiac Patient.
Physical Examination of the Cardiac Patient.
2. Pathopysiology and the Management of Cardiovascular Disorders:
Coronary Artery Disease and Angina.
Acute Myocardial Infarction.
Congestive Heart Failure.
Cardiogenic Shock.
Syncope.
Myocardial Trauma.
Hypertensive Emergencies.
3. Cardiac Arrhythmia's.
4. Reading an E.C.G.
5. Application of Monitoring Electrodes.
6. Specific Cardiac Arrhythmia's.
7. Life Threatening Cardiac Arrhythmia's.
8. Management of Cardiac Arrest.
Pre-Hospital Approach.
In-Hospital Team Approach.
9. Review of Basic Life Support (BLS).
10. Post-resuscitative Care.
11. Defibrillation.
12. Cardioversion.
13. Pharmacology.
PART 10.

Introduction to Advanced Trauma Management:

1. Initial Assessment and Management.
2. Management of the Upper Airway.
3. Thoracic Trauma.
4. Management of Hypovolemic Shock.
5. Head Injuries.
6. Major Maxillofacial Injuries.
7. Trauma of the Spine and Spinal Cord.
8. Abdominal Trauma.
9. Trauma of the Urinary Tract.
10. Management of Limb Injuries.
11. Trauma in Pregnancy.
12. Pediatric Trauma.
13. Management of Burns.
14. Blast and Gunshot Injuries.
15. Transport of the Injured Patient.
16. Major Accidents and Multiple Victim Incidents.
17. Incidents Involving Hazardous Substances.
18. Handling Distressed Relatives and Breaking Bad News.
19. Scoring Systems for Trauma.

MODULE 2 - CARDIOVASCULAR EMERGENCIES & ADVANCED PREHOSPITAL CARDIAC LIFE SUPPORT.

PART 1.
Review of Basic Life Support:
1. Adult CPR and Management of Airway Obstruction.
2. Pediatric CPR and Management of Airway Obstruction.
3. Infant CPR and Management of Airway Obstruction.
4. Cough CPR and The Pre-cordial Thump.
PART 2.
Review of the Anatomy of Circulatory System:
1. The Heart.
Gross Anatomy.
Structure of the Heart Wall.
Blood Supply to the Heart.
Cardiac Output - Starlings Law.
Blood Flow Through the Heart.
Extrinsic Control of the Heart.
2. The Major Arteries and Veins:
The Structure of the Blood Vessels.
The Blood Pressure and it's Regulation.
3. The Blood:
Functions and Components.
Blood Groups - ABO and Rhesus Systems.
The Lymphatic System.
4. Primary Nerves and Chemical Mediators.
5. Effects of Stimulation.

PART 3.
Common Cardiac Conditions and their Management:
1. Angina Pectoris.
2. Acute Myocardial Infarction.
3. Left Sided Heart Failure.
4. Right Sided Heart Failure.
5. Cardiogenic Shock.
6. Aortic Aneurysm.
7. Hypertensive Crisis
PART 4.
Electrocardiogram Recognition:
1. Electrophysiology.
2. Review of the Electrical Conduction System of the Heart.
The Isoelectric Line.
The P Wave.
The P-R Interval.
The QRS Complex.
The S-T Segment.
The T Wave.
The R-R Interval.
Relationships of the P wave, QRS complex and the T wave.
3. E.C.G. Electrode placement.
4. Sources of Artifact.
5. Life threatening Ventricular Arrhythmia's.
PART 5.
Arrhythmia Interpretation:
1. Normal Sinus Rhythm.
2. Sinus Arrhythmia.
3. Sinus Arrest.
4. Sinus Bradycardia.
5. Sinus Tachycardia.
6. Wandering Pacemaker.
7. Premature Atrial Contractions.
8. Premature Junctional Contractions.
9. Paroxysmal Supraventricular Tachycardia.
10. Atrial Flutter.
11. Atrial Fibrillation.
12. Junctional Rhythm.
13. First, Second and Third Degree Atrioventricular Blocks.
14. Bundle branch blocks.
15. Premature Ventricular Contractions.
16. Ventricular Tachycardia.
17. Ventricular Fibrillation.
18. Asystole.
19. Artificial Pacemaker Rhythms.
20. Artifacts.
PART 6.

 Conversion Techniques.
1. Electrical Conversion:
Ventricular Fibrillation.
Synchronized Cardioversion.
Unsynchronized Cardioversion.
2. External Pacing.
3. Implanted Pacemakers and Defibrillators.
4. Manual Defibrillators.
5. Semi-Automatic Defibrillators.
6. Automated External Defibrillators.
7. Transcutaneous Cardiac Pacing.
PART 7.
Additional Techniques:
1. Carotid Sinus Massage.
2. Intracardiac Injections.
3. Urinary Bladder Cathetherization.
4. Naso Gastric Tube Placement.
Devices Used in Resuscitation:
1. Mechanical CPR Devices.
AMBU Cardiopump.
Cardiac Presses.
Gas Powered Resuscitators/Ventilators.
PART 8.
Pharmacology:
1. Appropriate agents for use in treating Cardiac Arrest, Life Threatening
Arrhythmia's and the relief of pain and anxiety. The Characteristics and
uses of each medication:
Oxygen.
Nitrous Oxide.
Adenosine.
Atropine Sulphate.
Bretylium Tosylate.
Dopamine.
Epinepherine.
Furosemide.
Labetolol
Lidocaine Hydrochloride.
Nifedipine.
Nitro Glycerine.
Norepinephrine.
Propranolol.
Streptokinase.
Tissue Plasminogen Activator.
Verapamil.
2. The affects of Adrenergic and Dopaminergic receptors of the Autonomic Nervous
System.
3. Intropic Vasoactive Agents.
4. Vasodilators and Antihypertensives.
5. Beta-Blockers.
6. Diuretics

7. Alpha and Beta-Receptors.

8. Dopaminergic receptors.
9. Divisions of the Autonomic Nervous System - Sympathetic / Parasympathetic.
10. The timeliness of appropriate pharmacological treatment.
11. Indications, mechanisms of action, dosages and precautions for each medication.
PART 7.
Advanced Cardiac Life Support Algorithms (Philippine Heart Association):
1. Universal Emergency Cardiac Care.
2. Ventricular Fibrillation and Pulseless Ventricular Tachycardia.
3. Pulseless Electrical Activity.
4. Aystole.
5. Bradycardia.
6. Tachycardia.
7. Cardioversion.
8. Acute Pulmonary Edema.
9. Acute Myocardial Infarction.
IN - HOSPITAL A.C.L.S.
Individuals involved with In-Hospital resuscitation during advanced cardiac life support will be able to
demonstrate their knowledge and skills of:
Adapting to Team Resuscitation.
The role of the Team Leader.
Organizing and directing the team.
Problem Solving Skills.
The appropriate algorithm in accordance with Philippine Heart Association
Guidelines.

