EMT Clinical Performance Objectives
• Perform an organized primary assessment in a timely manner.
• Obtain a relevant and accurate patient history, chief complaint/problem, medications, and allergies in a systematic and timely manner.
• Perform a thorough exam with appropriate inquiry and inspection pertinent to the patient’s chief complaint with accurate findings.
• Interpret and correlate assessment information correctly.
• Develop an appropriate plan of action as appropriate for the situation.
• Assure the adequate delivery of oxygen to a patient, including the use of appropriate airway adjuncts and achieving or maintaining patency of the airway in a timely manner.
• Use all equipment correctly.
• Assess patient response to therapy and interventions.
• Communicate all pertinent information to team members.
• Complete patient care reports in an accurate, thorough, and legible manner.
• Function as a member of the patient care team
• Exhibit a professional demeanor.
• Build rapport with patient, family, and bystanders, showing consideration and respect for others, and instilling confidence in the patient.
• Participate in the evaluation of self; including accepting feedback and suggestions and taking necessary steps to correct performance.
• Re-supply all inventory per policy.
• Demonstrate respect for the dignity of everyone he or she is associated with in the practice of his or her professional duties.

EMT Student Scope of Practice

All EMT skills in the Iowa Scope of Practice may be performed in the clinical and field settings with the approval of and under the supervision of the preceptor.

EMT students are required to perform the following skills in the clinical or field settings on live patients to meet the requirements of the EMSLRC EMT Student Minimum Competency plan:

Skill (Number of successful attempts)

• Medical assessment (1)
• Trauma assessment (1)
• Vital signs (Pulse, Resp., BP, SpO2, Glucometry) (5)
• 12-Lead Acquisition (1)
• Oxygen Administration – Nasal Cannula (2)
• Dress and bandage a soft tissue injury (1)

EMT students are required to be exposed to the following conditions in live patients in the clinical or field settings:

• Pediatric patients <18 y/o (3)
• Adult patients 18-65 y/o (8)
• Geriatric patients >65 (5)
• Trauma patients (4)
• Medical – general complaints (5)
  • Neuro – CVA, TIA, Seizure
  • Environmental – Heat, Cold, Burn, Drowning   
  • Hemorrhage/Shock
• Psychiatric – Behavioral (2)
• Cardiac pathology or complaint (3)
• Respiratory (2)
• Field environment, i.e., EMS responses (5 – field only)

EMT students are required to have two BLS field leads. The BLS field lead is defined as the student taking the lead of an EMS call, performing an assessment, and delegating treatment up to the point where an AEMT or paramedic would take over the patient care.

Advanced EMT Clinical Performance Objectives

• Perform an organized primary assessment and intervene appropriately in a timely manner.
• Obtain a relevant and accurate patient history, chief complaint/problem, medications, and allergies in a systematic and timely manner.
• Perform a thorough exam with appropriate inquiry and inspection pertinent to the patient’s chief complaint with accurate findings.
• Interpret and correlate assessment information correctly.
• Identify breath sounds and have adequate knowledge of chest auscultation.
• Acquire a 12-Lead EKG in a timely manner.
• Develop and implement an appropriate plan of action as appropriate for the situation.
• Assure the adequate delivery of oxygen to a patient, including the use of appropriate airway adjuncts and achieving or maintaining patency of the airway in a timely manner.
• Correctly use supraglottic airways in a timely manner.
• Use all equipment correctly.
• Assess patient response to therapy and interventions.
• Communicate all pertinent information to team members.
• Complete patient care reports in an accurate, thorough, and legible manner.
• Function as a member of the patient care team
• Exhibit a professional demeanor.
• Build rapport with patient, family, and bystanders, showing consideration and respect for others, and instilling confidence in the patient.
• Participate in the evaluation of self; including accepting feedback and suggestions and taking necessary steps to correct performance.
• Re-supply all inventory per policy.
• Demonstrate respect for the dignity of everyone associated with in the practice of professional duties.

Advanced EMT Scope of Practice

The AEMT student may perform all EMT skills in the Iowa Scope of Practice in the clinical and field settings with the approval and supervision of the preceptor. AEMT students should be expected to be able to lead calls at the BLS level.

