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EDUCATION STANDARDS Tabe of Contents 2020 NATIONAL EMERGENCY MEDICAL SERVICES EDUCATION STANDARDS Tabe of Contents Executive Summary 4 Pathophysiology X Introduction X Life Span Development X Historical Development of EMS in the United States X The National EMS Education Standards X Public Health X Description, Explanation, and Rationale Related to the Update X Pharmacology X 2019 National EMS Scope of Practice Model Relationship X Principles of Pharmacology X NREMT Practice Analysis X Medication Administration X Domains of EMS: Learning, Competency, Authorization, and X Emergency Medications X Operational/Local Qualification X Education Standards vs. Instructional Guidelines vs. Curriculum X Airway Management, Respirations and Artificial Ventilation X What Are the Instructional Guidelines: X Airway Management X Beyond the Scope of the Project X Respiration X Degree Requirements X Artificial Ventilation X AEMT Accreditation X Portable Technologies X Assessment X Instructional Practices: X Scene Size-Up X Interprofessional Education, Simulation, Shadowing X Primary Assessment X Team Composition X History Taking X Sequence of Instruction X Secondary Assessment X Locally Identified Topics X Monitoring Devices X Implicit Expectations X Reassessment X Resource Documents/Appendix X Evidence Based Guidelines – NASEMSO Clinical Guidelines X Medicine X Education Standards with Noteworthy Adjustment X Medical Overview X Neurology X National EMS Education Standards X Abdominal and Gastrointestinal Disorders X Preparatory X Immunology X EMS Systems X Infectious Diseases X Research X Endocrine Disorders X Workforce Safety and Wellness X Psychiatric X Documentation X Cardiovascular X EMS System Communication X Toxicology X Therapeutic Communication X Respiratory X Medical/Legal and Ethics X Hematology X Genitourinary/Renal X Anatomy and Physiology X Gynecology X Non-Traumatic Musculoskeletal Disorders X Medical Terminology X Diseases of the Eyes, Ears, Nose, and Throat X 2 Tabe of Contents (continued) Shock and Resuscitation X Educational Infrastructure X Educational Facilities X Trauma X Student Space X Trauma Overview X Instructional Resources X Bleeding X Instructor Reparation Resources X Chest Trauma X Storage Space X Abdominal and Genitourinary Trauma X Sponsorship X Orthopedic Trauma X Programmatic Approval X Soft Tissue Trauma X Faculty X Head, Facial, Neck, and Spine Trauma X Medical Director Oversight X Environmental Emergencies X Hospital/Clinical Experience X Multisystem Trauma X Field Experience X Course Length X Special Patient Populations X Course Design X Obstetrics X Student Assessment X Neonatal care X Program Evaluation X Pediatrics X Geriatrics X Glossary for Education Standards X Patients With Special Challenges X References X EMS Operations X Principles of Safely Operating a Ground Ambulance X Acknowledgements and Stakeholder Input X Incident Management X Multiple Casualty Incidents X Appendix A: Resources for Curriculum Development X Air Medical X Vehicle Extrication X Hazardous Materials X Terrorism and Disaster X Clinical Behavior/Judgment X Assessment X Therapeutic Communication and Cultural Competency X Psychomotor Skills X Professionalism X Decision-Making X Record Keeping X Patient Complaints X Scene Leadership X Scene Safety X 3 Executive Summary In 2009, the EMS community came together to create the These elements include: original National EMS Education Standards (the Standards). • National EMS Core Content This represented a major step toward realizing the vision put • National EMS Scope of Practice Model forth in the 1996 EMS Agenda for the Future and further outlined • National EMS Education Standards in the EMS Education Agenda for the Future: A Systems Approach four years later. Following the recent release of a new • National EMS Certification National EMS Scope of Practice Model and EMS Agenda 2050, • National EMS Program Accreditation this revision of the Standards builds on this quarter-century of advancing EMS systems nationwide. This integrated system approach to EMS education is essential to achieving the goal of developing EMS clinicians across the The National EMS Education Standards outline the minimal country who are competent in the appropriate knowledge, skills, competencies for entry-level EMS clinicians to perform their and abilities for their licensure level. roles as outlined in the 2019 National EMS Scope of Practice Model. The Standards, while a national effort, were intentionally Noteworthy revisions found in the 2021 edition of the National created in a way that allows for diverse implementation methods EMS Education Standards are based upon inputs and to meet local needs and evolving educational practices. This considerations obtained from numerous sources. These include less prescriptive