MODULE 4 - ADVANCED PRE_HOSPITAL TRAUMA MANAGEMENT.

DURATION - 80 HOURS.
PART 1.
Mechanism of injury attributed to Road Traffic Accidents.
The Machine collision:
1. Head-on impact.
2. Lateral impact.
3. Rear shunt impact.
4. Rollover following impact.
The body collision:
1. Involving the steering wheel.
2. Involving the dashboard.
3. Involving the windshield.
4. Involving doors & sideposts.
The organ collision:
1. Coup & Contra-coup brain injuries.

2. Direct impact soft tissue injuries.

3. Hyperextension and flexion of the cervical spine.
4. Internal injuries due to shear, blunt and penetrating trauma.
Assessment through vehicle damage:
1. Exterior impact damage.
2. Interior impact damage.
3. Restraint systems.
Injury patterns:
1. Rapid vertical deceleration injuries.
2. Blast Injuries, projectile penetration injuries and wound ballistics.
PART 2.
Preliminary actions at the scene.
Scene Survey:
1. Assessment of hazards.
2. Single patient incidents.
3. Multiple patient incidents.
4. Extrication.
5. Essential equipment.
Patient assessment and management priorities:
1. Total overview on approach to the incident.
2. Patient assessment using the priority plan.
3. Critical interventions and transport decision.
4. Critical care and ongoing reassessment.
PART 3.
Initial and ongoing Airway Management Skills:
1. Airway Equipment & Adjuncts.
2. Observation.
3. Suctioning Equipment & Techniques.
4. Oxygenation.
5. Ventilation & Ventilation Techniques.
6. Basic & Advanced Airway Management.
PART 4.
Shock Evaluation and Management:
1. Basic Pathophysiology.
2. Shock Assessment.
3. Shock Syndromes:
Mechanical or Obstructive Shock.
Hypoxemic Shock.
4. Management of Post Traumatic Shock States.
PART 5.

 Special Fluid Resuscitation Skills:

1. Cannulation of the External Jugular Vein.
2. Intraosseous Infusion.
MODULE 1 : PREPARATION \ SELECTION:
PART 1.
Role of the Advanced EMT:
1. Overall Role of the Advanced Emergency Medical Technician.
2. Laws Governing Advanced Life Support Skills.
3. Issues Concerning the Health Professional :
Medical Ethics.
Death and Dying.
PART 2.
Human Systems - The Respiratory System:
1. Anatomy.
2. External and Internal Respiration.
3. Factors Influencing Carbon Dioxide in the Blood.
4. Factors Influencing Oxygen in the Blood.
5. Regulation of Ventilation.
6. Modified Forms of Respiration.
PART 3.
Human Systems - The Cardiovascular System:
1. Anatomy.
2. Cardiac Output.
3. Nervous and Chemical Control of the Heart.
4. The Electrical Conduction System of the Heart.
5. Basic Components of the E.C.G. Trace.
6. The Blood - Vascular System.
7. The Lymphatic System
PART 4.
Human Systems - The Nervous System:
1. Anatomy.
2. The Brain.
3. The Spinal Cord.
4. The Autonomic Nervous System.
5. The Peripheral Nervous System.
PART 5.
Human Systems - Review of Other Body Systems:
1. The Musculoskeletal System.
2. The Digestive System.
3. The Urinary System.
4. The Reproductive System.
5. The Endocrine System.

PART 6.
Patient Assessment - A Review.
1. The Overall Approach.
2. Taking the History.
3. The Physical Examination:
The Primary Survey.
General Appearance.
Vital Signs.
Examination of the Skin.
Examination of the Head and Neck.
Respiratory Assessment.
Cardiovascular Assessment.
Abdominal Assessment.
Assessment of the Extremities and Spine
Putting it all Together.
4. Presenting Medical Information.
PART 7.
Advanced Airway Management:
1. Hypoxia.
2. Oxygen Administration.
3. Adjunctive Equipment:
Airways.
Ventilation Devices for Patients Requiring Artificial Ventilation.
4. Suctioning:
Tracheal Suctioning in the Non- Intubated Patient.
Tracheal Suctioning in the Intubated Patient.
5. Management of Airway Obstruction.
6. Direct Laryngoscopy.
7. Endotracheal Intubation.
8. Chest Decompression Techniques.
9. The use of Positive End-Expiratory Pressure (Peep).
10. Cricothyrotomy.
11. Transtracheal Jet Insufflation.
PART 8.
Fluids and Shock:
1. Water and Electrolytes.
2. Osmosis.
3. Diffusion of Solutes.
4. The Electrolytes :
The Principal Cations.
The Principal Anions.
5. Acid - Base Balance :
Respiratory Acidosis.
Respiratory Alkalosis.
Metabolic Acidosis.
Metabolic Alkalosis.
6. Blood and its Components :
General Composition of Blood.
Formed Elements.

 Plasma.
Blood Typing.
Rh Factor.
7. Blood Preparations, Derivatives and Substitutes :
Whole Blood.
Packed Red Blood Cells.
Plasma.
Plasma " Substitutes ".
Crystalloids.
Complications of Blood Transfusion.
8. Abnormal States of Fluid and Electrolyte Balance :
Dehydration.
Overhydration.
Shock and Shock Types.
9. Peripheral Intravenous Infusion.
10. Complications of Intravenous Therapy.
11. Medical Anti-Shock Trousers :
Application of the MAST.
Indications and Contraindications of MAST.
Deflation of the MAST.
12. Central Venous Lines :
External Jugular Vein Cannulation.
Internal Jugular Vein Cannulation.
Subclavian Vein Cannulation.
Hazards and Complications of Jugular and Subclavian Cannulation.
PART 9.
Introduction to Advanced Cardiac Life Support:
1. Patient Assessment:
The History in the Cardiac Patient.
Physical Examination of the Cardiac Patient.
2. Pathopysiology and the Management of Cardiovascular Disorders:
Coronary Artery Disease and Angina.
Acute Myocardial Infarction.
Congestive Heart Failure.
Cardiogenic Shock.
Syncope.
Myocardial Trauma.
Hypertensive Emergencies.
3. Cardiac Arrhythmia's.
4. Reading an E.C.G.
5. Application of Monitoring Electrodes.
6. Specific Cardiac Arrhythmia's.
7. Life Threatening Cardiac Arrhythmia's.
8. Management of Cardiac Arrest.
Pre-Hospital Approach.
In-Hospital Team Approach.
9. Review of Basic Life Support (BLS).
10. Post-resuscitative Care.
11. Defibrillation.
12. Cardioversion.
13. Pharmacology.
PART 10.