Advanced EMT students are required to perform the following skills in the clinical or field settings on live patients to meet the requirements of the EMSLRC Advanced EMT Student Minimum Competency plan:

Skill (Number of successful attempts)

• Blood draw (5)
• Establish IV access with an 80% success rate (20)
• Administer IV bolus medication with a 100% success rate (10)
• Administer IM medication (3)
• Administer nebulized medication (5)
• Provide positive pressure ventilation with a BVM (5)
• Adult comprehensive assessment (5)
• Obtain a history (5)
• Airway assessment (5)
• Neuro assessment (5)
• Cardiac assessment (5)
• Trauma assessment (1)

Advanced EMT students are required to be exposed to the following conditions in live patients in the clinical or field settings:

• Pediatric patients <18 y/o (15)
  • Neonate 0-30d (min. 2)
  • Infant 1-12m (min. 2)
  • Toddler 1-2y (min. 2)
  • Preschool 3-5y (min. 2)
  • School-aged 6-12y (min. 2)
  • Adolescent (13-18 (min. 2)
• Adult patients 18-65 y/o (20)
• Geriatric patients >65 (15)
• Trauma patients (5)
• Medical – general complaints (8)
• Neuro – CVA, TIA, Seizure (5)
• Hemorrhage/Shock (2)
• Psychiatric – Behavioral (5)
• Cardiac pathology or complaint (8)
• Respiratory (8)
• Field environment, i.e., EMS responses (5 – field only)

Advanced EMT students are required to have 10 “field experience calls” prior to field internship. The field experience calls are where the student participates in the assessment and management (with assistance) as a team member or team leader 

In the capstone field internship phase, the Advanced EMT student will have 15 field lead calls, with at least 10 at the AEMT level, where the student provides assessment and management (without assistance) as the team leader up to the point where a paramedic would take over the patient care.

Paramedic Field Internship Performance Objectives

The paramedic field internship is a minimum of 360 hours and will offer the Paramedic Intern the opportunity to assess patients and lead calls based upon the skills explored in the didactic and clinical portions of the program. The environment will change from the controlled to the uncontrolled and will afford the intern the environment in which to “put it all together and think critically”. At the end of the field internship, the Paramedic Intern will accomplish a minimum of 60 Team Leads with 40 of those team leads being advanced life support calls. Eighteen of the last 20 field leads must be successful in order to complete the field internship. 

A call will be considered an ALS call if either: 

1) a medication other than oxygen is administered (by anyone on the team) -or- 

2) an ECG monitor and an IV (attempt) are performed together (by anyone on the team).

The Paramedic Intern will:
• Determine safety for self, team members, and patient and ensure an adequate work environment in a timely manner.
• Use universal precautions and wear appropriate personal protective equipment specific for patient condition, clean and sanitize equipment in accordance with provider policy and procedures.
• Initiate or delegate appropriate crowd control and deal effectively with family members and bystanders.
• Recognize the need for and request additional assistance or equipment needed in a timely manner.
• Perform an organized primary assessment and intervene appropriately in a timely manner.
• Obtain a relevant and accurate patient history, chief complaint/problem, medications, and allergies in a systematic and timely manner.
• Perform a thorough exam with appropriate inquiry and inspection pertinent to the patient’s chief complaint with accurate findings.
• Interpret and correlate assessment information correctly.
• Identify breath sounds and have adequate knowledge of chest auscultation.
• Identify cardiac rhythms and 12-Lead interpretations in an accurate and timely manner.
• Develop and implement an appropriate plan of action.
• Assure the adequate delivery of oxygen to a patient, including the use of appropriate airway adjuncts and achieving or maintaining patency of the airway in a timely manner.
• Correctly use advanced airways in a timely manner.
• Use all equipment correctly.
• Assess patient response to therapy and interventions.
• Communicate all pertinent information to team members.
• Utilize medical control appropriately, including organized and complete radio reports.
• Provide an accurate and relevant hand off report to the hospital staff.
• Complete patient care reports in an accurate, thorough, and legible manner.
• Function as a member of the patient care team.
• Assume a leadership role and direct members appropriately.
• Exhibit a professional demeanor.
• Build rapport with patient, family, and bystanders, showing consideration and respect for others, and instilling confidence in the patient.
• Participate in the evaluation of self; including accepting feedback and suggestions and taking necessary steps to correct performance.
• Re-supply all inventory per provider policy.
• Demonstrate respect for the dignity of everyone he or she is associated with in the practice of his or her professional duties.
• Respond to the field-learning environment in such a manner to invite confidence of patients, supervisors, peers, and other health care professionals.

The paramedic student in field internship has completed all classroom and clinical requirements. They may perform all previous skills and are expected to lead calls under supervision.

A successful field lead is defined as one where the paramedic student performed the assessment, developed a plan of treatment, and performed or delegated interventions with minimal assistance.