Gap Analysis Template - NASEMSO The National .

2013 National EMS Education Standards Gap Analysis Template-PEDIATRICSDRAFT: 1 September 2013A Companion Document to the 2009 Gap Analysis TemplatePediatric ConsiderationsFor Implementing the National EMS EducationStandards: Emergency Medical Responder (EMR)Emergency Medical Technician (EMT)Advanced Emergency Medical Technician (AEMT)Paramedic15 September 2013National Association of State EMS OfficialsFalls Church, VAThis study and report were made possible through Cooperative Agreement DTNH22-11-H-00338/0005 between theNational Highway Traffic Safety Administration Office of EMS and the National Association of State Emergency MedicalServices Officials. For questions or clarification related to this report, please contact NASEMSO Program Manager, KathyRobinson (robinson@nasemso.org) or email info@nasemso.org.

2013 National EMS Education Standards Gap Analysis Template-PEDIATRICS15 September 2013Table of ContentsIntroduction . 31. Cross Reference of Education Standards and Instructional Guidelines (bySections). 6Outline of the materials with helpful cross-references, specifically the page numbers related towhere one might find related material in the Education Standards and Instructional Guidelines.2. National EMS Education Standards Related to Pediatrics: MATRIX. 9The charts represent the recommended pediatric content as presented in the EducationStandards.3. Review of Pediatric Content: Instructional Guidelines . 11Emergency Medical Responder (EMR) . 11Emergency Medical Technician (EMT) . 11Advanced EMT (AEMT) . 12Instructional Guidelines: Paramedic . 144. New Course Considerations: Pediatrics . 155. Measuring Instructor and Practitioner Competency . 166. Integration With Model Clinical Guidelines . 187. Recommendations . 19Appendix A: Writing Educational Goals and Objectives . 21Page 2 of 21

2013 National EMS Education Standards Gap Analysis Template-PEDIATRICS15 September 2013IntroductionA component of the EMS Education Agenda: A Systems Approach (EducationAgenda), the National Highway Traffic Safety Administration (NHTSA) publishedthe National EMS Education Standards (Education Standards) in 2009. Becausestates needed to revise and/or develop processes to facilitate a smooth transitionfrom the U.S. Department of Transportation National Standard Curricula (NSC) tothe Education Standards, the National Association of State EMS Officials(NASEMSO) convened an expert panel with representation from several nationalstakeholder groups to establish a companion resource or Gap AnalysisTemplate for states.The purpose of the gap analysis was to identify skills, content, and new courseconsiderations not included in the previous National Standard Curricula for eachEMS practitioner level. The Gap Analysis Template was never intended as a“stand-alone” transition document; the template continues to serve as anothertool to facilitate implementation of the EMS Education Agenda. Its intendedaudience is state EMS offices although NASEMSO acknowledges that thecontent may be useful to a much broader audience.In 2013, NASEMSO convened a second expert panel to help address cognitive,psychomotor, and affective learning needs of EMS practitioners related to thecare of pediatric populations. The following goals were established: Identify evidence-based knowledge and skills that lead to improvements inthe delivery of EMS care for pediatric populationsIncrease input and enhance communications among EMS partner groupson pediatric education issuesIncrease pediatric competency for all EMS practitionersThe expert panel noted that the Education Standards effectively illustrate theincreasing complexity of knowledge and behaviors through the progression oflicensure levels and originate, in part, from the National EMS Scope of PracticeModel. Pediatric objectives are integrated throughout and the document reflectsthe differences in the breadth, depth, and considerations required at eachlicensure level. Depth (of knowledge): the amount of detail a student needs to knowabout a particular topic, Breadth: the number of topics or issues a student needs to learn in aparticular competency are difficult concepts for persons informally trainedPage 3 of 21

2013 National EMS Education Standards Gap Analysis Template-PEDIATRICS15 September 2013in educational methodology to comprehend and implement.Therefore, the panel identified several current barriers to effective pediatriceducation:1. Most programs have not allocated sufficient time to pediatricrelated didactic content, labs, or clinical experiences.2. EMS Programs often rely heavily on instructor-centeredteaching methods and do not gain the benefit of simulations(high fidelity or low tech) or contact with “real” children orclinical time in a pediatric care setting.3. It is unclear to many instructors how to design lesson plansand educational strategies that fully address the neededdepth and breadth of instruction.4. Educator time may be very limited for curriculumdevelopment, especially if it involves sophisticatedsimulations and/or AV aids.5. Adult students have different learning styles and are moremotivated to accept responsibility for learning whenconvinced of the need for knowing the information.The transition away from the NSC to the Education Standards is ongoing.NASEMSO believes that the primary goal should be that children of all ages,circumstances, and needs receive appropriate assessment and care from EMSpersonnel consistent with their scope of practice and local protocols. This is bestaccomplished through: effective entry level and continuing education for EMS and on-line medicalcontrol personnel; valid and reliable competency measurement tools; model evidence based guidelines that serve as a foundation for EMS careacross states and jurisdictions; and a robust quality management process that spans the entire career ofeach practitioner.This document will attempt to identify focus areas for ongoing EMS pediatriceducation and competency efforts.Essential components of EMS pediatric practice that lie outside the scope of theEducation Standards may include, but are not limited to: Pediatric Readiness Guidelines,Page 4 of 21