Introduction to Advanced Trauma Management:

1. Initial Assessment and Management.
2. Management of the Upper Airway.
3. Thoracic Trauma.
4. Management of Hypovolemic Shock.
5. Head Injuries.
6. Major Maxillofacial Injuries.
7. Trauma of the Spine and Spinal Cord.
8. Abdominal Trauma.
9. Trauma of the Urinary Tract.
10. Management of Limb Injuries.
11. Trauma in Pregnancy.
12. Pediatric Trauma.
13. Management of Burns.
14. Blast and Gunshot Injuries.
15. Transport of the Injured Patient.
16. Major Accidents and Multiple Victim Incidents.
17. Incidents Involving Hazardous Substances.
18. Handling Distressed Relatives and Breaking Bad News.
19. Scoring Systems for Trauma.

MODULE 2 - CARDIOVASCULAR EMERGENCIES & ADVANCED PREHOSPITAL CARDIAC LIFE SUPPORT.

PART 1.
Review of Basic Life Support:
1. Adult CPR and Management of Airway Obstruction.
2. Pediatric CPR and Management of Airway Obstruction.
3. Infant CPR and Management of Airway Obstruction.
4. Cough CPR and The Pre-cordial Thump.
PART 2.
Review of the Anatomy of Circulatory System:
1. The Heart.
Gross Anatomy.
Structure of the Heart Wall.
Blood Supply to the Heart.
Cardiac Output - Starlings Law.
Blood Flow Through the Heart.
Extrinsic Control of the Heart.
2. The Major Arteries and Veins:
The Structure of the Blood Vessels.
The Blood Pressure and it's Regulation.
3. The Blood:
Functions and Components.
Blood Groups - ABO and Rhesus Systems.
The Lymphatic System.
4. Primary Nerves and Chemical Mediators.
5. Effects of Stimulation.

PART 3.
Common Cardiac Conditions and their Management:
1. Angina Pectoris.
2. Acute Myocardial Infarction.
3. Left Sided Heart Failure.
4. Right Sided Heart Failure.
5. Cardiogenic Shock.
6. Aortic Aneurysm.
7. Hypertensive Crisis
PART 4.
Electrocardiogram Recognition:
1. Electrophysiology.
2. Review of the Electrical Conduction System of the Heart.
The Isoelectric Line.
The P Wave.
The P-R Interval.
The QRS Complex.
The S-T Segment.
The T Wave.
The R-R Interval.
Relationships of the P wave, QRS complex and the T wave.
3. E.C.G. Electrode placement.
4. Sources of Artifact.
5. Life threatening Ventricular Arrhythmia's.
PART 5.
Arrhythmia Interpretation:
1. Normal Sinus Rhythm.
2. Sinus Arrhythmia.
3. Sinus Arrest.
4. Sinus Bradycardia.
5. Sinus Tachycardia.
6. Wandering Pacemaker.
7. Premature Atrial Contractions.
8. Premature Junctional Contractions.

COPYRIGHT: LSTI
9. Paroxysmal Supraventricular Tachycardia.
10. Atrial Flutter.
11. Atrial Fibrillation.
12. Junctional Rhythm.
13. First, Second and Third Degree Atrioventricular Blocks.
14. Bundle branch blocks.
15. Premature Ventricular Contractions.
16. Ventricular Tachycardia.
17. Ventricular Fibrillation.
18. Asystole.
19. Artificial Pacemaker Rhythms.
20. Artifacts.

PART 6.
Conversion Techniques.
1. Electrical Conversion:
Ventricular Fibrillation.
Synchronized Cardioversion.
Unsynchronized Cardioversion.
2. External Pacing.
3. Implanted Pacemakers and Defibrillators.
4. Manual Defibrillators.
5. Semi-Automatic Defibrillators.
6. Automated External Defibrillators.
7. Transcutaneous Cardiac Pacing.
PART 7.
Additional Techniques:
1. Carotid Sinus Massage.
2. Intracardiac Injections.
3. Urinary Bladder Cathetherization.
4. Naso Gastric Tube Placement.
Devices Used in Resuscitation:
1. Mechanical CPR Devices.
AMBU Cardiopump.
Cardiac Presses.
Gas Powered Resuscitators/Ventilators.
PART 8.
Pharmacology:
1. Appropriate agents for use in treating Cardiac Arrest, Life Threatening
Arrhythmia's and the relief of pain and anxiety. The Characteristics and
uses of each medication:
Oxygen.
Nitrous Oxide.
Adenosine.
Atropine Sulphate.
Bretylium Tosylate.
Dopamine.
Epinepherine.
Furosemide.
Labetolol
Lidocaine Hydrochloride.
Nifedipine.
Nitro Glycerine.
Norepinephrine.
Propranolol.
Streptokinase.
Tissue Plasminogen Activator.
Verapamil.
2. The affects of Adrenergic and Dopaminergic receptors of the Autonomic Nervous
System.
3. Intropic Vasoactive Agents.
4. Vasodilators and Antihypertensives.

5. Beta-Blockers.
6. Diuretics
7. Alpha and Beta-Receptors.
8. Dopaminergic receptors.
9. Divisions of the Autonomic Nervous System - Sympathetic / Parasympathetic.
10. The timeliness of appropriate pharmacological treatment.
11. Indications, mechanisms of action, dosages and precautions for each medication.
PART 7.
Advanced Cardiac Life Support Algorithms (Philippine Heart Association):
1. Universal Emergency Cardiac Care.
2. Ventricular Fibrillation and Pulseless Ventricular Tachycardia.
3. Pulseless Electrical Activity.
4. Aystole.
5. Bradycardia.
6. Tachycardia.
7. Cardioversion.
8. Acute Pulmonary Edema.
9. Acute Myocardial Infarction.
IN - HOSPITAL A.C.L.S.
Individuals involved with In-Hospital resuscitation during advanced cardiac life support will be able to
demonstrate their knowledge and skills of:
Adapting to Team Resuscitation.
The role of the Team Leader.
Organizing and directing the team.
Problem Solving Skills.
The appropriate algorithm in accordance with Philippine Heart Association
Guidelines.
MODULE 4 - ADVANCED PRE_HOSPITAL TRAUMA MANAGEMENT.
DURATION - 80 HOURS.
PART 1.
Mechanism of injury attributed to Road Traffic Accidents.
The Machine collision:
1. Head-on impact.
2. Lateral impact.
3. Rear shunt impact.
4. Rollover following impact.
The body collision:
1. Involving the steering wheel.
2. Involving the dashboard.
3. Involving the windshield.
4. Involving doors & sideposts.
The organ collision:
1. Coup & Contra-coup brain injuries.
2. Direct impact soft tissue injuries.