format of the Standards allows for ongoing stakeholder comments, public comments, previous and related revision of EMS educational content consistent with scientific governmental resource documents (the original 2009 National evidence, educational practices, and community standards of EMS Education Standards, EMS Agenda 2050, and the newly care. revised 2019 National Scope of Practice Model), NREMT’s practice analysis, technological advances, known and evolving When applying the Standards to individual programs and best practices, and evidence-based medicine. classes, EMS educators have the freedom to develop their own curricula or use any of the wide variety of lesson plans The following areas within the Standards had notable revisions: and instructional resources that are available at each licensure public health, pediatrics, geriatrics, behavioral/psychiatric, level. This ensures that each program can specifically address cultural humility, EMS operations, pharmacology, and EMS individual and community needs. safety, wellness and resilience. Input was provided and every suggestion or recommendation was evaluated. Revision The National EMS Education Standards are not meant to stand and adjustments were based on a team discussion (with as a comprehensive document guiding the entire development expert consultation, when needed). Numerous revisions were of EMS clinicians, but rather one part of a comprehensive made; not all comments required alteration. Three differing system. EMS education programs will incorporate each element public comment periods were utilized for further input and of the education system proposed in the Education Agenda. transparency. 4 Introduction & Historical Development of EMS in the United States EMS has evolved and grown immensely since the first The Agenda for the Future was designed to guide government organized, national effort to develop EMS systems began in the and private organizations in EMS planning, development, 1960s. Compared to colleagues in healthcare and public safety, and policymaking at the national, state, and local levels. It EMS remains a young profession and continues to advance addressed 14 attributes of EMS, including the EMS education as we further define and enhance our structure, oversight, and system. The Agenda defined a vision for EMS education “based organization. on research,” “conducted by qualified instructors” and while employing “sound educational principles. As EMS system operations have developed, so has EMS education. In the early 1970s, registered nurses and physicians EMS Education Conference taught most EMS programs. Few student and instructor Soon after publication of the Agenda, representatives of resources related directly to prehospital emergency care. No 30 EMS-related organizations met at an EMS Education standards existed to define what EMS clinicians should know Conference sponsored by NHTSA to identify the necessary and what they should be able to do. By the early 2000s, most steps for implementing that vision. of this original framework was being replaced, and national education standards and a scope of practice were defined The EMS Education Conference resulted in several for the first time. Today, the profession has become more recommendations, including: sophisticated, and community expectations have increased. With healthcare, technology and science evolving faster than • The National EMS Education and Practice Blueprint (the ever, it is also important to revisit these topics and update these Blueprint) is a valuable component of the EMS education guidelines more frequently. system. A multidisciplinary panel, led by NHTSA, to identify core educational content more explicitly for each EMS Agenda for the Future licensure level, should revise it. In August 1996, the EMS Agenda for the Future was published. • National EMS Education Standards are necessary Developed with funding from the National Highway Traffic but need not include specific declarative material or Safety Administration and the Health Resources and Services lesson plans. NHTSA should support and facilitate the Administration, and led by the National Association of EMS development of national EMS Education Standards. Physicians and the National Association of State EMS Directors, the Agenda for the Future brought together stakeholders from • The Blueprint and national EMS Education Standards throughout EMS to create a unifying vision for emergency should be revised periodically, with major revisions medical services in the United States. occurring every 5 to 7 years, and minor updates made every 2 to 3 years. 5 EMS Agenda for the Future National EMS Core Content In 1998, NHTSA convened a group of educators who developed The National EMS Core Content was published in 2005. Core a document
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