2013 National EMS Education Standards Gap Analysis Template-PEDIATRICS15 September 2013 Performance measures to improve pediatric infrastructure, such as:o Availability of EMS online and off line pediatric medical direction,oAvailability pediatric equipment on ambulances,oEMS pediatric continuing education requirements,oInter facility pediatric transfer guidelines,oInter facility pediatric transfer agreements, andoHospital pediatric facility recognition.The Education Standards are one component of the EMS Education Agenda forthe Future: A Systems Approach. The Education Agenda and the followingcomponents: National EMS Core Content, National EMS Scope of PracticeModel, and the National EMS Education Standards are available atwww.ems.gov.The NASEMSO Implementation Team and Pediatric Working Group areavailable to provide technical assistance to states with the gap analysis and otherEducation Agenda implementation efforts. State officials that desire additionalinformation can contact NASEMSO via info@nasemso.org or call NASEMSOProgram Advisor Kathy Robinson at (703) 538-1799 ext 1894.Page 5 of 21

2013 National EMS Education Standards Gap Analysis Template-PEDIATRICSDRAFT: 1 September 20131. Cross Reference of Education Standards and Instructional Guidelines (by Sections)Please also see Section 2, National EMS Education Standards Related to Pediatrics: Matrix and Section 3, Review ofPediatric Content: Instructional Guidelines for pediatric references currently included in the Education Standards andInstructional Guides.Section TitlePreparatory EMS Systems Research Workforce Safety and Wellness Documentation EMS System Communication Therapeutic Communications Medical/Legal EthicsAnatomy and 131314EMREMTAEMTParamedicInstructional Instructional Instructional nesPage Number Page Number Page Number Page 2518241331Medical Terminology1421291954Physiology1422302055Life Span Development1424342272Public Health1526402376Pharmacology Principles of Pharmacology Medication Administration Emergency MedicationsAirway Management, Respiration, andArtificial Ventilation Airway Management Respiration Artificial 378788587901718183033374750573336399094100

2013 National EMS Education Standards Gap Analysis Template-PEDIATRICS15 September 2013Section TitlePatient Assessment Scene Size Up Primary Assessment History-Taking Secondary Assessment Monitoring Devices ReassessmentMedicine Medical Overview Neurology Abdominal and GastrointestinalDisorders Immunology Infectious Diseases Endocrine Disorders Psychiatric Cardiovascular Toxicology Respiratory Hematology Genitourinary/Renal Gynecology Non-traumatic MusculoskeletalDisorders Diseases of the Eyes, Ears, Nose, andThroatShock and ResuscitationTrauma Trauma 22222324EMREMTAEMTParamedicInstructional Instructional Instructional nesPage Number Page Number Page Number Page 587233353582821221229494244244Page 7 of 21

2013 National EMS Education Standards Gap Analysis Template-PEDIATRICS15 September 2013Section TitleTrauma con’t Bleeding Chest Trauma Abdominal and Genitourinary Trauma Orthopedic Trauma Soft Tissue Trauma Head, Facial, Neck and Spine Trauma Nervous System Trauma Special Considerations in Trauma Environmental Trauma Multi-System TraumaSpecial Patient Populations Obstetrics Neonatal Care Pediatrics Geriatrics Patients With Special ChallengesEMS Operations Principles of Safely Operating a GroundAmbulance Incident Management Multiple Casualty Incidents Air Medical Vehicle Extrication Hazardous Materials Awareness Mass Casualty Incidents Due toTerrorism and medicInstructional Instructional Instructional nesPage Number Page Number Page Number Page 200139377115200139377117118120122125126Page 8 of 384385

2013 National EMS Education Standards Gap Analysis Template-PEDIATRICSDRAFT: 1 September 20132. National EMS Education Standards Related to Pediatrics: MatrixThe following chart represents the recommended pediatric content as presented in the Education Standards (pages 4547).TOPICEMRSimple depth, simple breadth Newborn care Neonatal resuscitationNeonatalCareEMTEMR Material Plus:Fundamental depth,foundational breadthAssessment and management Newborn Neonatal resuscitationAEMTSame asPrevious LevelParamedicAEMT Material Plus:Complex depth, comprehensivebreadth Anatomy and physiology ofneonatal circulation Assessment of the newbornPresentation and management Newborn Neonatal resuscitationSimple depth, simple breadthEMR Material Plus:Age-related assessmentfindings, and age-relatedassessment and treatmentmodifications for pediatricspecific major diseases and/oremergenciesFundamental depth,Foundational breadthPediatrics Upper airway obstruction Lower airway reactivedisease Respiratory distress/failure/arrest Shock SeizuresAge-related assessmentfindings, age-related, anddevelopmental stage relatedassessment and treatmentmodifications for pediatricspecific major diseases and/oremergencies Upper airway obstruction Lower airway reactivedisease Respiratorydistress/failure/arrestSame asPrevious LevelAEMT Material Plus:Age-related assessment findings,age-related anatomic andphysiologic variations, age- relatedand developmental stage relatedassessment and treatmentmodifications of the pediatricspecific major or common diseasesand/or emergencies:Complex depth, comprehensivebreadth Foreign body (upper and lower)airway obstruction Bacterial tracheitis Asthma