3. Hyperextension and flexion of the cervical spine.

4. Internal injuries due to shear, blunt and penetrating trauma.
Assessment through vehicle damage:
1. Exterior impact damage.
2. Interior impact damage.
3. Restraint systems.
Injury patterns:
1. Rapid vertical deceleration injuries.
2. Blast Injuries, projectile penetration injuries and wound ballistics.
PART 2.
Preliminary actions at the scene.
Scene Survey:
1. Assessment of hazards.
2. Single patient incidents.
3. Multiple patient incidents.
4. Extrication.
5. Essential equipment.
Patient assessment and management priorities:
1. Total overview on approach to the incident.
2. Patient assessment using the priority plan.
3. Critical interventions and transport decision.
4. Critical care and ongoing reassessment.
PART 3.
Initial and ongoing Airway Management Skills:
1. Airway Equipment & Adjuncts.
2. Observation.
3. Suctioning Equipment & Techniques.
4. Oxygenation.
5. Ventilation & Ventilation Techniques.
6. Basic & Advanced Airway Management.
PART 4.
Shock Evaluation and Management:
1. Basic Pathophysiology.
2. Shock Assessment.
3. Shock Syndromes:
Mechanical or Obstructive Shock.
Hypoxemic Shock.
4. Management of Post Traumatic Shock States.
PART 5.
Special Fluid Resuscitation Skills:
1. Cannulation of the External Jugular Vein.
2. Intraosseous Infusion.

PART 6,
Spinal Trauma:
1. Review - The Normal Spinal Column and Cord.
2. Kinematics of Blunt Spinal Injury.
3. Spinal Cord Injury.
4. Mechanisms of Spinal Injury.
5. Assessment of Spinal Injuries.
6. Management of Spinal Injuries:
Immobilization & Extrication.
Special Situations.
7. Airway Intervention.
PART 7.
Head Injuries:
1. Review - Anatomy.
2. Pathophysiology of Head Trauma.
Intracranial Pressure.
Herniation Syndrome.
Anoxic Brain Injury.
3. Wounds to the Scalp.
4. Skull Injuries.
5. Brain Injuries.
6. Initial and Ongoing Assessment of Head Trauma Patients.
7. Management of the Head Trauma Patient.
8. Potential Problems.

PART 8.
Thoracic Trauma:
1. Review - Anatomy.
2. Pathophysiology of Thoracic Trauma.
3. Assessment and Management of Thoracic Trauma.
Open Pneumothorax.
Tension Pneumothorax.
Massive Heamothorax.
Flail Chest.
Cardiac Tamponade.
Tracheal or Bronchial Tree Injuries.
Myocardial Contusion.
Diaphragmatic Tears.
Oesophageal Injury.
Pulmonary Contusion.
Other chest Injuries.
4. Chest Decompression.
PART 9.
Abdominal and Pelvic Trauma:
1. Review - Anatomy.
2. Specific Injuries:

 Penetrating Trauma to the Abdomen.

Blunt Trauma to the Abdomen.
Genitourinary Injuries.
Pelvic Fractures.
3. Examination and Evaluation.
4. Stabilization and Management.
PART 10.
Trauma to the Extremities:
1. Review - Anatomy.
2. Mechanisms of Musculoskeletal Injuries to the Extremities.
3. Types of Musculoskeletal Injury to the Extremities:
Fractures
Dislocations.
Sprains & Strains.
Traumatic Amputations.
4. Assessment and Management Of Injuries to the Extremities.
PART 11.
Burn Injuries:
1. Review - Anatomy & Pathology of the Skin.
2. Hazards - Dealing with the Cause.
3. Assessment.
4. Characteristics of Various Depths of Burns.
5. Initial Field care.
6. Special Problems Associated with Burn Management:
Thermal burns.
Electrical Burns.
Chemical Burns.
Burns due to Radiation.
7. Primary and Secondary Transportation.
PART 12.
Trauma in Children:
1. Review - Anatomical Considerations.
2. Communications with Child and Family.
3. Equipment specifically designed for Pediatric use.
Pediatric Femoral Traction Splints.
Pediatric Cervical Collars.
Pediatric Bag Valve Mask Resuscitators.
Pediatric B/P Cuffs.
Pediatric Cannulae - Over the Needle & Butterfly.
Pediatric Drug Regimes.
Pediatric Ventilation Regimes.
Brownlow Tape.
4. Assessment of Pediatric Patients:
Scene Survey.
Assessment and Management of Respiration.
Assessment and Management of Circulation.
The Critical Trauma Decision.
Head Injuries - Level of Consciousness.

 Spinal Injuries.
Chest Injuries.
Abdominal and Pelvic Injuries.
Specific Injuries to the Extremities.
5. Airway & C. Spine Stabilization.
6. Common Mechanisms of Injury in Children.
7. Child Restraint Seats.
PART 13.
Trauma in the Elderly:
1. Pathophysiology of Aging.
2. Assessment of the Elderly Patient:
Scene Survey.
Evaluating Airway, Breathing and Circulation
Head Injuries.
Spinal Injuries.
Chest Injuries.
Abdominal and Pelvic Injuries.
Specific Injuries to the Extremities.
3. Critical Transport Decisions.

PART 14.
Trauma in Pregnancy:
1. Physiological Changes During Pregnancy.
2. Response to Hypovolemia.
3. Vehicular Collisions.
4. Blunt Trauma to the Abdomen.
5. Penetrating Trauma to the Abdomen.
6. Falls.
7. Evaluation.
8. Management of the Pregnant Patient.
9. Oxygen Administration.
10. Transportation.
PART 15.
Patients Under the Influence of Drugs or Alcohol:
1. Drug Abuse:
Abuse.
Physical Dependence.
Psychological Dependence.
Tolerance.
Drug Addiction.
Withdrawal Syndrome.
2. Drug Categories:
Narcotics.
Central Nervous System Depressants.
Central Nervous System Stimulants.
Hallucinogens.

3. Drug Overdose and Drug Toxicity.

4. General Principles of Assessment and Management.
5. Profile of the Alcoholic.
6. Medical Consequences of Alcohol.
Acute Alcoholic Intoxication.
Withdrawal Seizures.
Delirium Tremens.
7. Placement of Naso-Gastric Tubes.
8. Principles of Management of the Uncooperative Patient.
9. Principles of Long Term Management and the risk of Relapse.
PART 16.
Drowning, Barotrauma and Decompression Sickness:
1. Pathophysiology of Drowning.
2. Near Drowning and Secondary Drowning.
3. Acute Pulmonary Edema:
Left Ventricular Failure.
Acute Mountain/Altitude Sickness and High Altitude Pulmonary Edema.
4. Assessment of Diving Incidents:
Barotrauma of Descent and Ascent.
5. Decompression Sickness:
Type 1. Illness.
Type 2. Illness.
6. Management of Decompression Sickness.
7. Shallow Water Blackout.
PART 17.
Critical Trauma Situations - The Load & Go Decision:
1. Critical interventions.
2. The "Load and Go" Versus the "Stay and Treat" the Decision Making Process.
3. Stabilizing Measures.
4. Reassessment Surveys.
PART 18.
Cardiopulmonary Arrest due to Trauma:
1. The Pathophysiology of Cardiopulmonary Arrest due to Trauma.
2. Treatable Causes of Traumatic Cardiopulmonary Arrest:
Respiratory Causes.
Circulatory Causes.
3. Approach to Trauma Victims in Cardiopulmonary Arrest.
4. General Plan of Action.
5. Stabilizing Measures.
6. Reassessment Surveys.
PART 19.
Infection Control in the Pre-Hospital Setting:
1. Transmission of Communicable Diseases.
Direct Contact.
Contact with Contaminated Materials.

 Droplet Infection.
Human, Animal or Insect Bites.
Puncture by Contaminated Needle.
Contact with Contaminated Body Fluids.
2. Standard Precautions Against Disease Transmission:
Barrier Precautions During Patient Exposures.
Personal Precautions.
Ambulance Hygiene.
Handling of Items Exposed to Blood or Body Fluids.
3. Procedure after Accidental Exposure to Blood or Body Fluids.
PART 20.
Pre-Hospital Trauma Scoring:
1. Functions of Trauma Scoring.
2. Revised Trauma Scoring System:
Glasgow Coma Scale.
Respiratory Status.
Systolic Blood Pressure.
Pediatric Trauma Scoring System.
PART 21.
Injury Prevention:
1. The Injury Epidemic.
2. The Injury Process and Why Injuries Occur:
Analyzing Injury Events.
Phases of Injury Event.
3. General Principles for Safe Extrication.
4. Stages of Extrication:
Safety Surveys of the Scene and Stabilization.
Gaining Access to the Patient.
Providing Emergency Care.
Disentanglement.
Packaging and Removal.
5. Role of the EMS Provider in Injury Prevention and Control.
MINIMUM REQUIREMENTS:
Successful completion of selection interview / examinations.
Completion of nine hundred and sixty hours post "EMT I & I" appropriate Emergency Medical Services
experience to include emergency response duties.
Submission of log of experience gained.
EVALUATION:
One Hour Multiple Choice Paper.
One Hour Short Answer Paper.
One Hour Essay Paper.
One Hour Practical Skills Test.
Minimum of Thirty Minute Oral Examination given by Duly Appointed Panel.

1. Review - The Normal Spinal Column and Cord.

2. Kinematics of Blunt Spinal Injury.

3. Spinal Cord Injury.

4. Mechanisms of Spinal Injury.
5. Assessment of Spinal Injuries.
6. Management of Spinal Injuries:
Immobilization & Extrication.
Special Situations.
7. Airway Intervention.
PART 7.
Head Injuries:
1. Review - Anatomy.
2. Pathophysiology of Head Trauma.
Intracranial Pressure.
Herniation Syndrome.
Anoxic Brain Injury.
3. Wounds to the Scalp.
4. Skull Injuries.
5. Brain Injuries.
6. Initial and Ongoing Assessment of Head Trauma Patients.
7. Management of the Head Trauma Patient.
8. Potential Problems.
PART 8.
Thoracic Trauma:
1. Review - Anatomy.
2. Pathophysiology of Thoracic Trauma.
3. Assessment and Management of Thoracic Trauma.
Open Pneumothorax.
Tension Pneumothorax.
Massive Heamothorax.
Flail Chest.
Cardiac Tamponade.
Tracheal or Bronchial Tree Injuries.
Myocardial Contusion.
Diaphragmatic Tears.
Oesophageal Injury.
Pulmonary Contusion.
Other chest Injuries.
4. Chest Decompression.
PART 9.
Abdominal and Pelvic Trauma:
1. Review - Anatomy.
2. Specific Injuries:
Penetrating Trauma to the Abdomen.
Blunt Trauma to the Abdomen.
Genitourinary Injuries.
Pelvic Fractures.
3. Examination and Evaluation.
4. Stabilization and Management.
PART 10.

 Trauma to the Extremities:

1. Review - Anatomy.
2. Mechanisms of Musculoskeletal Injuries to the Extremities.
3. Types of Musculoskeletal Injury to the Extremities:
Fractures
Dislocations.
Sprains & Strains.
Traumatic Amputations.
4. Assessment and Management Of Injuries to the Extremities.
PART 11.
Burn Injuries:
1. Review - Anatomy & Pathology of the Skin.
2. Hazards - Dealing with the Cause.
3. Assessment.
4. Characteristics of Various Depths of Burns.
5. Initial Field care.
6. Special Problems Associated with Burn Management:
Thermal burns.
Electrical Burns.
Chemical Burns.
Burns due to Radiation.
7. Primary and Secondary Transportation.
PART 12.
Trauma in Children:
1. Review - Anatomical Considerations.
2. Communications with Child and Family.
3. Equipment specifically designed for Pediatric use.
Pediatric Femoral Traction Splints.
Pediatric Cervical Collars.
Pediatric Bag Valve Mask Resuscitators.
Pediatric B/P Cuffs.
Pediatric Cannulae - Over the Needle & Butterfly.
Pediatric Drug Regimes.
Pediatric Ventilation Regimes.
Brownlow Tape.
4. Assessment of Pediatric Patients:
Scene Survey.
Assessment and Management of Respiration.
Assessment and Management of Circulation.
The Critical Trauma Decision.
Head Injuries - Level of Consciousness.
Spinal Injuries.
Chest Injuries.
Abdominal and Pelvic Injuries.
Specific Injuries to the Extremities.
5. Airway & C. Spine Stabilization.
6. Common Mechanisms of Injury in Children.
7. Child Restraint Seats.
PART 13.

 Trauma in the Elderly:

1. Pathophysiology of Aging.
2. Assessment of the Elderly Patient:
Scene Survey.
Evaluating Airway, Breathing and Circulation
Head Injuries.
Spinal Injuries.
Chest Injuries.
Abdominal and Pelvic Injuries.
Specific Injuries to the Extremities.
3. Critical Transport Decisions.

PART 14.
Trauma in Pregnancy:
1. Physiological Changes During Pregnancy.
2. Response to Hypovolemia.
3. Vehicular Collisions.
4. Blunt Trauma to the Abdomen.
5. Penetrating Trauma to the Abdomen.
6. Falls.
7. Evaluation.
8. Management of the Pregnant Patient.
9. Oxygen Administration.
10. Transportation.
PART 15.
Patients Under the Influence of Drugs or Alcohol:
1. Drug Abuse:
Abuse.
Physical Dependence.
Psychological Dependence.
Tolerance.
Drug Addiction.
Withdrawal Syndrome.
2. Drug Categories:
Narcotics.
Central Nervous System Depressants.
Central Nervous System Stimulants.
Hallucinogens.
3. Drug Overdose and Drug Toxicity.
4. General Principles of Assessment and Management.
5. Profile of the Alcoholic.
6. Medical Consequences of Alcohol.
Acute Alcoholic Intoxication.
Withdrawal Seizures.
Delirium Tremens.
7. Placement of Naso-Gastric Tubes.
8. Principles of Management of the Uncooperative Patient.
9. Principles of Long Term Management and the risk of Relapse.
PART 16.

 Drowning, Barotrauma and Decompression Sickness:

1. Pathophysiology of Drowning.
2. Near Drowning and Secondary Drowning.
3. Acute Pulmonary Edema:
Left Ventricular Failure.
Acute Mountain/Altitude Sickness and High Altitude Pulmonary Edema.
4. Assessment of Diving Incidents:
Barotrauma of Descent and Ascent.
5. Decompression Sickness:
Type 1. Illness.
Type 2. Illness.
6. Management of Decompression Sickness.
7. Shallow Water Blackout.
PART 17.
Critical Trauma Situations - The Load & Go Decision:
1. Critical interventions.
2. The "Load and Go" Versus the "Stay and Treat" the Decision Making Process.
3. Stabilizing Measures.
4. Reassessment Surveys.
PART 18.
Cardiopulmonary Arrest due to Trauma:
1. The Pathophysiology of Cardiopulmonary Arrest due to Trauma.
2. Treatable Causes of Traumatic Cardiopulmonary Arrest:
Respiratory Causes.
Circulatory Causes.
3. Approach to Trauma Victims in Cardiopulmonary Arrest.
4. General Plan of Action.
5. Stabilizing Measures.
6. Reassessment Surveys.
PART 19.
Infection Control in the Pre-Hospital Setting:
1. Transmission of Communicable Diseases.
Direct Contact.
Contact with Contaminated Materials.
Droplet Infection.
Human, Animal or Insect Bites.
Puncture by Contaminated Needle.
Contact with Contaminated Body Fluids.
2. Standard Precautions Against Disease Transmission:
Barrier Precautions During Patient Exposures.
Personal Precautions.
Ambulance Hygiene.
Handling of Items Exposed to Blood or Body Fluids.
3. Procedure after Accidental Exposure to Blood or Body Fluids.
PART 20.

 Pre-Hospital Trauma Scoring:

1. Functions of Trauma Scoring.
2. Revised Trauma Scoring System:
Glasgow Coma Scale.
Respiratory Status.
Systolic Blood Pressure.
Pediatric Trauma Scoring System.

PART 21.
Injury Prevention:
1. The Injury Epidemic.
2. The Injury Process and Why Injuries Occur:
Analyzing Injury Events.
Phases of Injury Event.
3. General Principles for Safe Extrication.
4. Stages of Extrication:
Safety Surveys of the Scene and Stabilization.
Gaining Access to the Patient.
Providing Emergency Care.
Disentanglement.
Packaging and Removal.
5. Role of the EMS Provider in Injury Prevention and Control.
MINIMUM REQUIREMENTS:
Successful completion of selection interview / examinations.
Completion of nine hundred and sixty hours post "EMT I & I" appropriate Emergency Medical Services
experience to include emergency response duties.
Submission of log of experience gained.
EVALUATION:
One Hour Multiple Choice Paper.
One Hour Short Answer Paper.
One Hour Essay Paper.
One Hour Practical Skills Test.
Minimum of Thirty Minute Oral Examination given by Duly Appointed Panel.

Syllabus Registered EMT (Paramedic)

PART 1.
Introduction to Emergency Medicine:
1. Scope and Practice of Emergency Medicine:
Pre-Hospital Care.
Emergency Department Approach.

The Star of Life - the

universal symbol for EMS
or Emergency Medical

Services.
Surgical and Critical Care Decisions - The Golden Hour Principle.
Principles of Emergency Care.
2. Initial Approach to the Patient & Gathering Data:
Primary Survey.
Secondary Survey.
The History.
The Diagnostic Process - Decision Priorities and Preliminary Differential Diagnosis.
Diagnostic Adjuncts\Aids.
3. Transports Considerations.
4. Principles of Management.
5. Special Considerations.
6. Clinical Pearls.
7. Telemetry & Communications.
PART 2.
Neurological Disorders and Emergencies:
1. Review of Anatomy and Physiology of the Nervous System.
2. The Neurological Examination & The Glasgow Coma Scale.
3. Head and Spinal Trauma.
4. Altered Mental Status.
5. Headache & Facial Pain.
6. Dizziness & Vertigo.
7. Meningitis, Encephalitis and Brain Abscess.
8. Seizures & Status Epilepticus.
9. Cerebral Ischemia.
10. Cerebro-Vascular Accident.
11. Peripheral Neurological Lesions Vs. Central Nervous System Lesions.
12. Multiple Sclerosis.

PART 3.
Cardiovascular Diseases and Emergencies:
1. Review of Anatomy and Physiology of the Circulatory System.
2. Myocardial Ischemia and Infarction.
3. Pre-Hospital Thrombolytic Therapy.
4. Heart Failure & Pulmonary Edema.
5. Palpatations.
6. Diseases Effecting the Valves.
7. Endocarditis, Myocarditis and Pericardial Disease.
8. Pulmonary Embolism.
9. Hypertensive Emergencies.
10. Aortic Aneurysms.
11. Physiological Effects of Aging on the Cardiovascular System.
12. Cardiac Transplants.
13. Preliminary Diagnosis and Decision Priorities.
14. Principles of Pre-Hospital Management of Cardiovascular Diseases.
15. Special Considerations:
Pediatric Patients.
Geriatric Patients.
Diabetic Patients.

16. Pharmacology.
PART 4.
Pulmonary Diseases and Emergencies:
1. Review of Anatomy and Physiology of the Respiratory System.
2. Pneumonia's:
Bacterial, Viral & Mycoplasma.
Aspiration Pneumonia, Empysema and Lung Abscess.
3. Tuberculosis.
4. Chronic Obstructive Pulmonary Disease.
5. Acute Asthma.
6. Malignant Diseases of the Lungs.
7. Chest Trauma:
Pneumothorax.
Tension Pneumothorax
Subcutaneous Emphysema.
Heamothorax.
Flail Chest
Management of Pulmonary Diseases and Emergencies.
Relative Pharmacology.
PART 5.
The Digestive System, Diseases and Emergencies:
1. Review of the Anatomy and Physiology of the Digestive System.
2. Injuries to the Bucal Cavity.
3. Esophageal Emergencies.
4. Peptic Ulcers.
5. Perforated Viscus.
6. Acute Appendicitis.
7. Peritonitis
8. Haematemesis and Melena.
9. Intestinal Obstruction.
10. Hernia.
11. Ileitis and Colitis.
12. Colonic Diverticular Disease.
13. Ano-rectal Conditions.
14. Diarrhea and Food Poisoning.
15. Cholecystitis and Bilary Colic.
16. Hepatitis and Acute Jaundice.
17. Pancreatitis.
18. Liver Dysfunction and Failure.
19. Metabolic Complications of Diabetes Mellitus.
20. Acute Metabolic Acidosis and Alkalosis.
21. Hyponatremia.
22. Hyperkalemia.
23. Hypercalcemia.
24. Management of Digestive System Diseases and Emergencies.
PART 6.

 Genito -Urinary System Diseases and Emergencies:

1. Review of the Anatomy and Physiology of the Genito-Urinary System.
2. Emergency Renal Problems:
Acute Renal Failure.
Glomerulonephritis.
Pyelonephritis
Nephrotic Syndrome.
Cystitis & Renal Colic
Dysuria.
Urinary Tract Infections.
Rupture of the Urinary Bladder.
Ruptured Urethra.
Acute Retention of Urine.
3. Male Genital Problems:
Scrotal Edema
Direct Trauma to the Scrotum, Penetrating and Non-Penetrating
Balanoposthitis
Phimosis & Paraphimosis.
Entrapment Injuries.
Penile Fracture.
Priapism.
Torsion of the Testes & Appendages.
Epididymitis.
Testicular Malignancy.
4. Female Genital Problems:
Vulvovaginitis.
Genital Herpes.
Vaginal Foreign Bodies.
Rape Trauma Syndrome.
PART 7.
Muscoskeletal Injuries and Conditions:
1. Emergencies Involving the Eye:
Trauma to the Eye.
Injury to the Orbits.
Eyelid Injuries.
Injuries to the Globe.
2. Medical Emergencies Involving the Eye.
Central Retinal Artery Occlusion.
Other Ocular Emergencies.
General Management of Injuries to the Eye.
3. Injuries to the Face, Ears, Nose and Throat:
Facial Injuries.
Ear Injuries.
Trauma To the Nose & Mouth.
Injuries to the Jaw - Fractures & Dislocations.
4. Trauma to the Neck.
5. Trauma to the Shoulder.
6. Trauma to the Chest & Back.
7. Trauma to the Abdomen.
8. Trauma to the Pelvis & Lower Back.

9. Trauma to the Lower Limbs.

10. Trauma to the Upper Limbs.
11. Control of External Hemorrhage.
12. Control of Internal Hemorrhage.
13. Compartment Syndromes.
14. Muscle Ruptures.
15. Inflammatory Conditions.
16. Rheumatic Disorders.
PART 8.
Obstetric and Gynaecological Emergencies:
1. Review of the Anatomy and Physiology of the Female Reproductive System.
2. Non -Pregnancy Causes of Abdominal Pain:
Ovarian Torsion.
Mittelschmerz
Pelvic Inflammatory Disease.
Endometriosis.
Rupture of the Corpus Luteum.
3. Vaginal Bleeding:
Traumatic.
Non-Traumatic.
4. Physiological Changes in Normal Pregnancy:
Cardiovascular.
Pulmonary.
Renal.
Gastrointestinal.
Coagulation.
Hematological.
Metabolic.
Uterine.
5. Complications of Pregnancy:
First Trimester Bleeding.
Ectopic Pregnancy.
Spontaneous Abortion.
Septic Abortion.
Placenta Abruption.
Placenta Previa.
Third Trimester Bleeding.
Pre-Term Labor.
Pre-eclampsia
Eclampsia (Toxicity in Pregnancy).
Rh-Immune Globulin (RHIG RhoGAM)
Rupture of the Corpus Luteum.
Trauma During Pregnancy.
Normal Labor and Delivery.
6. Abnormal Deliveries:
Breech Presentation.
Prolapsed Umbilical Cord.
Limb Presentation.
Multiple Births.
Premature Births.
7. Complications of Labor & Delivery.

 Antepartal Heamorrhage.
Postpartum Heamorrhage.
Supine Hypotensive Syndrome.
Uterine Inversion.
Pulmonary Embolism.
Endometriosis.
Mastitis.
PART 9.
Disorders Presenting in Infancy and Childhood:
1. The Normal Development of the Infant and Child.
2. Techniques for the Approach to and Examination of Infants & Children.
3. Common Neonatal Problems:
Crying, Irritability and Lethargy.
Febrile Infants.
Intestinal Colic
Regurgitation.
Vomiting.
Diarrhea.
Dehydration.
Abdominal Distension.
Constipation.
4.. Cardio-Respiratory Disorders:
Pneumonia.
Croup.
Status Asthmaticus
Bronchiolitis
Epiglotitis
Cough & Nasal Congestion.
Noisy Breathing & Stridor
Apnea Vs Periodic Breathing
Syncope & Voluntary Breath Holding.
Cyanosis & Blue Spells.
5. Sudden Infant Death Syndrome.
6. Seizures in the Pediatric Age Group.
7. The Battered and / or Sexually Abused Child.
8. The Diabetic Child.
9. Heart Disease.
10. Abdominal Emergencies in Children.
11. Skin and Soft Tissue Infections.
12. Bacteremia and Sepsis.
13. Meningitis in Children.
14. Pneumonia in Children.
15. Gastroenteritis.
16. Muscoskeletal Disorders in Children.
17.Trauma In Children - General Considerations in the Injured Child:
Hypovolemia and Shock.
Fluid & Electrolyte Therapy.
Head Injuries.
Chest Trauma.
Blunt and Penetrating Abdominal Trauma.

 Kidney Injuries.
Pediatric Analgesia & Sedation.
Fractures of the Extremities.
17. The Handicapped or Disabled Child.
PART 9.
Infectious Diseases:
1. Sexually Transmitted Diseases:
Syphilis.
Gonorrhea.
N.S.U.
HIV Infection and AIDS.
2. Malaria.
3. Tetanus.
4. Rabies.
5. Tuberculosis.
6. Cholera.
7. Typhoid & Paratyphoid.
8. Viral Hepatitis.
9. Diphtheria.
10. Pertussis.
11. Poliomyelitis.
12. Dengue and Hemorrhagic Fever.
13. Common Parasitic Infections.
14. Tick-Borne Diseases.
15. Immunizations for Emergency Care Personnel.
16. Universal Precautions & Routine Measures for Preventing Spread of Disease.
PART 10.
Toxicology:
1. General Management of the Poisoned Patient:
History.
Physical Examination.
Principles of Management.
Self Protection Factors.
2. Ingested Poisons:
Strong Acids.
Strong Alkalis & Caustic Substances.
Petroleum Products.
Alcohol's.
Cyanide.
Organophosphates & Carbamates.
Paraquat.
Heavy Metals.
Poisonous Plants & Fungi.
Marine Life.
3. Common Pharmaceutical Preparations:
Aspirin & Other Salicylates.
Paracetamol.
Non-Steriodal Anti-inflammatory Agents.
Phenytoin.

 Amphetamines.
Antidepressants.
Narcotics.
Neuroleptics.
Barbiturates.
Benzopdiazepines.
Sedative-Hypnotics.
4. Illegal Narcotics and Other Substances:
Opium.
Heroine.
Cocaine.
Shabu.
Ecstacy.
Marijuana.
5. Inhaled Poisons:
6. Carbon Monoxide.
7. Freons.
8. Solvent Abuse.
9. Smoke Inhalation.
10. Absorbed Poisons:
Organo Phosphates.
Cyanide.
Lime.
Phenol.
11. Injected Poisons.
Self Injected Toxins.
Snakebites.
Arachnid Bites.
Insect Bites.
Mammalian Bites.
PART 11.
Environmental Emergencies:
1. The Physiology of Body Temperature Regulation.
2. Heat Exposure:
Head Edema.
Prickly Heat.
Heat Syncope.
Heat Cramps.
Heat Tetany.
Heat Exhaustion.
Heat Stroke.
General Management of Heat Exhaustion & Heat Stroke.
3. Cold Exposure:
Pathophysiology & Clinical Features.
Frostnip & Frostbite.
Hypothermia.
General Management of Cold Related Conditions.
4. High Altitude Ailments.
5. Hyperbaric Ailments:
Physical Principles.
Gas Laws.

 Barotrauma, Descent & Ascent.

Air Embolism.
Nitrogen Narcosis.
Decompression Sickness.
General Management of Hyperbaric Conditions.
6. Near Drowning:
Fresh Water.
Salt Water.
Secondary Drowning.
7. Burns and their Management:
Thermal Burns.
Chemical Burns.
Electrical Burns.
Radiation Injuries.
PART 12.
Endocrine Related Emergencies:
1. Hypoglycemia & Hyperglycemia.
Diabetic Ketoacidosis.
Alcoholic Ketoacidosis.
Lactic Acidosis.
Thyroid Storm.
Hyperthyroidism and Coma.
Adrenal Conditions.
PART 13.
The Emotionally Disturbed Patient:
1. Emotional Aspects of Illness & Injury:
Response of Patient.
Response of Relatives, Friends & Bystanders.
Response of EMS Staff.
Response to Mass Casualty Situations.
2. Behavioral Disorders:
Depression.
Suicide.
Suicide Threat or Attempt.
Rage, Hostility & Violent Behavior.
Paranoia.
Anxiety and Phobias.
Disorganization & Disorientation.
Clinical Features.
Interview & Assessment.
Stabilization.
Common Psychotropic Medications.
PART 14.
Review of General Pharmacology:
1. Drugs Used in the Field:
Activated Charcoal.
Aminophylline.

 Atropine Sulphate.
Bretylium Tosylate.
Calcium Preparations.
50% Dextrose Solution.
Diazepam.
Dopamine.
Epinepherine.
Furosemide
Lidocaine.
Mannitol.
Morphine Sulphate.
Naloxone.
Nitronox.
Norephedrine.
Oxygen.
Sodium Bicarbonate.
Syrup of Ipecac.
Verapmil.
2. Drugs Commonly Found in the Home:
Cardiovascular Medications.
Respiratory Medications.
Diabetic Medications.
Anticonvulsant.
Gastrointestinal Medications.
Psychotropic Medications.
PART 15.
Multiple Injuries, Multiple Casualties and Triage:
1. Assessment, Triage & Treatment of the Multiply Injured Patient.
2. Multiple Casualty Situations:
Multiple Victim Incident Planning & Scene Organization.
Principles of "Major" Incident Planning.
Management Roles in "Major" Situations.
Receiving the call and Responding.
Arrival at the Scene.
Establishing a Patient Collection Area.
Establishing a Primary Triage and Treatment Area.
Casualty Sorting.
Information Gathering & Record Keeping.
Priorities of Evacuation.
General Guidelines for Behavior in Mass Casualty Situations.
The Recovery Phase.
The Importance of Post Incident Counseling.
PART 16.
Management of EMS/Pre-Hospital Care Systems:
1. Basic Considerations of Management.
2. Underlying Principles of Organization & the Decision Process.
3. Management by Objectives.
4. The Philosophy of Management.
5. Rank Structure.
6. Functions of Management & the Management System.

7. Organization of Physical Facilities, Vehicles & Equipment.

8. Communications.
9. Reports & Statistics.
10. Policies & Procedures.
11. Disciplinary & Grievance Procedures.
12. Financial Control & Budgeting.
13. Overall Administrative Control.
MINIMUM REQUIREMENTS:
Nine hundred and sixty hours post "EMT (A)" appropriate Emergency Medical Services
experience to include emergency response duties.
Submission of log of experience gained.
Successful completion of selection interview / examinations.

EVALUATION:
One Hundred and Fifty Question Multiple Choice Paper.
One Hour Enumeration & Short Answer Paper - Fifty Questions.
Case Study Question Paper - Ten Cases.
Two Hour Essay Paper.
One Hour Practical Skills Test.
Forty Five Minute (minimum) Oral Examination given by Duly Appointed Panel.